广东省流动和常住人口先天性心脏病危险因素的差异分析

摘要

目的 研究流动人口与常住人口中先天性心脏病(CHD)危险因素的差异.方法 按病例对照研究方法,在界定的危险因素范围内,对流动和常住人口中各危险因素进行单因素及多因素非条件logistic(ENTER法)回归分析,并比较两人群调整后的危险因素种类和OR值.结果 入选流动人口病例855例,对照617例；常住人口病例1673例,对照1912例.流动人口特有的危险因素是孕母孕早期被动吸烟,特有的保护因素是家庭月收入高(≥1201元)；常住人口特有的危险因素是孕母糖尿病、梅毒感染、住装修半年居室以及胎婴儿为巨大儿.孕母文化程度高在流动人口中为危险因素,在常住人口中是保护因素.产次、孕母孕早期病毒感染、孕母接触化学制剂、孕母异常生育史等因素的OR值在流动人口中高于常住人口；孕母孕早期发热、胎婴儿低体重的OR值在流动人口中低于常住人口.结论 流动和常住人口各自有CHD危险因素,多个危险因素在不同人群中的风险有明显差异.%Objective To analyze the differences of risk factors on congenital heart defect (CHD) between floating population and permanent residents in Guangdong.Methods A multicenter case-control study was carried out to investigate the risk factors of CHD in floating population and in permanent residents.Data was from 34 Guangdong CHD Monitoring Network centers during the year of 2004 to 2011.Exposed information related to the parents at pre-pregnancy and early pregnancy periods,was collected,using the same questionnaire survey methodology in the two populations.Possible risk factors were analyzed by univariate analysis and multivariate non-conditional logistic regression (ENTER method) methods.Risk factors were compared between the two populations.Results Totally,855 CHD cases and their controls from the floating population,as well as 1673 cases and their controls from the permanent residents were included in this study.Age of the children under study was defined from 28th week of gestation to 1 year old postnatal.In the floating population,specific risk factor for CHD appeared as:matemal passive smoking in early pregnancy,while the specific protective factor as high family income.However,the specific risk factors would include:having diseases as maternal diabetes mellitus or syphilis,living in a newly (within half a year) decorated house or with fetal macrosomia in the permanent residents.High education level showed as a risk factor in floating population,however contrarily,as protective factor to the permanent residents.Except for the factors related to having fever of the mother and infant with low birth weight,factors as having history of diliveries more than two,with maternal virus infection,exposure to chemical agent and negative bearing history etc.,have higher OR values in floating population than in the permanent residents.Conclusion Significant differences of risk factors for CHD were noticed between floating population and the permanent residents,which have their individual specific risk factors.Most of the ORs appeared higher in floating population than in the permanent residents.