Research On The Influencing Factors Of 367 Children With Congenital Heart Disease In Yunnan Province

Objectives:The purpose of this study is to investigate the influencing factors of congenital heart disease(CHD)in our province,and analyze the influencing factors of different subtypes of CHD,so as to provide reference for prevention strategy and direction for further study on etiology of different CHD phenotypes.Methods:A case control study was applied.367 children aged 0～10 years old who were diagnosed with CHD by cardiac ultrasound and cardiovascular CT were selected as a case group.They were hospitalised in the in-patient department of cardiology,cardiac surgery,and pediatrics or in treatment in the clinic department of cardiology,cardiac surgery,pediatrics,and child care of the First Affiliated Hospital of Kunming Medical University in Yunnan Province between January 1,2016 and December 31,2016.Meanwhile,367 children aged 0～10 years old without congenital malformation were randomly selected as a control group.Parents of the two groups were given the same questionnaire and the survey was conducted in person by the researcher.The content includes:the mother’s information,the father’s information,and the children’s information.Epidata3.1 software was used to input data,and SPSS20.0 software was used for single factor analysis and multi-factor logistic regression analysis.Results:In this study,multi-factor logistic regression analysis showed that maternal education level(OR=0.462,95%CI:0.326-0.654),maternal abnormal reproduction history(OR=1.828,95%CI:1.520-2.197),maternal fever in the first 3 months of pregnancy(OR=2.675,95%CI:1.762-4.061),maternal mental events(OR=6.560,95%CI:4.407-9.766),maternal passive smoking(OR=4.092,95%CI:3.002-5.577),maternal exposure to pesticides(OR=4.183,95%CI:1.829-9.565),maternal nutrition(OR=0.112,95%CI:0.033-0.377),paternal education level(OR=0.261,95%CI:0.122-0.558)were associated with the occurrence of CHD.The influencing factors were not identical among different subtypes of CHD.The influencing factors for atrial septal defect(ASD)included maternal education level(OR=0.476,95%CI:0.275-0.826),maternal abnormal reproduction history(OR=2.625,95%CI:1.781-3.869),maternal exposure to pesticides(OR=6.007,95%CI:3.812-9.466),maternal mental events(OR=3.967,95%CI:2.397-6.565);The influencing factors for ventricular septal defect(VSD)included maternal education level(OR=0.215,95%CI:0.102-0.455),maternal abnormal reproduction history(OR=2.257,95%CI:1.396-3.648),maternal mental events(OR=5.028,95%CI:2.979-8.485),maternal passive smoking(OR=2.807,95%CI:1.624-4.849),paternal exposure to pesticides(OR=2.625,95%CI:1.763-3.907);The influencing factors for patent ductus arteriosus(PDA)included maternal education level(OR=0.763,95%CI:0.654-0.891),maternal abnormal reproduction history(OR=1.923,95%CI:1.003-3.687),maternal mental events(OR=3.180,95%CI:1.777-5.692),fetus number≥2(OR=1.556,95%CI:1.383-1.750);The influencing factors for complex CHD included maternal fever in the first 3 months of pregnancy(OR=3.080,95%CI:1.228-7.723)and abnormal birth weight(OR=3.831,95%CI:2.026-7.243).Conclusions:1.maternal abnormal reproduction history,maternal fever in the first 3 months of pregnancy,maternal mental events,maternal passive smoking,and maternal exposure to pesticides are risk factors of CHD;2.Parents’ educational level,intake of high quality protein,folic acid,multi vitamins and trace elements during pregnancy are the protective factors of CHD;3.The influencing factors that lead to different subtypes of CHD are not the same;4.Improvement of the educational level of parents,enhancement of the genetic counseling,screening before pregnancy,attention to mental health care during pregnancy,reasonable nutrition,prevention of infection,and avoidance of passive smoking and pesticides exposure can help reduce or prevent the occurrences of various types of CHD.