The Relation Of Environmental Factors Exposure During Preconception Or Gestations And Fetal With Congenital Heart Disease

Background:Congenital Heart Disease(CHD)is the most common birth defects,topped the list in a variety of birth defects,congenital malformations of a serious hazard to the health of infants and young children,cause of death of infanta and children,causing serious economic、 spiritual and medical burden to individuals、families and society. Many domestic and foreign literature of CHD risk factors but the cause of CHD is not clear.its occurrence is the result of interaction of genes、 chromosomal abnormalities and environmental. In recent years, with the rapid development of molecular biology techniques, congenital heart disease in the genetic aspects of great progress, scholars began to give environmental factors greater attention. Heart formation began in the first two weeks of the embryonic period, about four weeks from the circulation effect,up to eight weeks septal fully formed.So the critical period of embryonic heart development in the first2-8weeks after pregnancy3months is a cirtical period of fetal heart development. CHD risk period of the formation of the first threes pregnant during this sensitive period,pregnant woment exposed to adverse environmental factors and fetal cardiovascular malformations. Objective:Explore the3months prior to pregnancy of the pregnant women and pregnancy in the first3months after the environmental factors for exposure and fetal congenital heart disease and provide a scientific basis prevention and control of fetal congenital heart disease.Subjects and Methods:We used1:1matched case-control stydy design, Echocar-diographic diagnosis of fetal congental heart disease pregnant women in the Third Affiliated Hospital of ZhengZhou University face-to face questionnaire interviews fill out the pre-pregnancy and pregnancy environmental factors exposure questionnaire and in out patient select the age difference of no more than1year of age,the gestational age difference of not not more than1weeks of fetal echocardiography and normal pregnant women served as controls.Questionnaire:The questionnaire included:general(age. education level ethnicity、 residence、 family income、 occupation、 pregnant women before pregnancy and investigation of body weight、 the survey date when gestational age,etc.)3months before pregnancy and pregnancy risk factor for exposure with in the first3months living and working environment (noisy、 whether the decoration of the house、 whethe access to electronic products、 smoking and alcohol consumption、 if there are pesticides、 organic matter、 heavy metal exposure),pregnancy history,medical history and medication history(first trimester medication history、 abnormal reproductive history、 history of the cold of early pregnancy、 first trimester threatened abortion history),3months before pregnancy and after pregnancy nutrition food situation in the first three months(all kinds of food、 folic acid and multivitamins supplementary),the mental state of early pregnancy(whether the tension、 irritability、 depression)and negative life events(marital relations is not good、 serious illness or death of important relative、 life stress).Survey were recovered160valid questionnaires of which80were cases of control80copies.Describe the method of application of statistical analysis in general,using the2test, univariate and multivariate regression analysis to explore3 months before pregnancy and after pregnancy,the relationship of the first3months of environmental risk facrors for fetal congenital heart disease.First,univariate analysis of33supected risk factors,when the univariate analysis,statistically significant variables and statistically meaningless but meaningful professional variables in cluded in the multivariate model fitting.All information3.1Software entry use16.0for statistical analysis.Results:1. A case group and control group of pregnant aged27.59±4.58years,27.72±4.47years old P-value is0.848.Difference is statistically significant difference(P>0.05).2. The ethnicity、 education level、 income、 residences of tow cases and control groups is statistically significant(P>0.05),indicating that material balance of tow groups is good and have good comparability.3. Single factor logistic regression results showed that pregnancy within the first3months after prenatal exposure to noise、 their spouses3months before pregnancy drinking a history of exposure to maternal pre-pregnancy for six months pet、 abnormal pregnancy history、 the first3months pregnant after a cold、 early pregnancy experienced a major life negative events fetus for3CHD risk factors,while the mother before pregnancy and during early pregnancy regular consumption of milk、 meat and replenish the folic acid and multivitamins fetal proactive factors for CHD.4. Muitivariate logistic regression analysis showed that; the first3months after pregnancy prenatal exposure to noise(AOR=7.57)/pregnancy negative life events (AOR=6.15)、 abnormal pregnancy history(AOR=8.40)、 early pregnancy flu(AOR=8.84) increased fetal risk of CHD risk.however,supplementing folic acid and vitamins(AOR=0.13)in the early pregnancy and often using all kinds of meat (AOR=0.48)can reduce the risk of fetus CHDConclusion:1. Noise exposure during pregnancy、 experienced negative life events、abnaomal prenancu history、 early pregnancy flu may be risk factors for CHD; in early pregnancy folic acid supplements and vitamins、 regular consumption of a variety of meat may be the protection factors of CHD.2. Reduce or control exposure to harmful environmental factors in pregnant women living and working on the Prevention and Reduction of fetal congenital heart disease occur.