| Objective: Birth defects are disorders in the development of normal embryos resulted from genetic factors, environmental factor and their interaction. These disorders may lead to abnormal structure or function in embryos or new-born babies. Congenital heart disease is one of the most common birth defects. According to epidemiological investigation, the incidence of perinatal CHD in China varies between 0.69% and 1.44%, highest among all the birth defects, and constitutes a serious damage to the health of infants and children. Report says, the incidence of CHD in Hebei Province is 1.239‰, while in Cangzhou, it is 1.304‰. CHD is a common birth defect disease in Cangzhou, and as a serious threat to patients, it brings heavy burden to their families and society.Although researchers have studied genetics, epigenetics and risk factors of CHD, there still lacks retrospective analysis on the risk factors of CHD based on data from Cangzhou. Based on previous researches and data of the last 10 years, this paper analyzes regional distribution of birth defects in Cangzhou. Besides, we’ll track CHD incidence among new-borns and infants by developing a sampling survey on perinatal mothers. Meanwhile, we’ll also discuss OCPs’(organochlorine pesticides) impact on CHD and explore effective precaution measures.Methods:1 Retrospective analysis. We use this method to analyze the trend of CHD incidence in Cangzhou in the last decade. Based on birth defects monitoring data and prenatal screening data between 2003 and 2012, we try to draw a distribution map of birth defects incidence in Cangzhou and study the features of its regional distribution.2 Design questionnaire of the sampling survey. We use this method to find out influencing factors of CHD incidence in different regions of Cangzhou. We selected qualified samples out from Birth Defects Monitoring Report Cards and prenatal screening data and extracted every three counties from eastern(coastal), middle and western(inland) area. Then we conceived the Questionnaire on Concerning Factors of CHD Incidence in Cangzhou. Questions include: Mother’s physical condition, reproductive age, parents’ education background, mother’s diet during pregnancy, mother’s condition during pregnancy(just as whether they had bad living habits, had taken hazard medicine or had done prenatal screening tests or not), etc. Through sampling survey for high risky mothers and CHD children, we analyzed the influencing factors of CHD incidence in different areas of Cangzhou.3 Clinical test and correlation analysis. By collecting venous blood from mothers and their CHD children, together with samples from normal children, we tested their OCPs level and used Logistic Regression to study the correlation between OCPs and CHD incidence.Results:1 The differences between birth defects incidence of Cangzhou’s 16 counties and districts have no statistical significance(P > 0.05). If divided by GDP per capita, the difference between the more developed 6 counties and the other 10 less developed ones also has no statistical significance(2c= 0.367, P = 0.545). In the last decade, the incidence in the inland area is higher than that in the middle and coastal areas.2 The difference of reproductive age(2c= 23.7, P < 0.05), pregnancy history(spontaneous abortion, birth defects, being pregnant more than twice), situation during pregnancy(cold, medication, negative events stimulus, smoking, drinking), family history of genetic(2c=54.49, P < 0.05) are statistically significant. In Cangzhou the influence factors of CHD include catching cold during pregnancy(OR = 7.955), smoking(OR = 4.812), medication during pregnancy(OR = 2.954) are risk factors; having meat or dairy products frequently and prenatal diagnosis are protective factors.3 Method of blood OCPs detection was primarily setup.Conclusions:1 In recent years, the occurrence of birth defects in Cangzhou has been increasing. There is no significant difference between the birth defects incidences all of the 16 counties and there is no difference between urban and the agricultural counties. We found that the top three birth defects are cleft lip, congenital heart disease and multi finger(toe).2 We found that the occurrence of CHD in Cangzhou are closely related to reproductive age, parents educational level, family economic condition, eating habits, life habits, pregnancy condition, adverse reproductive history, etc. Pregnant women suffering from cold, smoking and taking drugs during pregnancy are higher risky factors.3 It is necessary for us to focus on if OCPs accumulation in local pregnant women’s blood. And it requires further study to determine whether it is related to the occurrence of CHD. |
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