| BackgroundCongenital heart disease(CHD)is one of the most important birth defects that indicates the structural or functional abnormality of the heart or large blood vessels that existed at birth.Cardiac development is a continuous and complex process.Any part of the process is affected or interferes that will Causes heart malformation.Congenital heart malformations are affected by both genetic and non-genetic factors,including chromosomal abnormalities,genetic mutations,environmental contamination,drug exposure,microbial infections,physiological and psychological factors of their parents.So far,the causes of congenital heart disease are still unclear,and the factors affecting each region are different.Since theimplementation of the two-child policy in 2016,there have been some changes in the incidence and possible influencing factors of congenital heart disease in China.Therefore,under the new situation,researches on the incidence and influencing factors of CHD in specific areas will be carried out to improve the quality of birth population and to reduce the burden on related families and society.At present,the prevalence and influencing factors of congenital heart disease in Conghua are still unclear.Therefore,it is of great clinical significance to study the factors affecting CHD in thisarea.ObjectivesTo determine the incidence of neonatal with CHD in Conghua area since 2016 and to analyze the risk factors and protective factors of CHD.Based on this,a new comprehensive intervention strategy will be proposed to achieve the goal of effectively reducing the incidence of CHD in this area.MethodsThe physical examination of the live births born in the obstetrics department of the The Fifth Affiliated Hospital of Southern Medical University from September 2016 to August 2018 was performed.Neonates with positive signs were subjected to echocardiography,and children with CHD were screened for entry into the case group.The control group was healthy live births born in the same unit at the same time period,and the case group and the control group were paired 1:1.Parents of the two groups of infants filled out the"Congenital Heart Disease Risk Factors Questionnaire".The data in the questionnaire was processed and analyzed using Excel and SPSS 19.0 software.Univariate logistic regression analysis was performed on the relevant statistical results.Combining the professional knowledge,the P<0.1 variable in the univariate analysis was entered into the multivariate conditional logistic regression model.The odds ratio(OR)of the exposure factors and its 95%confidence interval(Cl)were calculated.P<0.05 was considered statistically significant.ResultA total of 16,950 live births were screened,and 74 of the newborns with CHD were diagnosed.The detection rate was 4.37‰.There were 33 cases of si,mple CHD and 41 cases of complex CHD.There were 34 male infants and 40 female inf-ants.The detection rate between the two sexes was not statistically significant(x2 =0.496,P>0.05).There were 74 pairs of neonates in the case group and the control group,and 33 influencing factors were included in the study.Using single factor logistic binary regression analysis,there were 14 factors influencing the P<0.1.All the 14 factors were entered to the multivarnate logistic regression analysis model.8 influencing factors were selected,including maternal age>35 years(OR=2.957,95%CI:1.064-8.101),family monthly income<3000 yuan(OR=3.331,95%CI:1.429-7.767),parents have underlying diseases(OR=3.490,95%CI:1.320-9.222),threatened abortion(OR=3.235,95%CI:1.272-8.228),mother passive Suction(OR=2.979,95%Cl:1.285-6.907),distance from the room to the road<50 meters(OR=3.303,95%CI:1.347-8.101),early pregnancy cold fever(OR = 2.855,95%Cl:1.231)-6.618)and so on 7 risk factors and 1 protective factor such as supplementation of folic acid,vitamins,calcium,etc.(OR = 0.281,95%CI:0.110-0.717).ConclusionFor the purpose of promoting the policy of prenatal and postnatal care and improving the quality of the birth population in Conghua area,we need to focus on preventing tertiary prevention of CHD birth defects.First of all,we need to understand the influencing factors of CHD in the region,and the government and the media need to increase the pu'blicity efforts.Promoting age-appropriate births,reducing exposure to toxic chemicals,preventing infections,eating a balanced diet,and developing good habits are powerful preventive measures.Secondly,improving the coverage of prenatal examinations and improving the level of prenatal diagnosis and treatment can effectively reduce the number of births of severe CHD-deficient children.Finally,we need to urgently promote free medical examinations for children,and actively treat children with CHD to improve their quality of life and reduce mortality. |
PDF Full Text Request