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青海省儿童先天性心脏病影响因素的调查研究

张书勤 杨惠莲 戚继荣

张书勤, 杨惠莲, 戚继荣. 青海省儿童先天性心脏病影响因素的调查研究[J]. 中华疾病控制杂志, 2023, 27(9): 1013-1018. doi: 10.16462/j.cnki.zhjbkz.2023.09.005
引用本文: 张书勤, 杨惠莲, 戚继荣. 青海省儿童先天性心脏病影响因素的调查研究[J]. 中华疾病控制杂志, 2023, 27(9): 1013-1018. doi: 10.16462/j.cnki.zhjbkz.2023.09.005
ZHANG Shuqin, YANG Huilian, QI Jirong. Investigation of factors influencing congenital heart disease among children in Qinghai Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(9): 1013-1018. doi: 10.16462/j.cnki.zhjbkz.2023.09.005
Citation: ZHANG Shuqin, YANG Huilian, QI Jirong. Investigation of factors influencing congenital heart disease among children in Qinghai Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(9): 1013-1018. doi: 10.16462/j.cnki.zhjbkz.2023.09.005

青海省儿童先天性心脏病影响因素的调查研究

doi: 10.16462/j.cnki.zhjbkz.2023.09.005
基金项目: 

青海省卫生健康委员会重点课题 2021-wjzd-04

详细信息
    通讯作者:

    杨惠莲,E-mail: yanghuilian7005@163.com

    戚继荣,E-mail: qjr7@163.com

  • 中图分类号: R181

Investigation of factors influencing congenital heart disease among children in Qinghai Province

Funds: 

Qinghai Provincial Health Commission Key Projects 2021-wjzd-04

More Information
  • 摘要:   目的  分析青海省儿童先天性心脏病(congenital heart disease, CHD)的影响因素。  方法  采用病例对照研究,按性别和年龄相差<1岁进行1∶2个体匹配,纳入315名<6岁的儿童(病例组105名,对照组210名),影响因素采用条件logistic回归分析模型分析。  结果  单因素条件logistic回归分析模型筛选出14个差异均有统计学意义的CHD影响因素(均P<0.001),包括居住地海拔、民族、出生体重、母亲文化程度、家庭收入、孕期接受宣教、首次妊娠、孕期补充维生素、孕期主要饮用水、孕期食用蔬菜水果、孕期食用油炸腌制品、孕期体育锻炼、孕期饲养动物、孕期定期体检;多因素条件logistic回归分析模型分析筛选出6个有统计学意义的CHD影响因素,包括海拔>2 500 m(OR=4.84, 95% CI: 1.17~20.08, P=0.030)、出生体重≥2.5 kg(OR=0.10, 95% CI: 0.01~0.81, P=0.031)、母亲有大学及以上文化程度(OR=0.23, 95% CI: 0.07~0.76, P=0.016)、家庭人均月收入>1 500元(OR=0.03, 95% CI: 0.01~0.21, P=0.001)、孕期补充维生素(OR=0.06, 95% CI: 0.01~0.40, P=0.004)、孕期饮用纯净水(OR=0.05, 95% CI: 0.01~0.35, P=0.003)。  结论  与低海拔地区相比,居住在高海拔地区发生CHD的危险会高出4.84倍。家庭收入、母亲文化程度、母亲孕期生活方式与CHD的发生可能有关。
  • 表  1  儿童先天性心脏病基线水平的比较

    Table  1.   Comparison of baseline levels of congenital heart disease in children

    变量Variable 病例组
    Case group
    (n=105)
    对照组
    Control group
    (n=210)
    χ2
    value
    P
    value
    性别Sex 0.001 1.000
      男性Male 48(45.71) 96(45.71)
      女性Female 57(54.29) 114(54.29)
    年龄组/岁Age group/years 1.400 1.920
      <1 29(27.62) 63(30.00)
      1~<2 10(9.52) 15(7.14)
      2~<3 6(5.71) 15(7.14)
      3~<4 15(14.29) 24(11.43)
      4~<5 13(12.38) 23(10.95)
      5~6 33(31.43) 70(33.33)
    注:①以[人数(占比/%)]表示。
    Note: ① [Number of people (proportion/%)].
    下载: 导出CSV

    表  2  儿童先天性心脏病影响因素的单因素条件logistic回归分析模型

    Table  2.   Univariate conditional logistic regression analysis of influencing factors of congenital heart disease in children

    变量Variable 病例组
    Case group (n=105)
    对照组
    Control group (n=210)
    χ2
    value
    OR值value
    (95% CI)
    P
    value
    居住地海拔/m Altitude of residence /m
      2 230~2 500 42(40.00) 181(86.19) 1.00
      >2 500 63(60.00) 29(13.81) 43.93 4.86(2.92~8.09) <0.001
    民族Nationality
      汉族Han 33(31.43) 157(74.76) 1.00
      少数民族Minority 72(68.57) 53(25.24) 54.92 6.46(3.8~10.83) <0.001
    出生体重/kg Birth weight/kg
      <2.5 17(20.98) 9(4.37) 1.00
      ≥2.5 64(79.02) 197(95.63) 19.49 0.17(0.07~0.40) <0.001
    出生胎龄/周Gestational age/week
      早产或过期产Premature or postterm delivery 7(6.67) 13(6.19) 1.00
      足月Full-term delivery 98(93.33) 197(93.81) 0.03 0.92(0.36~2.39) 0.870
    母亲文化程度Mother′s education
      高中及以下High school and below 84(80.00) 46(21.90) 1.00
      大学及以上University and above 21(20.00) 164(78.10) 97.47 0.07(0.04~0.13) <0.001
    家庭月均收入/元Average monthly household income/yuan
      <1 500 60(57.14) 43(20.48) 1.00
      ≥1 500 45(42.86) 167(79.52) 42.76 0.19(0.12~0.32) <0.001
    母亲孕期接受宣教Pregnant mothers receive fertility education during pregnancy
      无No 81(77.14) 83(39.52) 1.00
      有Yes 24(22.86) 127(60.48) 39.69 0.19(0.11~0.33) <0.001
    首次妊娠First pregnancy
      否No 65(61.90) 86(40.95) 1.00
      是Yes 40(38.10) 124(59.05) 12.31 0.43(0.26~0.69) <0.001
    孕期补充维生素Vitamin supplements during pregnancy
      否No 34(32.38) 11(5.24) 1.00
      是Yes 71(67.62) 199(94.7) 42.12 0.12(0.06~0.24) <0.001
    孕期生病Sickness during pregnancy
      无No 71(67.62) 154(73.33) 1.00
      有Yes 34(32.38) 56(26.67) 1.12 1.32(0.79~2.19) 0.290
    孕期服药Taking medication during pregnancy
      无No 90(85.71) 186(88.57) 1.00
      有Yes 15(14.29) 24(11.43) 0.53 1.25(0.69~2.28) 0.470
    孕期居室(办公室)装修Decoration of the living room (office) during pregnancy
      无No 100(95.23) 199(94.76) 1.00
      有Yes 5(4.77) 11(5.24) 0.03 0.91(0.32~2.55) 0.860
    孕期主要饮用水Main drinking water during pregnancy
      纯净水Purified water 11(10.48) 112(53.33) 45.81 0.23(0.13~0.40) <0.001
      自来水Piped water 79(75.24) 94(44.76) 1.00
      湖、井水Lake or well water 15(14.28) 4(1.91) 7.59 3.91(1.35~11.5) 0.006
    孕期食用蛋肉鱼水产品、牛奶及豆制品
    Consumption of eggs, meat, fish and fish products, milk and soy products during pregnancy
      偶尔Occasionally 31(29.52) 27(12.86) 5.81 1.61(1.09~2.38) 0.016
      间常Occasionally and often 26(24.76) 53(25.24) 1.00
      经常Often 48(45.72) 130(61.90) 0.94 0.91(0.75~1.11) 0.330
    孕期食用蔬菜、水果 Consumption of vegetables and fruits during pregnancy
      偶尔Occasionally 18(17.14) 6(2.86) 2.23 1.70(0.80~3.62) 0.140
      间常Occasionally and often 19(18.10) 15(7.14) 1.00
      经常Often 68(64.76) 189(90.00) 12.40 0.84(0.75~0.95) <0.001
    孕期食用油炸、腌制品 Consumption of fried and pickled products during pregnancy
      偶尔Occasionally 63(60.00) 164(78.10) 14.65 0.81(0.71~0.92) <0.001
      间常Occasionally and often 22(20.95) 15(7.14) 1.00
      经常Often 20(19.05) 31(14.76) 3.52 0.71(0.49~1.03) 0.061
    孕期被动吸烟 Passive smoking during pregnancy
      无No 56(53.33) 104(49.52) 1.00
      有Yes 49(46.67) 106(50.48) 0.41 1.08(0.86~1.35) 0.524
    孕期适当体育锻炼Appropriate physical activity during pregnancy
      无No 77(73.33) 110(52.38) 1.00
      有Yes 28(26.67) 100(47.62) 12.74 0.56(0.40~0.79) <0.001
    孕期饲养动物Keeping animals during pregnancy
      无No 71(67.62) 193(91.90) 1.00
      有Yes 34(32.38) 17(8.10) 30.43 4.00(2.35~6.82) <0.001
    孕早期情绪Emotions in early pregnancy
      愉快Happy 33(31.42) 99(47.14) 6.77 0.68(0.50~0.93) 0.009
      一般General 63(60.00) 97(46.19) 1.00
      不愉快Unhappy 9(8.58) 14(6.67) 0 0.99(0.4~2.17) 0.982
    孕早期性生活Sex during early pregnancy
      无No 90(85.71) 177(84.29) 1.00
      有Yes 15(14.29) 33(15.71) 0.11 1.02(0.92~1.12) 0.739
    孕期定期产检Regular maternity check-ups during pregnancy
      无No 38(36.19) 28(13.33) 1.00
      有Yes 67(63.81) 182(86.67) 23.27 2.82(1.82~4.35) <0.001
    父亲吸烟Father smoking
      否No 52(49.52) 125(59.52) 1.00
      是Yes 53(50.48) 85(40.48) 2.84 0.83(0.67~1.04) 0.092
    父亲饮酒Father Drinking
      否No 64(60.95) 144(68.57) 1.00
      是Yes 41(39.05) 66(31.43) 1.81 0.89(0.74~1.06) 0.178
    母亲性格自我评价Self-assessment of mother′s character
      内向Introversion 49(46.67) 92(43.81) 1.00
      外向Extraversion 56(53.33) 118(56.19) 0.23 0.95(0.77~1.18) 0.631
    母亲孕期情绪Mothers′ moods during pregnancy
      稳定Steadiness 79(75.24) 170(80.95) 1.00
      不稳定Unsteadiness 26(24.76) 40(19.05) 1.38 1.30(0.84~2.01) 0.240
    母亲孕期经历负性事件 Experiencing negative events during pregnancy
      无No 86(81.90) 169(80.48) 1.00
      有Yes 19(18.10) 41(19.52) 0.09 1.02(0.91~1.14) 0.761
    注:①数据有缺失。②使用频次分为偶尔(0~<3次/月),间常(3次/周),经常(≥4次/周)。③是指被调查者在1周内有≥1 d的时间处于被动吸烟的环境,每天吸入烟雾≥15 min。④孕妇生活事件量表。⑤以[人数(占比/%)]表示。
    Note: ①There are data gaps. ②Frequency of use is categorized as occasional (0~<3 times/month), intermittent (3 times/week), frequent (≥4 times/week). ③It was defined as the respondent being in a passive smoking environment for ≥1 d in a 1-week period and inhaling smoke for ≥15 min per day. ④ Maternal Life Events Scale. ⑤[Number of people (proportion/%)].
    下载: 导出CSV

    表  3  儿童先天性心脏病影响因素的多因素条件logistic回归模型分析

    Table  3.   Multivariate conditional logistic regression of influencing factors of congenital heart disease in children

    变量Variable χ2
    value
    OR值value
    (95% CI)
    P
    value
    居住地海拔/m Altitude of residence /m
      2 230~2 500 1.00
      >2 500 6.50 6.74(1.55~29.18) 0.011
    出生体重/kg Birth weight/kg
      <2.5 1.00
      ≥2.5 4.68 0.10(0.01~0.81) 0.031
    母亲文化程度Mother′s education
      高中及以下High school and below 1.00
      大学及以上University and above 5.80 0.23(0.07~0.76) 0.016
    家庭月均收入/元Average monthly household income/yuan
      <1 500 1.00
      ≥1 500 12.07 0.03(0.01~0.21) 0.001
    孕期补充维生素Vitamin supplements during pregnancy
      否No 1.00
      是Yes 8.41 0.06(0.01~0.40) 0.004
    孕期主要饮用水Main drinking water during pregnancy
      纯净水Purified water 1.00
      自来水Piped water 8.70 0.05(0.01~0.35) 0.003
    下载: 导出CSV
  • [1] Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. DOI: 10.1016/s0140-6736(19)30427-1.
    [2] He Y, Xu W, Su Z, et al. Addressing the rising burden of congenital heart disease in China[J]. Lancet Child Adolesc Health, 2020, 4(4): e7. DOI: 10.1016/s2352-4642(20)30061-4.
    [3] Van Der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis[J]. J Am Coll Cardiol, 2011, 58(21): 2241-2247. DOI: 10.1016/j.jacc.2011.08.025.
    [4] Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies[J]. Int J Epidemiol, 2019, 48(2): 455-463. DOI: 10.1093/ije/dyz009.
    [5] Chun H, Yue Y, Wang Y, et al. High prevalence of congenital heart disease at high altitudes in Tibet[J]. Eur J Prev Cardiol, 2019, 26(7): 756-759. DOI: 10.1177/2047487318812502.
    [6] Zheng JY, Qiu YG, Li DT, et al. Prevalence and composition of CHD at different altitudes in Tibet: a cross-sectional study[J]. Cardiol Young, 2017, 27(8): 1497-1503. DOI: 10.1017/S1047951117000567.
    [7] Li JJ, Liu Y, Xie SY, et al. Newborn screening for congenital heart disease using echocardiography and follow-up at high altitude in China[J]. Int J Cardiol, 2019, 274: 106-112. DOI: 10.1016/j.ijcard.2018.08.102.
    [8] Ma LG, Chen QH, Wang YY, et al. Spatial pattern and variations in the prevalence of congenital heart disease in children aged 4-18years in the Qinghai-Tibetan Plateau[J]. Sci Total Environ, 2018, 627: 158-165. DOI: 10.1016/j.scitotenv.2018.01.194.
    [9] Hasan A. Relationship of high altitude and congenital heart disease[J]. Indian Heart J, 2016, 68(1): 9-12. DOI: 10.1016/j.ihj.2015.12.015.
    [10] Jr WTF. Altitude and cold weather: are they vascular risks?[J]. Curr Opin Cardiol, 2014, 29(4): 396-402. DOI: 10.1097/hco.0000000000000064.
    [11] Stoll C, Alembik Y, Roth MP, et al. Risk factors in congenital heart disease[J]. Eur J Epidemiol, 1989, 5(3): 382-391. DOI: 10.1007/BF00144842.
    [12] Yu D, Feng Y, Yang L, et al. Maternal socioeconomic status and the risk of congenital heart defects in offspring: a meta-analysis of 33 studies[J]. PLoS One, 2014, 9(10): e111056. DOI: 10.1371/journal.pone.0111056.
    [13] Yang J, Carmichael SL, Canfield M, et al. Socioeconomic status in relation to selected birth defects in a large multicentered US case-control study[J]. Am J Epidemiol, 2008, 167(2): 145-154. DOI: 10.1093/aje/kwm283.
    [14] Vrijheid M, Dolk H, Stone D, et al. Socioeconomic inequalities in risk of congenital anomaly[J]. Arch Dis Child, 2000, 82(5): 349-352. DOI: 10.1136/adc.82.5.349.
    [15] Meyer RE, Siega-Riz AM. Sociodemographic patterns in spina bifida birth prevalence trends--north Carolina, 1995-1999[J]. MMWR Recomm Rep, 2002, 51(RR-13): 12-15.
    [16] Zhang M, Wang L, Huang R, et al. Risk factors of malnutrition in Chinese children with congenital heart defect[J]. BMC Pediatr, 2020, 20(1): 213. DOI: 10.1186/s12887-020-02124-7.
    [17] Fekete K, Berti C, Cetin I, et al. Perinatal folate supply: relevance in health outcome parameters[J]. Matern Child Nutr, 2010, 6 Suppl 2(Suppl 2): 23-38. DOI: 10.1111/j.1740-8709.2010.00261.x.
    [18] Summary for Patients: Maternal folate level and congenital heart disease[J]. Ann Intern Med, 2022, 175(9): 1-26. DOI: 10.7326/p22-0014.
    [19] Chen H, Zhang Y, Wang D, et al. Periconception red blood cell folate and offspring congenital heart disease : nested case-control and mendelian randomization studies[J]. Ann Intern Med, 2022, 175(9): 1212-1220. DOI: 10.7326/m22-0741.
    [20] Tyagi R, Verma S, Dash N, et al. Folate deficiency: a possible association with congenital heart defects[J]. Indian J Pediatr, 2022, 89(10): 1013-1015. DOI: 10.1007/s12098-022-04125-z.
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  • 收稿日期:  2022-06-18
  • 修回日期:  2022-09-18
  • 网络出版日期:  2023-10-12
  • 刊出日期:  2023-09-10

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