目的探讨孕妇孕前体重指数(BMI)及相关因素与胎儿先天性心脏病(CHD)发病的关系。方法采用以医院为基础的病例对照研究及问卷调查方法,将2010年1月-2014年1月福建省妇幼保健院检查确诊CHD的186例孕妇作为病例组,以无任何先天畸形的正常孕妇286例作为对照组,根据孕妇BMI分为3组:体重过低组(BMI〈18.5)、正常体重组(BMI=18.5~23.9)和体重超重组(BMI≥24.0)。结果单因素logistic回归分析结果显示,孕前BMI〈18.5的孕妇胎儿患CHD风险增加(OR=1.59)。多因素逐步回归显示,孕前体重过低(BMI〈18.5)、居住于农村、孕妇文化程度初中及以下、喝碳酸饮料、浓茶、存在先兆流产,其胎儿CHD风险增加;口服复合维生素和糖果巧克力是CHD的保护因素。结论重视管理育龄妇女孕前体重及饮食习惯,有助于预防和降低胎儿CHD的发病。
Objective To explore the relationship between maternal pre-pregnancy body mass( BMI) index and the related factors and fetal congenital heart disease(CHD).Methods A hospital- based case- control study and questionnaire survey were performed,186 pregnant women diagnosed as CHD definitely were selected from the hospital as case group,286 normal pregnant women without any congenital birth defects were selected as control group. The pregnant women were divided into three groups according to BMI:low weight group( BMI18. 5),normal weight group( BMI =18. 5-23. 9),and overweight group( BMI≥24. 0). Results Univariate logistic analysis showed that CHD risk increased in low weight group( OR =1.59). Multivariate stepwise regression analysis showed that low pre-pregnancy BMI( 18. 5),living in the countryside,low educational level( junior middle school or below),drinking carbonated drinks or strong tea,and threatened abortion increased the risk of CHD; oral administration of multivitamin and chocolates was a protective factor of CHD. Conclusion Paying attention to maternal pre-pregnancy BMI and eating habits can prevent and reduce the incidence rate of fetal CHD.