Prevalence and risk factors of congenital heart defects among live births: a population-based cross-sectional survey in Shaanxi province, Northwestern China.
Prevalence and risk factors of congenital heart defects among live births: a population-based cross-sectional survey in Shaanxi province, Northwestern China.
复制标题
陕西省活产儿先天性心脏病患病率及危险因素的横断面调查
DOI：
10.1186/s12887-017-0784-1
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发表时间：
2017-01-13
期刊：
影响因子：
2.4
通讯作者：
Yan H
中科院分区：
文献类型：
--
作者：
Pei L;Kang Y;Zhao Y;Yan H
研究背景我国西北地区近一半的人口居住在陕西省，但关于该地区先天性心脏病（CHD）流行病学特征的人群基础数据有限。目的了解陕西省2010 - 2013年出生婴儿冠心病的患病情况及流行病学特征。方法采用分层多阶段抽样方法，对陕西省2010 - 2013年出生婴儿进行调查。通过问卷调查记录参与者的特征，回顾医疗记录，并使用专门的新生儿超声心动图诊断CHD。Poisson回归模型，以评估任何冠心病和可能的危险因素之间的关联。ResultsA共29098活婴儿进行了调查，总患病率为76.0（95%CI：66.3，86.7）每10000活婴儿。调查地区主要和次要CHD患病率分别为26.1/10000和49.8/10000。Poisson回归分析显示，与单胎婴儿相比，双胎和多胎婴儿的CHD患病率比值更高（PRR：3.1，95% CI：1.6，6.1）。以陕南地区为参照，北方（PRR：0.4，95%CI：0.3，0.6）和关中地区（PRR：0.5，95%CI：0.4，0.7）冠心病的PRR较低。30岁以上母亲的PRR高于25岁以下母亲（PRR：1.6，95% CI：1.0，2.5），且产次≥3次的母亲高于仅产次的母亲（PRR：2.2，95% CI：1.2，4.2）。存活婴儿患CHD的风险与CHD家族史呈正相关（PRR：9.8，95%CI：5.3，18.1）。流动人口CHD患病率低于常住人口（PRR：0.6，95%CI：0.4，0.9）。结论陕西省及西北地区婴幼儿CHD是一个严重的健康问题。本研究对西北地区冠心病的干预具有重要的政策意义。
BackgroundNearly half of the population of Northwest China live in Shaanxi province, but population-based data on the epidemiologic characteristics of congenital heart defects (CHD) in this population is limited. The study aimed to investigate the prevalence and epidemiologic characteristics of the CHD among infants born between 2010 and 2013 in Shaanxi province.MethodsInfants born between 2010 and 2013 in Shaanxi province were surveyed using a stratified multi-stage sampling method. Participant characteristics were recorded by questionnaire, medical records were reviewed and CHD was diagnosed using a specialized neonatal echocardiography. A Poisson regression model was applied to assess the association between any CHD and possible risk factors.ResultsA total of 29098 live infants were surveyed with an overall prevalence of 76.0 (95% CI: 66.3, 86.7) per 10000 live infants. The prevalence of major and minor CHD were 26.1 and 49.8 per 10000 live infants, respectively, in surveyed areas. Poisson regression analysis indicated that, compared with singleton infants, the prevalence rate ratio of CHD was higher in twin and multi-fetal infants (PRR:3.1, 95% CI:1.6, 6.1). Using southern Shaanxi as a reference, the PRR of CHD were lower in northern (PRR:0.4, 95% CI:0.3, 0.6) and central Shaanxi province (PRR:0.5, 95% CI:0.4, 0.7). PRR was higher in mothers over 30 years of age than in those under 25 years (PRR:1.6, 95% CI:1.0, 2.5), and in mothers with ≥3 parity than that in mothers with only one parity (PRR:2.2, 95% CI:1.2, 4.2). The risk for CHD among live infants was positively associated with family history of CHD (PRR: 9.8, 95% CI: 5.3, 18.1). Additionally, CHD was less common in the floating population than the permanent population (PRR: 0.6, 95% CI: 0.4, 0.9).ConclusionThe CHD among live infants seemed to be a serious health problem in Shaanxi province as well as in Northwestern China. Our research have important policy implications for recommendations on CHD intervention in Northwest China.