摘要
目的 探讨新生儿先天性心脏病(先心病)患病率和妊娠初期增补叶酸的预防效果。方法 对1992年1月1日至1998年12月31日嘉兴市妇幼保健院出生的全部活婴31 470例，进行先心病前瞻性调查；调查1996年8月1日至1998年7月31日7 445例活产婴儿的母亲孕前1月至孕后3月内增补叶酸情况与先心病的发病关系；调查1994年6月1日至1998年12月31日出生的217例先心病的母亲妊娠初期增补叶酸情况。结果 31 470例新生儿中检得先心病312例，不包括单纯性动脉导管未闭和缺损直径小于5 mm的房间隔缺损(ASD)。其中彩色多普勒超声心动图(CDFM)诊断298例，尸检确诊14例，患病率9.91‰。室间隔缺损(VSD)居首位(51.6%)，患病率5.12‰。重症复杂先心病新生儿期死亡32例，病死率10.3%。7 445例新生儿的母亲孕期增补叶酸情况与先心病患病率关系，增补叶酸组先心病患病率7.43‰，未补组患病率15.17‰。两组患病率差异有显著性意义，(P<0.01)，相对危险度(RR)0.4898，归因危险度(AR)0.00774，归因危险比数(ARP)51.02%。重症复杂先心病患病率未补组为增补组的4.6倍。217例先心病中母亲孕初增补叶酸组占30.9%，未补组占69.1%。重症复杂畸形增补组7例占11.4%，未补组34例占22.7%。结论 应用CDFM是先心病检出率增加的主要原因。妊娠初期增补叶?
Objective To determine the incidence o f congenital heart disease (CHD) in newborns and the role of folic acid on reduc ing or preventing CHD in early pregnancy. Methods A prospective study was conducted on all the 31 470 live-births in Jiaxing Maternity and Child Health Hospital from January 1st, 1992 to December 31st, 1998. The relatio nship between CHD and the maternal consumption of folic acid from 1 month before pregnancy to 3 months after pregnancy was studied. The patients recruited in th e study were women who gave birth to a total of 7 445 livebirths from Augu st 1st, 1996 to July 31st, 1998. Results We found 312 newborns with CHD (excluding simple PDA and VSD of <5 mm) of the 312 newborns, 298 were d etected by color Dopler echocardiogram (CDFM)and 14 by autopsy. The incidence wa s 9.91‰ with VSD 5.12‰ topping the list of CHD. Thirtytwo babies wit h complex heart disease died in the newborn period, with a mortality of 10.3% . The incidence of CHD was 7.43‰ in the folic acid group, and 15.17‰ in the nonfolic acid group. The difference was statistically significont between the 2 groups (P<0.01). RR was 0.4898, AR was 0.00774, and AR P was 51.02%. The incidence of severe complex cardiac deformity in the non folic acid group was 4.6 times that of the folic acid group. Of the 217 wome n discharging babies with CHD during January 1st, 1994 and December 31st, 1998,30.9% belonged to the folic acid group, and 69.1%to the nonfolic acid group. Seven severe complex deformity belonged to the folic acid group (11.4% ), and 34 the nonfolic acid group (22.7%). Conclusions The incidence of CHD was the highest in the newborn period. The incidence decrea sed with the death of severe complex heart disorders and the spontaneous closure of some cases of VSD and ASD. The main reason of a high detection rate of CHD w as due to the application of CDFM. Taking folic acid in early pregnancy may redu ce the incidence of CHD, especially the incidence of complex CHD.
出处
《中国当代儿科杂志》
CAS
CSCD
2000年第5期320-322,325,共4页
Chinese Journal of Contemporary Pediatrics
关键词
新生儿
先天性心脏病
患病率
叶酸
Folic acid
Congenital heart diseases
Incidence
Newbor n
