中国新生儿先天性心脏病危险因素的Meta分析

Risk factors for congenital heart disease in Chinese neonates: a Meta analysis

摘要:

目的 探讨中国新生儿先天性心脏病（CHD）的主要危险因素，为CHD的预防提供参考依据。方法 系统搜集2001~2016年研究中国新生儿CHD危险因素的病例对照研究，提取相关数据，按照NOS量表对纳入文献进行质量评价，敏感性分析采用不同模型分析同一资料，采用Egger's检验评估发表偏倚。结果 共纳入17篇病例对照研究，其中病例组2 930例，对照组4 952例。Meta分析显示中国新生儿CHD主要危险因素为：孕母高龄（OR=2.649，95%CI：1.675~4.189）、感冒或发烧（OR=4.558，95%CI：2.901~7.162）、孕早期用药（OR=3.961，95%CI：2.816~5.573）、被动吸烟（OR=2.766，95%CI：1.982~3.859）、不良生育史（OR=2.992，95%CI：1.529~5.856）、接触噪声（OR=3.030，95%CI：1.476~6.217）、受到辐射（OR=2.363，95%CI：1.212~4.607）、居室新装修（OR=4.979，95%CI：3.240~7.653）、孕期糖尿病（OR=5.090，95%CI：3.132~8.274）、饲养宠物（OR=2.048，95%CI：1.385~3.029）。结论 孕母高龄、感冒或发烧、孕早期用药、被动吸烟、不良生育史、接触噪声、受到辐射、居室新装修、孕期糖尿病、饲养宠物可能增加新生儿CHD的患病风险。

Abstract:

Objective To investigate the major risk factors for congenital heart disease (CHD) in Chinese neonates and to provide a reference for the prevention of CHD. Methods A literature search was performed to collect the case-control studies on the risk factors for CHD in Chinese neonates published in 2001-2016. The relevant data were extracted accordingly. The quality of included studies was assessed by Newcastle-Ottawa Scale. Sensitivity analysis was conducted using different models to analyze the same data. The publication bias was assessed by Egger's test. Results A total of 17 case-control studies involving 2 930 cases and 4 952 controls were included. The Meta analysis showed that the major risk factors for CHD in Chinese neonates were as follows:mother with advanced age (OR=2.649, 95%CI:1.675-4.189), cold or fever (OR=4.558, 95%CI:2.901-7.162), medication use in early pregnancy (OR=3.961, 95%CI:2.816-5.573), passive smoking (OR=2.766, 95%CI:1.982-3.859), abnormal childbearing history (OR=2.992, 95%CI:1.529-5.856), noise exposure (OR=3.030, 95%CI:1.476-6.217), radiation exposure (OR=2.363, 95%CI:1.212-4.607), decoration (OR=4.979, 95%CI:3.240-7.653), gestational diabetes (OR=5.090, 95%CI:3.132-8.274), and pet raising (OR=2.048, 95%CI:1.385-3.029). Conclusions Mothers with advanced age, cold or fever, medication use in early pregnancy, passive smoking, abnormal childbearing history, noise exposure, radiation exposure, decoration, gestational diabetes, and pet raising may increase the risk of CHD in Chinese neonates.