Logistic regression analysis of risk factors in perinatal period for neonates with birth defects
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摘要:目的 分析围孕期危险因素对新生儿出生缺陷的影响。方法 选取2014年12月—2018年12月陕西省旬阳县妇幼保健院分娩的出生缺陷新生儿120例为观察组, 另选取同期在本院分娩健康新生儿360例为对照组。调查2组新生儿父母情况，包含居住地、年龄、经济情况、职业和文化程度等; 记录孕产妇不良孕产史、孕期不良情绪、多胎、孕早期感冒史、孕早期服用药物、孕早期被动吸烟、孕检及婚检情况等，对新生儿出生缺陷的影响因素行单因素、多因素Logistic回归分析。结果 与对照组相比，观察组产妇文化程度、居住地、经济状况、职业均较差，差异有统计学意义(P < 0.05)。单因素Logistic分析显示，影响新生儿出生缺陷因素包含不良孕产史、孕期不良情绪、多胎、孕早期感冒史、孕早期服用药物、孕早期被动吸烟、孕检、孕前检查及婚检。Logistic分析结果显示，新生儿出生缺陷保护因素为孕检、婚检，新生儿出生缺陷独立危险因素为不良孕产史、孕期不良情绪、孕早期感冒史和孕早期服用药物(P < 0.05)。结论 新生儿出生缺陷危险因素包含不良孕产史、孕期不良情绪、孕早期感冒史和孕早期服用药物，临床应倡导孕产妇行孕检，及时了解胎儿发育情况，做好相应预防工作。Abstract:Objective To analyze the effects of risk factors in perinatal period on birth defects of neonates.Methods Totally 120 neonates with birth defects from December 2014 to December 2018 in Xunyang County Maternal and Child Health Care Hospital were selected as observation group, and 360 healthy newborns were selected as control group. The conditions of parents of newborns were investigated in both groups, including residence, age, economic status, occupation and educational level. Meanwhile, the history of unhealthy pregnancy and childbirth, unhealthy mood during pregnancy, multiple pregnancies, history of cold in early pregnancy, medication in early pregnancy, passive smoking in early pregnancy, pregnancy examination and marital examination were recorded. The influencing factors of birth defects were analyzed by single factor and multi-factor Logistic regression.Results Compared with the control group, the educational level, residence, economic status and occupation of the puerperas in the observation group were significantly worse (P < 0.05). Univariate Logistic analysis showed that the factors affecting neonatal birth defects were history of adverse pregnancy and childbirth, adverse mood during pregnancy, multiple births, history of cold in early pregnancy, medication in early pregnancy, passive smoking in early pregnancy, pregnancy examination, pre-pregnancy examination and premarital examination. Logistic analysis showed that the protective factors of neonatal birth defects were pregnancy examination and premarital examination, and the independent risk factors of neonatal birth defects were history of adverse pregnancy and childbirth, adverse mood during pregnancy, history of cold in early pregnancy and medication in early transportation (P < 0.05).Conclusion Risk factors of neonatal birth defects are various, including history of unhealthy pregnancy and childbirth, unhealthy mood during pregnancy, history of cold in early pregnancy and medication in early operation. Pregnant women should be advocated for pregnant examination inorder to timely master the condition of fetal development and complete the corresponding prevention work.
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表 1 2组新生儿临床资料对比(X±s)
组别 出生体质量/g 性别 平均胎龄/周 分娩方式 男 女 剖宫产 自然分娩 观察组(n=120) 3 019.75±367.14* 64 56 37.51±1.68* 79* 41* 对照组(n=360) 2 251.09±364.28 187 173 39.50±1.52 113 247 与对照组比较, *P < 0.05。 
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表 2 2组产妇人口学特征情况对比[n(%)]
人口学特征 观察组(n=120) 对照组(n=360) t/χ2 P 文化程度 小学及以下 56(46.67) 85(23.61) 5.178 < 0.05 初中或者高中 36(30.00) 100(27.78) 大专及以上 28(23.33) 175(48.61) 年龄 < 25岁 43(35.83) 133(36.94) 0.309 >0.05 25~35岁 53(44.17) 146(40.56) >35岁 24(20.00) 81(22.22) 居住地 城镇 45(37.50) 188(52.22) 6.992 < 0.05 农村 75(62.50) 172(47.78) 经济状况 月收入 < 3 000元 51(42.50) 88(24.44) 7.041 < 0.05 月收入3 000~5 000元 33(27.50) 130(36.11) 月收入>5 000元 36(30.00) 142(39.44) 职业 家庭主妇或者农民 76(63.33) 147(40.83) 6.316 < 0.05 服务业、商业从业人员 15(12.50) 40(11.11) 干部、知识分子 10(8.33) 74(20.56) 工人 14(11.67) 76(21.11) 其他 5(4.17) 23(6.39)
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表 3 影响新生儿出生缺陷的单因素Logistic分析
相关因素 回归系数 标准差 P OR 95%CI 不良孕产史 0.570 0.160 0.004 1.618 1.003~2.640 孕期不良情绪 0.316 0.161 0.015 1.314 1.005~1.662 多胎 0.736 0.152 0.039 2.121 0.741~3.053 孕早期感冒史 0.583 0.148 0.004 2.106 1.204~2.382 孕早期服用药物 0.629 0.182 0.002 1.904 1.482~3.100 孕早期被动吸烟 0.705 0.193 0.041 0.693 0.105~1.021 孕检 -0.939 0.179 0.001 0.455 0.300~0.719 孕前检查 -0.690 0.151 0.002 0.635 0.451~1.042 婚检 -0.719 0.148 0.001 0.409 0.238~0.816
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表 4 影响新生儿出生缺陷的多因素Logistic分析
相关因素 回归系数 标准差 P OR 95%CI 不良孕产史 0.500 0.201 0.020 1.469 1.003~1.906 孕期不良情绪 0.441 0.189 0.030 1.309 1.060~2.009 孕早期感冒史 0.640 0.166 0.010 1.538 1.230~2.551 孕早期服用药物 0.620 0.168 0.011 1.629 1.073~2.804 孕检 -0.828 0.181 0.003 0.366 0.300~0.748 婚检 -0.721 0.182 0.001 0.460 0.320~0.881
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