| ObjectivesA case-control study was conducted among children with congenital heart disease under the age of 6 from the Lanzhou University First Hospital from August 26,2017 to July 11,2018.It is to investigate the influencing factors of congenital heart disease in Gansu Province,which provides scientific reference for the exploration and prevention of the causes of congenital heart disease.At the same time,to understand the physical development and nutriture of children with congenital heart disease,to provide a basis for improving the prognosis of children and improve the quality of life.MethodsThis study was designed as a case-control study with 1:2 frequency matching.From August 26,2017 to July 11,2018,157 children with congenital heart disease who were diagnosed with echocardiography,hospitalized in the Department of Cardiovascular Surgery,Lanzhou University First Hospital,were conducted a questionnaire survey from their parents or guardians.One-to-one inquiry by the unified training investigators,and filled out the "Investigation Table on Influencing Factors of Congenital Heart Disease in Children in Gansu Province".At the same time,333 children without CHD who of the same age and gender were selected as the control group for the physical examination department of Lanzhou Maternal and Child Health Hospital and Lanzhou Chengguan District Maternal and Child Health Station.The data of the questionnaire survey were statistically described by SPSS after database construction,entry and collation.The multi-factor unconditional logistic regression analysis was used to screen the influencing factors of congenital heart disease in children in Gansu Province.According to the principle of informed and voluntary,the growth and development of some children with congenital heart disease were evaluated.There were 74 cases in the case group and 148 cases were in the control group.The height(length),weight,head circumference,etc,of the two groups were compared.The height for age Z-score(HAZ),the weight for age Z-score(WAZ)and the weight for height Z-score(WHZ)were calculated in the two groups.The physical development and nutritional status of the two groups were compared.Results1.Among the children with congenital heart disease in Gansu Province,the highest incidence was ventricular septal defect in 62 cases(39.49%),followed by arterial patent ductus in 27 cases(17.20%)and atrial septal defect in 24 cases(15.29%),11 cases of Fallot’s quadruple syndrome(7.01%);18 cases of malformation(11.46%),8 cases(3.83%)of other types such as pulmonary hypertension and ventricular enlargement.2.There were no significant difference between the two groups in the height/length,body weight,head circumference and chest circumference(P>0.05).This study found that 25.68% of children with congenital heart disease had growth retardation,18.92% had low body weight,which was higher than that of the control group(P<0.05).3.The incidence of congenital heart disease was related to the nationality(P=0.041).Passive smoking during pregnancy was related to children with congenital heart disease.Frequent exposure to passive smoking was a risk factor for children with congenital heart disease,OR=7.434(1.706~32.391),P=0.008.The increase of weight during pregnancy was higher than the normal risk factor for congenital heart disease,OR=3.816(1.369~10.633),P=0.010.Negative life events during pregnancy ≥3 were risk factors for congenital heart disease,OR=10.635(2.796~40.447),P=0.001.The distance between the mother’s residence during pregnancy and the main trunk of the traffic was related to the occurrence of congenital heart disease,OR=1.678(1.018~2.765),P=0.042.Higher per capita monthly income is a protective factor for children with congenital heart disease,OR=0.078(0.038~0.163),P<0.0005.The mother’s first pregnancy is the protective factor for congenital heart disease in the offspring,OR=0.273(0.095~0.786),P=0.016.Whether parents have performed serological screening for chromosomal abnormalities is associated with the occurrence of congenital heart disease,OR=0.102(0.038~0.278),P<0.0005.Mothers often eat egg,meat,fish products,milk and soy products during pregnancy to protect the children fall in the congenital heart disease,OR= 0.122(0.027~0.550),P=0.006.The mother’s proper physical exercise during pregnancy is a protective factor for congenital heart disease,OR=0.141(0.033~0.599),P=0.008.Conclusions1.Among the distribution of the types of congenital heart disease,the top three were ventricular septal defect,patent ductus arteriosus,and atrial septal defect,accounting for 71.98% of the total.2.The growth retardation rate of children with congenital heart disease was 25.68%,and the low body weight rate was 18.92%,which were higher than the control group.3.The national and the distance between the mother’s residence during pregnancy and the main trunk of the traffic are related to the occurrence of congenital heart disease;the environment is often exposed to passive smoking during pregnancy,and the weight gain during pregnancy is higher than normal and negative life events during pregnancy≥3 are risk factors for CHD in children.4.Higher per capita monthly income,mother’s first child-birth,maternal nutrition supplement during pregnancy,proper physical exercise during pregnancy,and chromosomal abnormality serological screening of both husband and wife before pregnancy were protective factors for CHD. |
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