A Risk Assessment And Intervention Study On Environmental Risk Factors For The Birth Defects Of The Perinatals In Guangxi Province

【Objective】The purpose of this study was to investigate the relationship between a series of maternal, antenatal, perinatal, socioeconomic, emotional and environmental variables and the occurrence of birth defects' of Guangxi Province in a setting different from those in which previous analytic epidemiologic studies had been undertaken, so that we can take the intervention measures and aim directly at promoting the quality of the newborns.【Methods】The study was to calculate ,compare and analyze the relationship between the incidence rate of perinatals' birth defects with the index of environmental quality. Using the methods of 1:R case control study , the risk assessment and intervention model consisted of three submodels,one was the totel model ,which consisted of 905 perinatals born in the year 2000, 281 cases with birth defects and 624 controls ; another one was the minority ethnic group model ,which consisted of 228 perinatals born in the year 2000, 63 cases with birth defects and 165 controls; and the last one was the facial birth defects model , which consisted of 150 perinatals born in the year 2000, 50 cases with birth defects and 100 controls. Both controls were chosen among the neighbors of the index cases who were healthy perinatals with the same sex and without birth defects born in the same area at the same time. Statistical analysis was done by modeling the data through COX proportional hazards regression model(PHREG or COX regression). 【Result】 The average incidence rate of birth defects of the perinatals in Guangxi Province of the year 2000 was 123.15/104 .Among all the types of the birth defects , the incidence rate of the Bart's syndrome(22.71/104) was the highest .And the incidence rate of the birth defects' of eight cities from the lowest to the hightest respectively was Beihai City(40.60/104),Hepu County (46.00/104),Guilin City (87.00/104),Liuzhou City (102.56/104),Qinzhou City (111.50/104),Nanning City (184.07/104),Wuzhou City (404.00/104)and Yulin City (420.00/104).And the incidence rate of the birth defects' of Beihai City was the lowest, which may be owned to the optimal quality. The COX regression multivariate analyses showed an increased risk of perinatals' birth defects and the statistically significant (p < 0.05) risk factors of potential causal importance (relative risk,RR)were: maternal hormone exposure during pregnancy(RR = 5.006), maternal pesticide exposure during pregnancy(RR = 2.216), maternal pregnancy complications (RR = 2.163), maternal sedatives exposure during pregnancy(RR = 2.058), maternal traditional Chinese medicine exposure during pregnancy(RR = 1.960),maternal chronic disease exposure(RR = 1.818), paternal chemicals exposure (RR = 1.701), maternal overburdened physical labor during pregnancy (RR = 1.544).For the minority ethnic group model, maternal pesticide exposure during pregnancy(RR = 24.819), maternal with thalassemia (RR = 18.413), maternal chronic disease(RR = 4.253) and maternal pregnancy complications (RR = 2.584) may be the potential environmental teratogen risk factors .To the facial birth defects model, maternal traditional Chinese medicine exposure during pregnancy(RR = 5.398) and maternal pregnancy complications (RR = 2.436) may be the potential environmental teratogen risk factors .【Conclusion】 Birth defects could be occured for the environmental factors respects to the exposure factors during pregnancy such as maternal hormone ,pesticide,sedatives,traditional Chinese medicines ,overburened physical labor and paternal chemicals exposure ,etal. in Guangxi . For the minority ethnic group , maternal pesticide exposure during pregnancy, maternal with thalassemia, maternal chronic disease and maternal pregnancy complications might be the potential environmental teratogen risk factors .To the facial birth defects model, maternal traditional Chinese medicine exposure during pregnancy and maternal pregnancy complication...