Relevant Factors And Preventive Measures Of Ntds Occurred In Its Study Of Impact

Objectives:Neural tube defects resulted in mortality and disability of infants, brought great suffering to society, families and individuals, became serious threat to human health and the quality of population. we wanted to understand the state of receiving health education, receiving genetic eugenics counseling, taking folic acid, screening the influential factors which may be related to the occurrence of NTDs and assess the economic burden which is caused by health expenditure of lying-in woman during pregnancy and the knowledge of lying-in woman preventing NTDs to provide a model of scientific and comprehensive intervention for NTDs.Methods:This study adopted 1:1 matched case-control study and selected Pingyao, Jiexiu, Qixian, Heshun, Lingshi, Zhongyang as research site.The cases who were selected from Jan 2006 to Dec 2008 in monitoring report were all lying-in mother who had children of NTDs.The year of birth, region of Residence, the puerperal hospital of the control was the same with the case.Then the investigators who had received unified training went into each the study object's house or summoned them to the hospital for face-to-face interviews to complete pre-designed questionnaire. t test,x2 test, conditional Logistic regression analysis, rank sum test and so on. were used for statistical analysis of collected data with SAS8.0 and SPSS 13.0 software.Results:(1) 34 variables which were statistically significant by single-factor conditional Logistic regression and some suspectable factors were inducted into multiple conditional Logistic regression analysis.And eight variables were entered into the final regression model: planning pregnancy, mental state during pregnancy, passive smoking during pregnancy, Husband of the lying-in woman exposed to toxic hazardous substances during progestation, sickness during pregnancy, adjusting diet during pregnancy, high frequency of intaking nuts during early pregnancy, taking folic acid. And their OR values were respectively 0.265,0.444,8.413,3.804,7.087,0.254,0.549,0.131. The lying-in woman intaking folic acid 3 months before pregnancy, started month of intaking folic acid during pregnancy, time of intaking folic acid during pregnancy were statistically significant between two groups.Their x2 values and P values were respectively 25.543,17.161,8.318 and 0.000,0.001,0.016.(2) Reading the magazines or books and publicity leaflets or brochures which were the ways of receiving health education was statistically significant by x2 test between two groups.Reasons of receiving and unreceiving Genetic eugenics counseling between two groups were statistically significant by x2 test (x2=8.230,11.969å'Œ, P=0.041,0.018). The location of receiving health education, time, institution of eugenics counseling and effect of eugenics counseling were no statistically significant between two groups.(4) Knowing folic acid before or during pregnancy, the food containing folic acid, relation between NTDs and environmental harmful factors, knowing effect of intaking folic acid during pregnancy, intaking folic acid to prevent NTDs, knowing eugenic genetic counseling to prevent NTDs, prenatal check prevent NTDs, knowing prenatal time of screening NTDs, knowing the time of taking folic acid, and knowing whether women who had children of NTDs had a child like this were statistically significant by x2 test. And their x2 values and P values were respectively 25.476,11.074,11.466,21.979,13.590,7.803,9.128, 20.882,15.445,7.766,and 0.000,0.001,0.009,0.000,0.000,0.005,0.003,0.000,0.004,0.021.(5) The time of prenatal examinations, second time, third time of ultrasonic inspection between two groups was statistically significant by x2 test. The times of examinations in clinic service and times of ultrasonographic during pregnancy between two groups was statistically significant by rank sum test, Z values and P values were respectively-7.059 and 0.OOO.The percentage that health expendifure hold the proportion of household income was no significant difference between two groups, Z value and P value were respectively-0.388 and 0.698. The direct health expendifure in clinic service, the indirect health expendifure in clinic service, the direct health expendifure in hospital, the indirect health expendifure in hospital were detected by byx2 test, but only found that the direct health expendifure in clinic service had statistically difference (x2=38.849, P=0.000).Conclusions:(1) Our study found that planning pregnancy, good mental state during pregnancy, high frequency of intaking nuts during early pregnancy, persistently intaking folic acid during progestation and early pregnancy, adjusting the diet during early pregnancy were protective factors of NTDs.while the passive smoking during pregnancy, husband of lying-in woman exposure to toxic hazardous substances during progestation, sickness during pregnancy were risk factors of NTDs.(2) The proportion of receiving health education through going to hospital and listening to doctors, listening to lectures or radio, watching television or movies, reading newspapers, magazines or books, posters or blackboard newspaper, leaflets or brochures etc were fairly low. And the health education could be received in the hospital, department of birth control, community or villages and at home and so on to improve their knowledge of preventing NTDs.(3) The lying-in woman knowledge of preventing NTDs in the control group was higher than that of the case group. The lying-in woman knowledge of preventing NTDs in the case group needed to be further improved.(4) The times of check in the control group were much higher than the case group's. while the prenatal examinations during pregnancy didn't cause more economic burden to lying-in woman. It is feasible to do prenatal examinations during pregnancy.