The Influencial Factors Of Birth Defects In China:a Meta Analysis

PART ONE:THE INFLUENTIAL FACTORS OF BIRTH DEFECTS OF CHINA:A META ANALYSISObjectiveTo explore influential factors related to perinatal birth defects to provide evidence for help making the best prevention methods and active interventions.Methods21 papers were analyzed by meta-analysis. The treatment and control cases were 6112 and 15741. The papers were screened preliminarily according to inclusion and exclusion standard, and then the fixed-model and random-model were selected according to the homogeneity test.ResultsThe main results of single-factor-analysis were as follows:family history of birth defects 36.22, early pregnancy of infectious disease 5.62, early pregnancy exposure to chemicals 4.19, paternal smoking 3.89, contact sedatives during pregnancy 3.19, pregnancy complication 2.94, high protein food feed 0.37; The main results of multiple-factor-analysis were as follows:early pregnancy of infectious disease7.65, poor prenatal mental state5.44, early pregnancy fever4.70, early pregnancy exposure to toxic chemical3.90, history of abortion3.59, supplement of multivitamin during pregnancy 0.45.ConclusionThe main risk factors of birth defects in our country are family history of birth defects, early pregnancy of infectious disease, early pregnancy exposure to chemicals, paternal smoking, pregnancy complication. The protective factors are feed more high protein food, supplement of multivitamin during pregnancy and taking folic acid during pregnancy.PART TWO:EFFECT OF PREGNANCY COMPLICATIONS AND GESTATIONAL EXPOSURE TO TOXIC CHEMICAL ON BIRTH DEFECT:A SYSTEMATIC EVALUATIONObjectiveInvestigating the impact on birth defect of pregnancy complications and gestational exposure to toxic chemical, to provide scientific basis for effective intervention measures.MethodsEleven studies were included, the quality evaluation and information extraction were carried out on the studies according to include and exclude standard.3248 examples in case group and 5722 examples in control group. Fixed or random effects model was used according to heterogeneity test results, and the combined result was analyzed by Chi-square test. The publication bias of the studies was also evaluated.ResultsThe combined results of single factor analysis of pregnancy complications was 1.074 (0.926-1.222), showed that pregnancy complications were risk factors of birth defects. Te combined results of single factor and multiple factors analysis of gestational exposure to toxic chemical were 1.349 (0.935-1.762),1.403 (1.031-1.774), also showed that gestational exposure to toxic chemical was a risk factor of birth defects.ConclusionPregnancy complications and gestational exposure to toxic chemical are risk factors of birth defects, this targeted provides reference to birth defects prevention.PART THREE:EFFICACY AND SAFETY OF THE INTERVENTIONAL THERAPY AND SURGICAL REPAIR OF ATRIAL SEPTAL DEFECTS:A SYSTEMATIC REVIEWObjectiveEvaluate the efficiency and safety of transcatheter closure and surgical repair of Atrial Septal Defect (ASD) using Meta-analysis method to provide a reference for clinical treatment.MethodsThe CBM, CNKI, WanFang Med Online and VIP were searched for all controlled trials. Screening, quality evaluation and information extraction was carried out on the studies according to include and exclude standard. The software RevMan 5.2 was used for data analysis.Results13 included studies were not randomized controlled trials,984 examples in intervention group and 890 examples in surgery group. The combined results showed that the procedural success rate of transcatheter closure group was lower than that of surgery (13 controlled trails,96.64% VS 99.66%, RR=0.97,95%CI:0.96-0.98, P<0.0001). Although the instant residual shunt rate of transcatheter closure group was higher than that of surgery (13 controlled trails,2.31% VS 1.70%, RR=1.45,95% CI: 0.75-2.82, P=0.27), it’s total complication rates was, lower than that of surgery (12 controlled trails,6.07% VS 20.26%, RR=0.29, 95%CI:0.22-0.39, P<0.00001).ConclusionThe procedural success rate of transcatheter closure group was lower than that of surgery group, but the complication rate was lower than that of surgey group. Transcatheter closure of PDA is an ideal procedure within acceptable limits owing to its reliability, safety, min-invasiveness and short hospitalization.