文章摘要
李智文,任爱国,张乐,郭湛英,金永生,李竹.母亲饮食因素与神经管畸形危险性的病例对照研究[J].中华流行病学杂志,2006,27(10):831-835
母亲饮食因素与神经管畸形危险性的病例对照研究
Dietary factors and the risk of neural tube defects: a case-control study in Shanxi province, China
收稿日期:2006-01-05  出版日期:2014-09-18
DOI:
中文关键词: 出生缺陷;神经管畸形;饮食因素;病例对照研究
英文关键词: Birth defects;Neural tube defects;Dietary factors;Case-control study
基金项目:国家“十五”科技攻关课题资助项目(2002BA709811);中美出生缺陷病因研究合作项目(S040059)
作者单位E-mail
李智文 北京大学生育健康研究所  
任爱国 北京大学生育健康研究所 renag@sohu.com 
张乐 北京大学生育健康研究所  
郭湛英 山西省卫生厅基层卫生与妇幼保健处  
金永生 山西省卫生厅基层卫生与妇幼保健处  
李竹 北京大学生育健康研究所  
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中文摘要:
      目的探讨母亲饮食因素在神经管畸形(NTD)发病中的作用。方法选择山西省出生缺陷高发的平定、昔阳、太谷和泽州4个县,进行以人群为基础的出生缺陷病例对照研究。病例为2003年1月至2005年6月在4个县监测到的363例NTD病例,对照为同期在同地区出生的523名无体表畸形的健康婴儿。结果单因素分析结果表明,与NTD发生有关的饮食因素有食用肉类、蛋奶、豆类、腌菜、发芽土豆、食物烹调习惯、饮用水水源类型、饮啤酒、红酒或米酒和饮茶。在调整妇女文化程度和畸形生育史的基础上,多因素。logistic回归分析表明,肉类和豆类为NTD的保护因素, NTD的危险性随着肉类、豆类食用频率的增加逐渐下降,其在人群中的归因危险度(PAR)分别为69.4%和22.0%。食用腌菜为危险因素,NTD危险性随着腌菜食用频率增加而显著增加,具有明显的剂量反应关系,其PAR值为18.5%。此外,饮用河水或池塘水的妇女较饮用井水或自来水者的危险性增高(OR=3.42,95%CI:1.44-8.09),每天饮茶者较不饮或偶尔饮茶妇女的危险性增高(OR=4.65,95%CI:1.41-15.36),但二者PAR值较低,分别为4.7%和2.6%。结论富含叶酸的肉类和豆类对NTD发生具有显著的保护作用。怀孕前后食用腌菜、饮用河水或池塘水以及每天饮茶是NTD的危险因素。
英文摘要:
      Objective Dietary factors that could potentially be related to the risk of birth defects are still unknown in Shanxi province, a region with high prevalence of neural tube defects(NTDs) in China. The main aim of this study was to evaluate the association between NTDs and local dietary factors. Methods A population-based case-control study was conducted during 2003 - 2005 in four selected counties of Shanxi province with 363 NTDs cases ascertained and 523 control babies without any external birth defects. Results By multivariate logistic regression analysis, we found the NTDs risk was significantly associated with low consumption of meat and legume, high consumption of pickled vegetables, noncentralized supply of drinking water and drinking tea after adjusting for maternal education level and birth defects history. A significant dose response trend was found between the NTDs risk and the lower frequencies of meat and legume consumption and higher frequency of pickled vegetable consumption, with population attributable risks (PAR) of 69.4%,22.0% and 18.5%,respectively. Mothers who got their drinking water from river or pond during periconceptional period were more likely to have a NTD-affected pregnancy [OR = 3.42,95% CI:1.44-8.09, population attributable risk (PAR) = 4.7 %] compared with those who utilized tap or well water. Those who drank tea everyday had an elevated risk of having a NTD-affected pregnancy compared with those who didn' t (OR = 4.65,95% CI:1.41-15. 36, PAR = 2.6%). Conclusion Higher intake of meat and legume protects a woman from having a NTD-affected pregnancy, and consumption of pickled vegetables, drinking water from river or pond and drinking tea everyday increase the risk of having such a pregnancy in the study population.
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