Abstract:

Objective    To investigate the association between environmental factors and nonsyndromic cleft of the lip and/or palate （NSCL/P）in Yantai district. Methods    A retrospective case-control study was carried out. Totally 152 NSCL/P children were selected as cases from Department of Oral and Maxillofacial Surgery of Yantai Stomatological Hospital between June 2012 and September 2015. And 176 controls were chosen from other diagnosis in the same department during the same period. The two groups matched in age and gender. The parents of participants were inquired by physicians regarding the risk factors and the answers by filling in a questionnaire. Chi-square and multivariate logistic regression analysis were used to analysis the data. Results    There was significantly increased NSCL/P risk with high maternal age （P = 0.005）， family history （P < 0.001）， abortion history （P = 0.028）， poor parental education level （P＜0.001）， tobacco and alcohol （P＜0.05）， common cold or fever （P = 0.021）， drug use （P = 0.004）and maternal stress （P=0.035）. Reduced NSCL/P risk was found with folic acid supplementation （P = 0.009）， adequate maternal age （P = 0.005）and high parental education （P＜0.001）. Conclusion    The proper amount of folic acid， the appropriate age of childbearing and the high education are the protective factors of NSCL/P while family history， abortion history， drug use during pregnancy， tobacco and alcohol， and maternal stress are the risk factors for NSCL/P in Yantai.

Key words: cleft lip, cleft palate, environmental factors, association

摘要：

目的    探讨烟台地区非综合征性唇腭裂（nonsyndromic cleft lip and/or palate， NSCL/P）与致病环境因素的关系。方法    选择2012年6月至2015年9月烟台市口腔医院口腔颌面外科收治的152例烟台地区NSCL/P患儿作为病例组，同期收治的176例非NSCL/P患儿为对照组，两组患儿的年龄、性别相匹配。通过调查问卷的方式对两组患儿的父母在怀孕早期可能暴露的环境因素进行统计，并对所得数据进行χ2检验和多因素logistic回归分析。结果    明显增加NSCL/P患病风险的环境因素包括：母亲高龄生育（P = 0.005）、家族遗传史（P＜0.001）、母亲流产史（P = 0.028）、父母受教育程度低（P＜0.001）、母亲饮酒史（P = 0.046）、父亲吸烟史（P = 0.039）、母亲感冒或发热史（P = 0.021）、母亲早期用药物史（P = 0.004）、母亲情绪异常史（P = 0.035）；明显降低NSCL/P患病风险的因素为母亲叶酸摄入史（P = 0.009）、母亲适龄生育年龄（P = 0.005）、父母受教育程度高（P＜0.001）。结论    母亲适量的叶酸摄入、适宜的生育年龄以及父母受教育程度高等因素为烟台地区NSCL/P的保护因素；家族遗传史、母亲流产史、母亲早期用药史、母亲饮酒史、父亲吸烟史、母亲情绪异常史等因素为烟台地区NSCL/P的危险因素。

关键词: 唇裂, 腭裂, 环境因素, 相关性