Objective: To analyze the incidence and risk factors of congenital heart disease (CHD) in Qingdao. Methods: A prospective study was adapted, and study participants were pregnant women who underwent prenatal screening in Qingdao from August 2018 to June 2020 and their offspring (the whole population coverage). CHD in neonates was screened by using the pulse oximetry saturation and heart auscultation, and the final diagnosis was determined by the result of echocardiography. Multivariable logistic regression was performed to analyze the risk factors of CHD. Results: The study included 115 238 live births, among which 709 were diagnosed with CHD, with an incidence of 6.15/1 000. Ventricular septal defect, atrial septal defect, as well as ventricular septal defect and atrial septal defect were the main CHD subtypes, with incidences of 2.97/1 000 (342/115 238), 1.01/1 000 (116/115 238), and 0.39/1 000 (45/115 238), respectively, comprising 48.2% (342/709), 16.4% (116/709), and 6.3% (45/709) of the CHD cases. The results of multivariable logistic regression showed that the offspring of women with a graduate degree (compared to junior high school or below) (OR=1.66, 95%CI: 1.15-2.40), pregnancy history of CHD (OR=9.50, 95%CI: 5.37-16.81), pregestational diabetes mellitus (OR=3.40, 95%CI: 1.58-7.32) had a higher risk of having CHD, whereas the offspring of multiparous women was associated with a lower risk of CHD (OR=0.84, 95%CI: 0.71-0.99). In addition, compared with male newborns, female newborns have a higher risk of having CHD (OR=1.18, 95%CI: 1.01-1.39). Conclusions: The incidence of CHD in Qingdao is 6.15/1 000, with ventricular septal defect, atrial septal defect, as well as ventricular septal defect and atrial septal defect being the main subtypes. Maternal education, parity, pregnancy history of CHD, pregestational diabetes mellitus, and offspring gender are associated with CHD occurrence.
目的： 分析青岛地区先天性心脏病（CHD）的发生情况及其危险因素。 方法： 采用前瞻性研究，以2018年8月至2020年6月在青岛地区进行产前筛查的妊娠妇女及其子代为研究对象（青岛地区全人口覆盖）。新生儿CHD的筛查主要通过经皮血氧饱和度和心脏听诊，并根据超声心动图进行最终确诊。应用多因素logistic回归模型分析CHD的危险因素。 结果： 共纳入115 238名活产儿，其中共有709名确诊为CHD，发病率为6.15‰。室间隔缺损、房间隔缺损及室间隔缺损合并房间隔缺损是CHD主要的发病亚型，发病率依次为2.97‰（342/115 238）、1.01‰（116/115 238）和0.39‰（45/115 238），构成比分别为48.2%（342/709）、16.4%（116/709）和6.3%（45/709）。多因素logistic回归模型分析结果显示，母亲教育水平为研究生（与初中及以下比较）（OR=1.66，95%CI：1.15~2.40）、有CHD孕育史（OR=9.50，95%CI，5.37~16.81）、糖尿病合并妊娠（OR=3.40，95%CI：1.58~7.32）为新生儿CHD的危险因素，而有生育史的母亲其子代发生CHD的风险较低（OR=0.84，95%CI：0.71~0.99）。另外，相较于男性新生儿，女性新生儿有较高的CHD发病风险（OR=1.18，95%CI：1.01~1.39）。 结论： 青岛地区CHD的发病率为6.15‰，室间隔缺损、房间隔缺损及室间隔缺损合并房间隔缺损是主要发病亚型；母亲的教育水平、生育史、CHD孕育史、糖尿病合并妊娠以及子代的性别与CHD的发生相关。.