140 / 2019-11-05 23:04:32

Geographical variations in risk factors associated with birth defects among alive infants in Shaanxi province, Northwestern China

birth defect,spatial heterogeneity,Geographically weighted logistic regression

Geographical variations in risk factors associated with birth defects among alive infants in Shaanxi province, Northwestern China
Abstract
Background
Previous studies have shown spatial heterogeneity of risk factors for birth defects in different regions, and we aimed to explore regional differences with the impact of maternal lifestyle during pregnancy on birth defect burden.
Methods
Social demographic information of infants (and their mothers) born in shaanxi province between 2010 and 2013 were collected by stratified multi-stage sampling method. Non-spatial logistic regression model and geographic weighted logistic regression model were used to analyze the relationship between maternal lifestyle during pregnancy and the burden of birth defects.
Results
In the current study, a total of 29,098 samples were included, and the overall morbidity of birth defects was approximately 216.17 per 10,000 live infants. In terms of the fetal number, twin and multi-fetal greatly increased the BD incidence rather than single fetal (OR: 3.269, 95%CI:2.125-5.029). Similarly, the non-spatial and spatial models showed similar results.In addition, second parity was positively related to higher risk of BD among infants in comparison with only one parity (OR: 1.315, 95%CI:1.107-1.561). The spatial model also showed that second parity of mothers was positively correlated with BD occurrence among about 43.4% of participants (P<0.05). Furthermore, the rate of BD was lower in the floating population (OR: 0.596, 95% CI: 0.479-0.742) than permanent population. However, the spatial model indicated that approximately 77.4% of participants mainly spread over the Central Shaanxi, the risk of BD was lower in the floating population than permanent population (p < 0.05).Additionally, compared to infants born to mothers without a history of passive smoking during pregnancy, results revealed a higher odds ratio of BD (OR:1.590, 95%CI:1.313-1.925) among infants born to women with a history of passive smoking in pregnancy. But the spatial model indicated that the frequency of passive smoking was found to be positively associated with BD for near 74.4% of participants in Middle and South Shaanxi province (P< 0.05).
Conclusions
In Shaanxi province of northwest China, birth defects among alive births threatens human health seriously, also brings heavy burden to the family and the society. In addition, maternal negative lifestyles during pregnancy may increase the incidence of congenital malformations, which is consistent with the results shown in the non-spatial and spatial models. However, the effects of some related factors were distinctive in different areas, reflecting spatial heterogeneity. Therefore, different intervention strategies can be formulated for local regions, so that more limited resources can be used to prevent and control the prevalence of birth defects.
Keywords:birth defect, spatial heterogeneity, Geographically weighted logistic regression