ﺑﺮرﺳﯽ ارﺗﺒﺎط ﺑﯿﻦ ﻣﻮاﺟﻬﻪ ﺷﻐﻠﯽ ﻣﺎدر ﺑﺎ ﺣﻼل و ﺧﻄﺮ وﻗﻮع ﻧﺎﻫﻨﺠﺎري ﻫﺎي ﻣﺎدرزادي ﻗﻠﺒﯽ در ﻧﻮزادان

Maternal occupational exposure to solvents and the risk of congenital heart defects in offspring

ﻣﻘﺪﻣﻪ: ﺷﻨﺎﺧﺖ ﻣﯿﺰان ﻣﻮاﺟﻬﻪ ﻣﺎدران ﺑﺎ ﺣﻼل ﻫﺎ و ﺑﺮرﺳﯽ ارﺗﺒﺎط آن ﺑﺎ ﻧﺎﻫﻨﺠﺎري ﻣﺎدرزادي ﻗﻠﺒﯽ در ﻧﻮزادان ﻣﯽ ﺗﻮاﻧﺪ در ﺷﻨﺎﺧﺖ ﻋﻮاﻣﻞ ﻣﺤﯿﻄﯽ ﻣﻮﺛﺮ در ﺑﺮوز ﻧﺎﻫﻨﺠﺎري ﻣﺆﺛﺮ ﺑﺎﺷﺪ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ارﺗﺒﺎط ﺑﯿﻦ ﻣﻮاﺟﻬﻪ ﺷﻐﻠﯽ ﻣﺎدران ﺑﺎ ﺣﻠّﺎل و ﺑﺮوز ﻧﺎﻫﻨﺠﺎري ﻣﺎدرزادي ﻗﻠﺐ در ﻧﻮزادان اﻧﺠﺎم ﺷﺪ. روش ﺑﺮرﺳﯽ: در اﯾﻦ ﻣﻄﺎﻟﻌﮥﻣﻮرد ـﺸﺎﻫﺪي، 200 ﻧﻮزاد ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن اﻓﺸﺎر ﯾﺰد ﮐﻪ ﻧﺎﻫﻨﺠﺎري ﻣﺎدرزادي ﻗﻠﺒﯽ داﺷﺘﻨﺪ ﺑﻪ ﻋﻨﻮان ﻧﻤﻮﻧﻪ و 400 ﻧﻮزاد ﺳﺎﻟﻢ ﻫﻤﺴﺎن ﺷﺪه وارد ﻣﻄﺎﻟﻌﻪ ﺷﺪﻧﺪ. از ﭘﺮﺳﺸﻨﺎﻣﻪ اي ﻣﺘﺸﮑﻞ از ﺳﻪ ﻗﺴﻤﺖ ﺑﻪ ﻋﻨﻮان اﺑﺰار ﮔﺮدآوري اﺳﺘﻔﺎده ﺷﺪ. ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎ از ﻃﺮﯾﻖ ﻣﺼﺎﺣﺒﻪ ﺗﻠﻔﻨﯽ ﺗﮑﻤﯿﻞ ﺷﺪ. اﻃﻼﻋﺎت ﻣﺮﺑﻮط ﺑﻪ ﺷﻐﻞ ﻣﺎدران از ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎ اﺳﺘﺨﺮاج و ﺑﺮرﺳﯽ ﺗﻤﺎس ﺷﻐﻠﯽ ﻣﺎدر ﺑﺎ اﺳﺘﻔﺎده از روش ﻣﺎﺗﺮﯾﮑﺲ ارزﯾﺎﺑﯽ ﺷﻐﻞ اﻧﺠﺎم ﺷﺪ. ﺑﺮرﺳﯽ ﺧﺼﻮﺻﯿﺎت دﻣﻮﮔﺮاﻓﯿﮏ از ﻃﺮﯾﻖ آزﻣﻮن ﻫﺎي آﻣﺎري اﻧﺠﺎم ﺷﺪ. ﺗﻌﯿﯿﻦ ارﺗﺒﺎط ﺑﯿﻦ ﻣﻮاﺟﻬﻪ ﺷﻐﻠﯽ ﻣﺎدر ﺑﺎ ﺣﻠّﺎل و ﺑﺮوز ﻧﺎﻫﻨﺠﺎري ﺑﺎ اﺳﺘﻔﺎده از ﻧﺴﺒﺖ ﺷﺎﻧﺲ و ﻧﺴﺒﺖ ﺷﺎﻧﺲ ﺗﻌﺪﯾﻞ ﺷﺪه ﻣﺤﺎﺳﺒﻪ ﮔﺮدﯾﺪ. ﻧﺘﺎﯾﺞ: ﺗﻤﺎس ﺷﻐﻠﯽ ﻣﺎدران ﺑﺎ ﺣﻼل ﻫﺎ در ﻧﻤﻮﻧﻪ ﻣﻮرد (91/5%) ﻧﺴﺒﺖ ﻧﻤﻮﻧﻪ ﺷﺎﻫﺪ (83/2%) ﺑﯿﺸﺘﺮ ﺑﻮده اﺳﺖ و اﯾﻦ راﺑﻄﻪ از ﻟﺤﺎظ آﻣﺎري ﻣﻌﻨﯽ دار ﻣﯽ ﺑﺎﺷ(1/21-4/05=OR=2/16،%95 CI) ﺑﻌﺪ از ﺣﺬف اﺛﺮ ﻋﻮاﻣﻞ ﻣﺪاﺧﻠﻪ ﮔﺮ ﺗﻔﺎوت ﻣﻌﻨﺎداري ﺑﯿﻦ ﻣﻮاﺟﻬﻪ ﻣﺎدر ﺑﺎ ﺣﻼل و ﻧﺎﻫﻨﺠﺎري ﻗﻠﺒﯽ در ﻧﻮزادان ﻣﺸﺎﻫﺪه ﻧﺸﺪ(0/69-5=AOR =1/85،%95 CI). ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﯾﺎﻓﺘﻪ ﻫﺎي اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن ﻣﯽ دﻫﺪ ﮐﻪ ﯾﮑﯽ از ﻋﻮاﻣﻠﯽ ﮐﻪ اﺣﺘﻤﺎﻻً ﺑﺮ ﺳﻼﻣﺖ ﺟﻨﯿﻦ ﺗﺄﺛﯿﺮﮔﺬار اﺳﺖ ﺗﻤﺎس ﻣﺎدر ﺑﺎ ﺣﻼل ﻫﺎ ﻣﯽ ﺑﺎﺷﺪ. در اﯾﻦ راﺳﺘﺎ آﻣﻮزش ﻣﺎدران در ﺧﺼﻮص رﻋﺎﯾﺖ اﺳﺘﺎﻧﺪاردﻫﺎي ﺣﻔﺎﻇﺖ ﺷﻐﻠﯽ ﻣﯽ ﺗﻮاﻧﺪ ﺗﺄﺛﯿﺮ ﺑﺴﺰاﯾﯽ در ﮐﻨﺘﺮل ﻣﻮاﺟﻬﺎت ﺷﻐﻠﯽ و ﮐﺎﻫﺶ ﻧﺎﻫﻨﺠﺎريﻫﺎي ﻣﺎدرزادي داﺷﺘﻪ ﺑﺎﺷﺪ

Introduction: Recognition of maternal exposure to solvents and its relationship with congenital heart defects in infants can be effective in identifying effective environmental factors in the occurrence of anomalies. The aim of this study was to determine the relationship between maternal occupational exposure to solvent and birth congenital heart defects in infants. Method: In this case control study, 200 infants referred to Afshar Hospital of Yazd, who had congenital heart defects, were included in the sample as well as 400 healthy matched infants. A questionnaire consisting of three parts was used as a tool. The questionnaires were completed through a telephone interview. Mothers' job information was extracted from the questionnaires and a survey of maternal care was done using a matrix of job evaluation. Demographic characteristics were assessed by statistical tests. The relationship between occupational exposure to solvent and anomalies was calculated using odds ratios and adjusted odds ratios. Results: The maternal occupational exposure to solvents in the case sample (91.5%) was significantly higher than the control sample (83.2%), and this relationship was statistically significant (OR = 2/16, 95% CI=1/21-4/05) after the elimination of the effect of interfering factors, there was no significant difference between mother's exposure to solvent and cardiac anomalies in infants (AOR = 1.85, 95% CI=0/69-5). Conclusion: The findings of this study indicate that one of the factors that may affect the health of the fetus is the mother's contact with solvents. In this regard, mothers' training on compliance with occupational safety standards can have a significant effect on occupational exposure control.