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目的了解影响出生缺陷发生的相关因素,制定干预措施。方法以三级妇幼保健网为依托,选择了3所县级以上医院、6个乡镇医院为监测点,对1997年1月1日至2005年12月31日间在监测点出生的28632例围产儿进行了出生缺陷监测。结果发现出生缺陷儿195例,各年度的出生缺陷发生率分别为5.30‰、6.38‰、6.04‰、6.55‰、7.75‰、7.50‰、7.40%、7.21%、7.59%,呈明显的上升趋势;出生缺陷前五位分别是多指、唇裂合并腭裂、脊柱裂、先天性脑积水及无先天性心脏病;产妇年龄大于30岁是出生缺陷的高危因素,发生率为11‰;孕母的学历高低与出生缺陷儿发生率有明显差别,大专以上学历的发生率为2.61‰,而高中以下学历的发生率为7.05‰;出生缺陷儿死亡是导致围产儿死亡的主要原因。结论为降低出生缺陷儿的发生,要采取早期干预措施,提高出生人口素质,选择最佳受孕年龄,做好出生缺陷危险因素筛查与风险评估、孕前咨询、宣传教育、卫生指导,构建防治出生缺陷的长效机制,减少缺陷儿的出生。
Objective To understand the factors that affect birth defects and to make interventions. Methods Based on the three-level maternal and child health care network, three hospitals above the county level and six township hospitals were selected as monitoring points. A total of 28,632 cases were surveyed at the monitoring sites from January 1, 1997 to December 31, 2005 Births were monitored for birth defects. The results showed that there were 195 cases of birth defects, the incidence of birth defects in each year was 5.30 ‰, 6.38 ‰, 6.04 ‰, 6.55 ‰, 7.75 ‰, 7.50 ‰, 7.40%, 7.21% and 7.59% The first five birth defects were multiple fingers, cleft lip with cleft palate, spina bifida, congenital hydrocephalus and no congenital heart disease. Maternal age> 30 years old was the risk factor of birth defects, the incidence was 11 ‰; There was a significant difference between the educational level and the birth defect rate. The incidence rate of college education was 2.61 ‰, while that of high school education was 7.05 ‰. The death of birth defects was the main cause of perinatal death. Conclusion To reduce the incidence of birth defects, early interventions should be taken to improve the quality of the birth population, select the best age for conception, screening and risk assessment of risk factors for birth defects, pre-pregnancy counseling, publicity and education, health guidance, and establishment of birth control Defective long-acting mechanism to reduce the birth of defective children.