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目的:探讨产前超声监测胎儿心头比和颈项透明层厚度对高龄妊娠胎儿出生缺陷风险的评估价值。方法:选择2018年3月至2020年3月在我院行超声检查的3 112例孕妇，根据其胎儿有无出生缺陷分为无出生缺陷组（2 957例）与有出生缺陷组（155例），比较两组胎儿心头比、颈项透明层厚度，采用Spearman检验分析胎儿心头比、颈项透明层厚度与胎儿出生缺陷的相关性，Logistic回归分析胎儿出生缺陷的危险因素，受试者工作特征曲线（ROC）分析胎儿心头比、颈项透明层厚度预测胎儿出生缺陷的价值。结果:与无出生缺陷组相比，有出生缺陷组胎儿心头比、颈项透明层厚度增加（n P<0.05）；胎儿心头比、颈项透明层厚度与胎儿出生缺陷呈正相关（n P<0.05）；胎儿心头比增加、胎儿颈项透明层厚度增加是胎儿出生缺陷的危险因素（n P<0.05）；颈项透明层厚度评估胎儿出生缺陷风险的价值优于心头比（n P<0.05）；心头比联合颈项透明层厚度评估胎儿出生缺陷风险的价值优于两项单独检查（n P<0.05）。n 结论:产前超声监测胎儿心头比和颈项透明层厚度联合评估高龄妊娠胎儿出生缺陷风险的价值较高，有助于降低高龄妊娠胎儿出生缺陷，对优生优育意义重大。“,”Objective:To investigate value of prenatal ultrasound monitoring of fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness in assessing the risk of birth defects in pregnant women of advanced maternal age.Methods:A total of 3112 pregnant women who underwent ultrasound examination in our hospital between March 2018 and March 2020 were enrolled and divided into birth defect free group (n n=2957) and birth defect group (n n=155) according to presence of birth defects. The fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness were compared between groups. The correlation between fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness and fetal birth defects was analyzed by spearman test. The risk factors of fetal birth defects were analyzed by Logistic regression. The value of fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness in predicting fetal birth defects was analyzed by receiver operating characteristic curve (ROC) .n Results:The fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness in the birth defect group were larger than those in the birth defect free group (n P<0.05) . The fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness were positively correlated with the incidence rate of fetal birth defects (n P<0.05) . Increased fetal cardiac diameter to biparietal diameter ratio and increased nuchal translucency thickness were risk factors for fetal birth defects (n P<0.05) . Nuchal translucency thickness performed better than fetal cardiac diameter to biparietal diameter ratio in assessing the risk of fetal birth defects (n P<0.05) . The combined detection of fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness was more clinically valuable than either alone in assessing the risk of fetal birth defects (n P<0.05) .n Conclusion:Prenatal ultrasound monitoring of fetal cardiac diameter to biparietal diameter ratio and nuchal translucency thickness offers high clinical value in assessing the risk of fetal birth defects in pregnant women of advanced maternal age and effectively reducing birth defects, therefore is important from an eugenic perspective.