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目的了解西安市围产儿出生缺陷的动态流行特征,为今后出生缺陷预防工作的重点提供科学依据。方法对2010-2015年西安市所有产科医院上报的出生缺陷资料进行统计描述。结果出生缺陷平均发生率为89.62/104(87.50/104,91.74/104),缺陷发生率逐年上升(χ~2=157.13,P<0.01)。出生缺陷发生率位于前5位的依次为:先天性心脏病(26.53/104)、多指(趾)(13.10/104)、总唇腭裂(11.42/104)、神经管缺陷(6.06/104)、先天性脑积水(5.08/104),共占出生缺陷总数的69.39%。其中,先天性心脏病的发生率呈逐年上升趋势(χ2=837.65,P<0.01)。出生缺陷发生率城市高于农村(OR=1.108,95%CI:1.056~1.162),男婴高于女婴(OR=1.151,95%CI:1.097~1.208),母亲年龄<20岁(OR=1.764,95%CI:1.532~2.032)和母亲年龄≥35岁(OR=1.283,95%CI:1.179~1.395)也是缺陷儿发生的危险因素。缺陷儿以活产居多(72.54%),通过超声和临床诊断的病例各占52.83%和46.24%,产前诊断率为33.20%。结论西安市2010-2015年围产儿出生缺陷发生率总体有增加的趋势,应不断提高各监测点的产前诊断能力,从而降低本地区的缺陷发生水平,提高出生人口素质。
Objective To understand the dynamic epidemiological characteristics of birth defects in perinatal children in Xi’an and to provide a scientific basis for the prevention of birth defects in the future. Methods The data of birth defects reported by all maternity hospitals in Xi’an from 2010 to 2015 were statistically described. Results The average incidence of birth defects was 89.62 / 104 (87.50 / 104,91.74 / 104). The incidence of defects increased year by year (χ ~ 2 = 157.13, P <0.01). The incidence of birth defects in the top 5 were congenital heart disease (26.53 / 104), multiple digits (13.10 / 104), total cleft lip and palate (11.42 / 104), neural tube defects (6.06 / 104) , Congenital hydrocephalus (5.08 / 104), accounting for 69.39% of the total number of birth defects. Among them, the incidence of congenital heart disease increased year by year (χ2 = 837.65, P <0.01). The incidence of birth defects was higher in urban areas than in rural areas (OR = 1.108, 95% CI: 1.056-1.162), higher for male infants than for female infants (OR = 1.151, 95% CI: 1.097-1.208) 1.764, 95% CI: 1.532-2.032) and maternal age ≥35 years (OR = 1.283, 95% CI: 1.179-1.395) were also risk factors for the development of defective children. Defective children with live births (72.54%), by ultrasound and clinical diagnosis of the cases accounted for 52.83% and 46.24%, the prenatal diagnosis rate was 33.20%. Conclusions The incidence of perinatal birth defects in 2010-2015 in Xi’an tends to increase. Therefore, the prenatal diagnosis ability of each monitoring point should be continuously improved to reduce the occurrence of defects and improve the quality of birth population.