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目的了解山东省出生缺陷的流行趋势、顺位变化和分布特征,探寻引起出生缺陷可能的危险因素。方法以调查问卷为基础,依据《中国出生缺陷监测工作手册》进行诊断,采用分层、随机、整群的抽样方法,逐户进行调查。结果此次调查共收集了有效调查问卷82 651份,婴幼儿共计99 181人,发生出生缺陷691人,出生缺陷发生率为6.97‰;男性出生缺陷发生率为8.10‰,女性出生缺陷发生率为5.63‰;农村出生缺陷发生率为7.44‰,城市出生缺陷发生率为6.20‰;性别、城乡出生缺陷发生率经卡方检验,均有统计学意义。出生缺陷前五位的顺位为先天性心脏病、多/并指(趾)、总唇裂(唇裂、腭裂、唇腭裂)、先天性脑积水、尿道下裂。结论山东省出生缺陷发生率处于较低水平,并有性别、城乡差异。优生筛查、增补叶酸对降低出生缺陷具有保护作用。高龄孕妇、父亲接触毒物或职业危害因素、吸烟是出生缺陷的危险因素。
Objective To understand the epidemic trend, sequence change and distribution of birth defects in Shandong Province and to explore the possible risk factors of birth defects. Methods Based on the questionnaire, the diagnosis was made according to “Handbook of Birth Defects Monitoring in China”, and stratified, randomized and cluster sampling methods were used to carry out household surveys. Results A total of 82 651 valid questionnaires were collected in this survey. A total of 99 181 infants and young children were collected. There were 691 birth defects and 6.97 ‰ birth defects. The incidence of birth defects in men was 8.10 ‰. The incidence of female birth defects was 5.63 ‰; the incidence of rural birth defects was 7.44 ‰, the incidence of urban birth defects was 6.20 ‰; The incidence of gender, urban and rural birth defects by chi-square test were statistically significant. The top five birth defects are congenital heart disease, multiple / and finger (toe), the total cleft lip (cleft lip, cleft palate, cleft lip and palate), congenital hydrocephalus, hypospadias. Conclusions The incidence of birth defects in Shandong Province is at a low level with gender, urban-rural differences. Eucalyptus screening, folic acid supplementation to reduce birth defects have a protective effect. Elderly pregnant women, fathers exposure to toxic or occupational hazards, smoking is a risk factor for birth defects.