随访后校正的新生儿先天性心脏病发病率研究

Incidence of congenital heart disease screened in 9156 term neonates at birth should be corrected after one year follow-up

目的新生儿初生时筛查出的先天性心脏病（简称先心病），经随访后再确诊先心病，以求获得较准确的先心病发病率。方法对北京郊区3家医院2002年1月至2007年1月出生0～7d的足月活产儿9156例进行先心病筛查，可疑者再经彩色多普勒超声心动图诊断，出院后每3个月定期随访至1岁，以明确诊断。结果按北京市统一的《出生信息登记卡》要求登记生后0～7d先心病者272例，发病率为2．97％（272／9156）；其中当时即能确诊先心病者73例，需经随访才能确诊者199例，失访51例，148例经随访，仅10例能确诊先心病，其余均可排除先心病。另有11例初生时未查出先心病，出院后被新确诊。最终确诊先心病共94例。发病率校正为1．03％（94／9105）。结论统计新生儿先心病发病率，应以随访1年校正诊断后为准。

Objective The neonates with congenital heart disease （CHD） screened after birth should be followed-up to exclude abnormalities of fetal transition and this study aimed at defining a more accurate incidence of neonatal CHD. Methods Totally, 9156 term neonates at 0-7 d after birth were recruited from 3 rural hospitals from Mar. 2002 to Jan. 2007. Color Doppler echocardiography was performed for the infants with clinical suspected CHD. The infants with CHD and mild defect were followed-up from 3 month to 1 year periodically in the outpatient clinic after discharge. Results Seventy-three infants were confirmed CHD and 199 were mild defect at birth. The incidence of neonatal CHD of 2.97% （272/9156）. Only 148 of the 199 mild defect cases were followed-up, among them only 10 cases were diagnosed with CHD and 51 were lost. Another 11 new cases were detected after discharge. CHD were finally confirmed in 94 cases and the corrected incidence of neonatal CHD was 1. 03% （94/9156）. Conclusions The neonatal CHD should be diagnosis until one year old to provide a more accurate incidence.