唐氏筛查高危孕产妇妊娠结局随访分析

Follow-up analysis on pregnancy outcome with high risk of Down＇s syndrome

目的 了解北京市西城区唐氏高危人群妊娠结局、超声筛查等情况,了解经唐氏高危者与出生缺陷的关系,完善出生缺陷的二级预防.方法 对2008年10月1日-2009年9月30日间北京市西城区产科医院随机抽取466名唐氏筛查高危患者,对每例孕产妇妊娠结局通过病案室调取病历及电话进行随访.结果 ①不同年龄组中唐氏高危筛查有明显统计学意义（χ2=22.396,P=0.001）;②466例唐氏筛查高危孕妇,妊娠结局异常67例（14.4%）,其中出生缺陷42例;③42例出生缺陷中,19例由超声筛查发现,14例由唐氏筛查羊水穿刺发现,4例超声筛查及唐氏筛查同时发现异常,3例唐氏筛查与超声筛查均未发现异常.结论 ①21-三体高危与孕妇年龄有关;②唐氏筛查高危与妊娠结局异常、出生缺陷相关;③唐氏筛查与超声筛查互为补充.

Objective To investigate the relation between high risk of Down＇ s syndrome and birth defect by studying the pregnancy outcome with high risk of Down＇ s syndrome and ultrasound screening in Xicheng district of Beijing, and to improve secondary prevention of birth defect. Methods From October 1 st of 2008 to September 30th of 2009, 466 cases with high risk of Down＇ s syndrome were randomly selected from Gynecological Hospitals in Xicheng district of Beijing and followed up by the way of case extraction and telephone. Results There were statistical differences among groups of different ages in screening Down＇ s syndrome （X2 = 22. 396, P = 0. 001 ）. Of 466 pregnant women with high risk of Down＇ s syndrome, there were 67 abnormal deliveries （ 14.4% ）, including 42 cases with birth defects. Among 42 cases with birth defects, 19 were found to be abnormal before delivery by ultrasound screening, 14 by amniocentesis in screening Down＇ s syndrome, 4 both by ultrasound screening and Down＇ s syndrome screening, but 3 were not found either by Down＇ s syndrome screening or by ultrasound screening. Conclusion Trisomy 21 high risk is related with pregnant women＇ s age, and high risk of Down＇ s syndrome is associated with abnormal pregnancy outcome and birth defects. Down＇ s syndrome screening and ultrasound screening could complement each other in detecting pregnancy outcome and birth defect.