广州市2009至2010年出生缺陷监测分析

Monitoring analysis of birth defects from 2009 to 2010 in Guangzhou

目的 探讨广州市2009至2010年出生缺陷发生率、发生类型、转归及影响因素.方法 收集并分析广州市全部148家医院在2009至2010年期间分娩儿出生缺陷监测资料.结果 共监测352 084例围产儿,发生出生缺陷5 724例,出生缺陷发生率162.6/万,前五位缺陷类型依次是先天性心脏病、多指（趾）、总唇腭裂、马蹄内翻足和外耳其他畸形.男性围产儿的出生缺陷发生率高于女性（177.74/万 vs 144.66/万,P〈0.05）,早产儿的出生缺陷发生率高于足月儿（756.40/万 vs 122.19/万,P〈0.05）,孕母年龄越大,发生出生缺陷的风险越高（P〈0.05）.严重出生缺陷的治疗性引产率超过60%.结论 广州市出生缺陷发生率偏高,应重视对男婴、早产儿的先天畸形检查,加强对高龄孕妇的管理.提高产前确诊率和致死性畸形的治疗性引产率.

Objective To explore the incidence, type, outcomes and influencing factors of birth defects in Guangzhou from 2009 to 2010. Methods The data of birth defects during this period from all of 148 hospitals in Guangzhou was collected and analyzed. Results Among 352 084 perinatal infants monitored, 5 724 cases were detected with birth defects with incidence of 162.6 per ten thousand. The first five birth defects were congenital heart disease, polydactylia, total cheiloschisis/palatoschisis, congenital talipes equino varus and deformity of external ear in order. The incidence of birth defects in boys was higher than that in girls （ 177.74/ten thousand vs 144.66/ten thousand, P 〈 0.05）, and it was higher in premature infants than term infants （756.40/ten thousand vs 122. 19/ten thousand, P 〈 0..05 ）. The older the pregnant women were, the greater the risk of birth defects was. The rate of therapeutic termination of severe birth defects was more than 60%. Conclusion The incidence of birth defects is slightly high in Guangzhou. Attention should be paid to malformation examination on male infants and premature infants, and the management on advanced age pregnant women should be strengthened. In addition, prenatal diagnostic rate and the rate of therapeutic termination of fetal malformations need to be increased.