三峡库区0～14岁儿童出生缺陷调查与分析

Investigation and analysis of 0～14 years old children with birth defects in Three Gorges Reservoir Area

目的:了解三峡库区7个区县0～14岁儿童的出生缺陷现状。方法:按ICD-10所列病种设计调查表,采用分层整群随机抽样现场对0～14岁儿童出生缺陷开展调查,包括出生缺陷的种类、发生率、城乡儿童出生缺陷发生比例、不同部位发生情况等,收集出生缺陷/遗传病信息数据。结果:获得有效调查问卷7 977份,出生缺陷种类24种患儿158例,出生缺陷发生率19.81‰。前4位为:唇裂73例,发生率9.152‰;肢体畸形17例,发生率2.137‰;脑积水14例,发生率1.755‰;心脏畸形12例(男童5例,女童7例),发生率1.504‰。其中男童95例,出生缺陷发生率22.37‰;女童63例,出生缺陷发生率16.89‰,男童明显高于女童(χ2=204.44,P<0.005)。城市儿童2 198例(27.55%)中出生缺陷42例,农村儿童5 779例(72.45%)中出生缺陷116例;城市儿童出生缺陷发生率19.11‰,农村为20.07‰,两者比较无统计学差异(χ2=0.076,P=0.782)。发生部位第一位是面部缺陷86例(54.43%),第二位为神经缺陷20例(12.66%),第三位为四肢缺陷17例(10.76%),第四位为心脏缺陷12例(7.59%),第五位为泌尿生殖缺陷6例(3.80%),其他缺陷17例(10.76%)。结论:对出生缺陷扩大监测地区、监测时间、监测病种,加强孕前优生指导和检查,做好出生缺陷预防干预,降低出生缺陷发生率。

Objective：To understand Three Gorges Reservoir Area 7 counties 0~14 years old children＇s birth defects present situation,type,incidence,urban and rural children＇s birth defect occurrence,occurring at different positions of the situation,collect birth defects/genetic disease information data to prevent birth defects and provide the scientific basis.Methods：According to ICD-10 coding diseases listed design questionnaire,stratified cluster random sampling was used to the scene to carry out investigations on the 0~14 years old children suffering from birth defects.Results：There were 7 977 meals available questionnaire,including 24 types of birth defect with 158 people,and the incidence of birth defects was 19.81‰.The first 4 types of the study were cleft lip（73 cases,incidence 9.152‰）;limb deformities（17 cases,incidence 2.137 ‰）;hydrocephalus（14 cases,incidence 1.755‰）;cardiac malformations（12 cases including 5 cases of boys and 7 cases of girls,incidence 1.504‰）.There were 95 boys with the incidence of birth defects 22.37‰,63 girls with the incidence of birth defects 16.89 ‰.The boy＇s incidence of birth defects was obviously higher than that of girl（chi-square=204.44,P0.005）.There were 42 children with birth defects in 2 198 urban children（27.55%） and 116 children with birth defects in 5 779 rural children（72.45%）.The urban children＇s birth defect rate was 19.11 ‰ and the countryside was 20.07‰.There was no statistical difference（chi-square = 0.076,P= 0.782） between them.Location was the first facial defects 86 cases（54.43%）,the second for nerve defect 20 cases（12.66%）,the third for limbs defect 17 cases（10.76%）,the fourth for heart defects 12 cases（7.59%）,the fifth for urogenital defect 6 patients（3.80%）,other defects 17 cases（10.76%）.There was significant difference（chi-square = 34.11,P0.01） between the first birth defects and other parts.Conclusion：Birth defects＇ monitoring area,monitoring time,monitoring disease should be expanded and healthy pregnant guidance and inspection should be strengthened to prevent birth defects intervention and reduce the incidence of birth defects.