宜昌市夷陵区36586例围产儿出生缺陷监测结果分析

A Survey on Birth Defects Among 36586 Perinatal Infants in Yiling District,Yichang

目的:了解宜昌市夷陵区围产儿出生缺陷发生状况及影响因素。方法:对夷陵区内医疗保健机构2005-2013年出生缺陷监测数据进行整理,分析出生缺陷的发生率、缺陷类型、发生出生缺陷儿母亲孕期情况,并跟踪随访。结果:9年期间共监测36 586例围产儿,出生缺陷345例,出生缺陷发生率9.43‰,出生缺陷发生率从2007-2011年呈逐年上升趋势,2012年开始下降。缺陷类型前5位为先天性心脏病、多指、唇腭裂、外耳畸形、脑积水和马蹄内翻足;男性围产儿出生缺陷发生率高于女性围产儿(P=0.049);母亲来自农村的出生缺陷发生率高于城镇(P<0.001);产前确诊率为37.39%;母亲孕早期患病、接触化学物质及异常生育史与出生缺陷有一定相关。结论:加强健康教育、遗传咨询与孕前优生检查,做好孕期保健和产前检查,指导高危孕妇、农村孕妇进行产前筛查与诊断,是减少我区出生缺陷发生的关键与有效措施。

Objective：To survey the incidence and related factors of birth defects among perinatal infants in Yiling District of Yichang,Hubei province.Methods：Data of birth defects among perinatal infants in health care organizations of Yiling District from 2005 to 2013were collected according to the monitoring projects National Birth Defects Monitoring Requirements and Maternal Mortality,Mortality and Birth Defects of Children under 5Reporting System in Hubei Province.Incidence,types of birth defects and prenatal related factors were analyzed.Results：The incidence of birth defects among 36 586 perinatal infants during 9years was 9.43‰（345cases）,and there was an upward trend from 2007 to 2011,then downward in 2012.The perinatal birth defects stood on the first 5rank of incidence list followed by congenital heart disease,multi-finger,cleft lip and palate,hydrocephalus,and clubfoot.The male birth defects were more frequent seen than female（P=0.049）.The incidence of birth defects of perinatal infants whose mother from rural areas was higher than those whose mother from city（P〈0.001）.37.39%cases were confirmed in prenatal diagnosis.Illness of mother during early pregnancy,exposure to chemical substances and abnormal reproductive history might be associated with birth defects.Conclusion：Strengthening health education,genetic counseling,pre-pregnancy eugenic examination,pregnancy andprenatal care,and guiding high-risk and rural pregnant women to prenatal screening and diagnosis,are critical and effective measures to reduce the incidence of birth defects in our region.