上海市浦东新区出生缺陷患儿父母生育年龄与常见缺陷疾病的关系探讨

Study on the Relationship between the Common Types of Birth Defects and Birth Age of Parents of the Perinatal Infants in Pudong, Shanghai

目的探讨上海市浦东新区出生缺陷患儿父母生育年龄与常见缺陷疾病的关系。方法收集2011—2013年浦东新区出生缺陷监测资料,包括患儿出生时间、出生缺陷病种、父亲年龄、母亲年龄等。根据国际疾病分类（ICD-10）标准将出生缺陷病种划分为：神经系统先天性畸形（Q00-Q07）、眼、耳、面和颈部先天性畸形（Q10-Q18）、循环系统先天性畸形（Q20-Q28）、呼吸系统先天性畸形（Q30-Q34）、唇裂和腭裂（Q35-Q37）、消化系统的其他先天性畸形（Q38-Q45）、生殖器官先天性畸形（Q50-Q56）、泌尿系统先天性畸形（Q60-Q64）、肌肉骨骼系统先天性畸形和变形（Q65-Q79）、其他先天性畸形（Q80-Q89）和染色体异常,不可归类在他处者（Q90-Q99）11类出生缺陷,统计各年度出生缺陷患儿数量;根据《中国人群出生缺陷监测方案》,将母亲年龄划分为15-19、20-24、25-29、30-34、35-39、40-44岁6个年龄组,将父亲年龄划分为15-19、20-24、25-29、30-34、35-39、40-44、45-49岁7个年龄组,按出生缺陷种类分别统计各年龄段父、母亲人数。结果 2011年,浦东新区出生缺陷患儿332例,出生总数38 729人,出生缺陷发生率为0.86%;2012年出生缺陷患儿547例,出生总数45 107人,出生缺陷发生率为1.21%;2013年出生缺陷患儿326例,出生总数29 418人,出生缺陷发生率为1.11%。2011—2013年,出生缺陷类型发生顺位居前三位的是肌肉骨骼系统先天性畸形和变形,循环系统先天性畸形,眼、耳、面和颈部先天性畸形。在出生缺陷疾病中,发生顺位居首位的是先天性心脏病,其次是多指（趾）和外耳其他畸形。先天性心脏病、多指（趾）、外耳其他畸形患儿父亲、母亲年龄分布比较,差异均有统计学意义（P〈0.01）。先天性心脏病在30-34岁构成比高于其他年龄段（P〈0.05）;多指（趾）和外耳其他畸形在25-29岁构成比均高于其他年龄段（P〈0.05）。结论父母生育年龄与出生缺陷类型关系密切,先天性心脏病患儿父母年龄较高,为30-34岁,多指（趾）和外耳其他畸形患儿父母年龄多处于25-29岁;应针对不同年龄段生育父母制定更为个性化的预防方案。

Objective To investigate the relationship between birth defects in children and the birth age of the parents in Pudong,Shanghai. Methods Collecting the monitoring data of birth defect between 2011 and 2013 in Pudong New Area including birth time, types of birth defects, fathers＇ age and mothers＇ age. According to the International Classification of Disease（ ICD- 10）,the birth defect diseases include 11 kinds of congenital abnormalities： nerve system（ Q00- Q07）,eyes,ears,faces and necks（ Q10- Q18）,circulatory system（ Q20- Q28）,respiratory system（ Q30- Q34）,cleft and palate（ Q35- Q37）,digestive system（ Q38- Q45）,reproductive organs（ Q50- Q56）,urinary system（ Q60- Q64）,skeleton and muscular system（ Q65- Q79）,others and chromosome abnormalities（ Q80- Q89） and the one that can not be classified into other systems（ Q90- Q99）. According to ＂ Chinese Population Birth Defect Monitoring Project ＂, mothers＇ age was divided into six groups： 15- 19,20- 24,25- 29,30- 34,35- 39,40- 44, and fathers＇ age was divided into seven groups： 15- 19,20- 24,25- 29,30- 34,35- 39,40- 44,45- 49. The number of birth defect was calculated each year and so were the number of mother and father with defect infant in each age stage according to the classification of birth defect types. Results In 2011,the incidence of birth defects in Pudong New Area was 332,accounting for 0. 86% in the total of38 729 new- borns; in 2012 and 2013,the numbers were 547 and 326, accounting for 1. 21% and 1. 11% in the total of45 107 and 29 418, respectively. During 2011- 2013, the first three congenital abnormalities were skeleton and muscular abnormalities and distortion,circulatory system abnormality,eye,ear,face,neck abnormality. Congenital heart disease was the first and multi finger（ toe） and external ear malformation was the second in the sequences of occurrence and the birth age distribution of the mothers and fathers had statistical significance（ P〈 0. 01）. The rate of congenital heart disease was the highest in parents aged 30- 34 with significant difference（ P〈 0. 05） and the rate of multi- finger（ toe） was the highest in 25- 29 age group with significance（ P〈 0. 05）. Conclusion Parents＇ birth age is closely related to types of birth defect. Parents of infants with congenital cardiac disease are aged 30- 34,which is relatively higher. The parents of infants with multi finger（ toe） and external ear malformation are mostly aged 25- 29. Personalized intervention measures should be taken according to parents with different birth ages.