山东省出生缺陷流行病学调查研究

Investigation on the epidemiology of birth defects in Shandong province

目的了解山东省出生缺陷的流行趋势、顺位变化和分布特征,探寻引起出生缺陷可能的危险因素。方法以调查问卷为基础,依据《中国出生缺陷监测工作手册》进行诊断,采用分层、随机、整群的抽样方法,逐户进行调查。结果此次调查共收集了有效调查问卷82 651份,婴幼儿共计99 181人,发生出生缺陷691人,出生缺陷发生率为6.97‰;男性出生缺陷发生率为8.10‰,女性出生缺陷发生率为5.63‰;农村出生缺陷发生率为7.44‰,城市出生缺陷发生率为6.20‰;性别、城乡出生缺陷发生率经卡方检验,均有统计学意义。出生缺陷前五位的顺位为先天性心脏病、多/并指(趾)、总唇裂(唇裂、腭裂、唇腭裂)、先天性脑积水、尿道下裂。结论山东省出生缺陷发生率处于较低水平,并有性别、城乡差异。优生筛查、增补叶酸对降低出生缺陷具有保护作用。高龄孕妇、父亲接触毒物或职业危害因素、吸烟是出生缺陷的危险因素。

Objective：To investigate the prevalence trends,sequence changes and distribution characteristics of birth defects in Shandong Province,and to explore the possible risk factors causing birth defects. Methods：Stratified random cluster sampling method was used in the investigation based on a questionnaire and ＂Chinese Birth Defects Monitoring Handbook＂. Results：This survey were collected 82 651 copies of valid questionnaires with 99 181 infants including 691 patients with birth defects,and the incidence rate of birth defects was 6.97‰. Male incidence rate was 8.10‰ and female incidence rate was 5.63‰. The incidence rate in rural areas was 7.44‰,and the urban was 6.20‰. There was statistical significance between male and female,rural and urban areas in the incidence rate of birth defects by chi-square test. The top five order of birth defects was congenital heart disease,multiple / parallel（toe）,total cleft lip（cleft lip,cleft palate,cleft lip and palate）,congenital hydrocephalus,hypospadias. Conclusions：The prevalence of birth defects in Shandong Province was at a low level,and had gender,urban and rural differences. Birth health screening and folic acid supplements have a protective effect on birth defects reduction. Advanced maternal age,the father exposure to toxic hazards and smoking are risk factors for birth defects.