杭州市2014～2015年医院监测多胎出生缺陷情况调查分析

Investigation and analysis of hospital monitoring of multiple birth defects in Hangzhou from 2014 to 2015

目的通过对杭州市2014年1月~2015年12月医院监测多胎出生缺陷发生情况、类型进行分析,为多胎围产儿出生缺陷预防、控制工作提供科学、准确的依据。方法 采用流行病学回顾性调查研究方法,按照国家出生缺陷医院监测方案,分析监测医院内出生或引产的围产儿（孕周≥28周）,在此期间首次确诊的主要出生缺陷资料。结果 纳入监测范围内医院共出生围产儿75 798例,其中合并出生缺陷1529例,总出生缺陷发生率为20.2‰;多胎围产儿3466例,合并出生缺陷112例,发生率为32.3‰。出生缺陷第一顺位为先天性心脏病,多胎围产儿出生缺陷发生率明显高于单胎出生缺陷率,产前确诊率明显低于单胎（P〈0.05）。结论 规范多胎孕期超声筛查,提高产前筛查及诊断水平,可有效降低多胎出生缺陷发生率。

Objective To analyze the incidence and types of muhiple birth defects monitored in hospitals in Hangzhou from January 2014 to December 2015, and to provide scientific and accurate basis for the prevention and control of birth defects in multiple perinatal births. Methods A retrospective epidemiological survey was conducted to analyze and monitor the perinatal infants who were born or induced in the hospital （gestational age≥ 28 weeks）, and the data of the birth defects initially diagnosed during the period of perinatal birth. Results 75 798 cases Of perinatal birth were included in the monitoring scope, including 1529 cases of birth defects, and the total birth defect rate was 20.2%0; multiple births were in 3466 cases, and combined birth defects were in 112 cases, with the incidence of 32.3%0. The first place for birth defects was congenital heart disease. The incidence rate of birth defects in multiple perinatal birth was significantly higher than that in single birth defects, and the prenatal diagnosis rate was significantly lower than that in single birth（P〈0.05）. Conclusion Standardization of multiple pregnancy screening ultrasound, and improvement of prenatal screening and diagnostic level are able to effectively reduce the incidence of multiple birth defects.