秦皇岛流动人口新生儿出生缺陷的疾病类型及其影响因素分析

Analysis on the type of different diseases of birth defects and its influencing factors in Qinghuangdao floating population

目的:分析秦皇岛流动人口新生儿出生缺陷的疾病类型及其影响因素。方法:选取2010年2月至2016年12月在秦皇岛地区分娩的流动人口出生缺陷儿50例作为观察组,同期选择经确诊为无出生缺陷的新生儿250例作为对照组,记录出生缺陷儿的疾病类型与预后情况,同时对两组新生儿与父母的一般资料进行分析。结果:50例出生缺陷儿中,苯丙酮尿症6例,先天性甲状腺功能低下症8例,唐氏综合征9例,性染色体及其他常染色体异常7例,肌肉骨骼系统畸形5例,循环系统畸形10例,其他畸形5例。活产45例,死胎或死产2例,产后7 d内死亡1例,2例为产前诊断为出生缺陷后进行治疗性引产。两组新生儿的胎龄、体重、分娩方式等比较,差异有统计学意义(P<0.05)。单因素分析显示,两组产妇自然流产史、孕早期服用药物、孕早期接触危险物质、孕早期被动吸烟、孕早期感冒史、居住地存在污染源等因素比较,差异具有统计学意义(P<0.05)。多因素条件Logistic回归分析显示,孕早期感冒史、居住地存在污染源、孕早期服用药物、自然流产史为导致新生儿出生缺陷的独立危险因素(均P<0.05)。结论:秦皇岛流动人口新生儿缺陷中循环系统畸形及唐氏综合征所占比例较高,产妇孕早期感冒史、居住地存在污染源、孕早期服用药物、自然流产史为导致秦皇岛流动人口新生儿出生缺陷的独立危险因素,应加强产前疾病筛查以降低流动人口的新生儿出生缺陷率。

Objective： To analyze the type of different diseases of birth defects and its influencing factors in Qing- huangdao floating population. Methods： From February 2010 to December 2016, 50 cases with birth defects in Qinhuangdao was selected as an observation group, and 250 normal cases were enrolled as a control group, the type of different diseasesand prognosis were recorded and compared. Results： There were 6 cases had phenylke- tonuria, 8 cases had congenital hypothyroidism, 9 cases had Down＇s syndrome, 7 cases had sex chromosomes and other common chromosomal abnormalities, 5 cases got musculoskeletal system deformed, 10 cases got circulatory system anomaly, and 5 cases got other malformation in the observation group. Live births in 45 cases, stillbirth or stillbirth in 2 cases, and postpartum death within 7 days in one case. 2 cases prenatally diagnosed with birth de- fects received labor induction. There were significant differences in gestational age, weight and delivery mode be- tween the two groups（P〈0.05）. The history of spontaneous abortion, early pregnancy medication, early pregnan- cy exposure to dangerous substances, early pregnancy passive smoking, early pregnancy cold history, live in the presence of pollution sources were correlated with birth defects （P〈 0. 05）. Multivariate logistic regression analy- sis revealed that early pregnancy cold history, live in the presence of pollution sources, early pregnancy medica- tion and spontaneous abortion history were independent risk factors for birth defects （P〈 0.05）. Conclusion： The proportion of birth defects with circulatory system anomaly and Down＇s syndrome was high in Qinhuangdao float- ing population. The early pregnancy cold history, live in the presence of pollution sources, early pregnancy medication and spontaneous abortion history were independent risk factors for birth defects. Therefore, neonatal disease screening should be strengthened in order to reduce the rate of birth defects.