广东省出生缺陷检出情况的空间聚集性分析

Spatial aggregation analysis of incidence of birth defect in Guangdong

目的了解广东省围产儿出生缺陷检出的空间聚集性分布,为制定区域性出生缺陷防控策略提供参考依据。方法以2015-2016年在广东省所有助产机构分娩的围产儿(孕满28周至出生后7天)及产妇为研究对象,采用SaTScan进行空间扫描分析,运用ArcGis对出生缺陷检查率的地区分布及空间扫描分析结果进行地图呈现。结果 2015-2016年广东省所有助产机构监测的出生缺陷发生率为143.60/万(47 188/3 286 009),发病率前五位的出生缺陷种类分别是:先天性心脏病、G6PD缺乏症、多指(趾)、胎儿水肿综合征、马蹄内翻足。空间扫描统计结果显示,近两年广东省存在3个有统计学意义的出生缺陷聚集区域(RR值分别为4.31、1.62、1.28,均P<0.001):一级聚集区域为佛山市,检出率为502.00/万;二级聚集区域为珠海市、中山市和深圳市,总检出率为208.70/万;三级聚集区域为东莞市和广州市,总检出率为175.22/万。结论广东省出生缺陷存在聚集性分布特征,需要开展区域差异性出生缺陷防控策略。

Objective To investigate the special aggregation of birth defect in Guangdong Province so as to provide scientific evidence for regional preventive strategies. Methods Perinatal and maternal information was collected from all midwifery hospitals in Guangdong from 2015 to 2016. SaTScan software was employed to analyze the spatial aggregation, and ArcGis was used for map rendering. Results The incidence of birth defect from 2015 to 2016 in Guangdong was 143.60/10 000 （47 188/3 286 009）. The types of birth defect with high incidence in Guangdong were congenital heart disease, G6PD deficiency, polydactyly, fetal hydropsy, and talipes equinovarus in order. Spatial scanning statistical results showed that there were 3 birth defect concentrated areas with statistically significance （P〈0.001）. The first concentrated area was Foshan, and the incidence was 502.00/10 000, the second one comprised Zhuhai, Zhongshan and Shenzhen with incidence of 208. 70/10 000, and the third one comprised Dongguan and Guangzhou with incidence of 175.22/10 000. Conclusion There is an aggregation distribution characteristic of birth defect in Guangdong , so it is in need of regional preventive strategies.