2007至2016年上海市新生儿唇腭裂出生缺陷率发生趋势分析

Analysis of birth defect rate trend of cleft lip and palate in Shanghai from 2007 to 2016

目的分析上海市2007至2016年新生儿唇腭裂的出生缺陷率变化趋势，为唇腭裂的预防、治疗与护理提供参考。方法收集上海市2007年1月至2016年12月出生登记信息，分析新生儿唇腭裂的出生缺陷率、性别比例及与母亲年龄的关系，采用年均变化百分比分析时间变化趋势。结果上海市近10年唇腭裂患儿的总出生缺陷率为9.37/万，整体呈下降趋势，比2007年下降28.20%。其中单纯性唇裂总下降率为40.86%，唇裂合并腭裂总下降率为54.60%，单纯性腭裂的出生缺陷率呈上升趋势，总体上升率为14.34%。单纯性腭裂患儿中女性是男性的1.6倍，单纯性唇裂患儿中男性是女性的1.8倍；唇裂合并腭裂患儿中男性是女性的1.5倍。42.01％的新生儿母亲年龄为25- 29岁，在此年龄段新生儿唇腭裂的出生缺陷率最低，为8.53／万。母亲年龄过低或过高均可增加新生儿唇腭裂的发生风险，母亲年龄〈20岁的婴儿唇腭裂出生缺陷率达13.08/万，母亲年龄≥40岁时，其新生儿唇腭裂的出生缺陷率达18.82/万。结论上海市近10年新生儿唇腭裂的总体出生缺陷率呈下降趋势，单纯性唇裂和唇裂合并腭裂明显下降，但是单纯性腭裂有上升趋势。〈20岁或≥40岁的母亲都将增加新生儿唇腭裂出生缺陷的风险。

ObjectiveTo analysis the rate of birth defects of cleft lip and palate among newborns in Shanghai during 2007 and 2016 and describe its change trend, for the purpose of prevention, treatment and nursing of newborns with cleft lip and palate.MethodsBirth registration information in Shanghai during January 2007 and December 2016 were collected. Rate of birth defects, gender ratio and maternal age of newborns with cleft lip and palate were analyzed. Annual percent change was applied to analyze the trend.ResultsThe total birth defect rate of children with cleft lip and palate was 937/million in the past 10 years in Shanghai, showing an overall decreasing trend, decreased 28.20% compared to the data of 2007. The total birth defect rate of newborns with cleft lip decreased 40.86%. Overall decline rate of newborns with cleft lip and palate was 54.60%, but birth defect rate of newborns with the isolated cleft palate rised 14.34%. The number of female isolated cleft palate newborns were 1.6 times higher than those of male isolated cleft palate newborns, male newborns with cleft lip were 1.8 times higher than that of the female newborns with cleft lip. Male newborns with cleft lip and palate were 1.5 times as much as the female newborns with cleft lip and palate. Maternal age is mainly 25 to 29 years old, accounting for 42.01% of the total number of mothers, the according birth defect rate was lowest as 853/million. When maternal age is too low or too high, the risk of neonatal cleft lip and palate could increase. Birth defects of cleft lip and palate was up to 130.8/million when maternal age is less than 20, while birth defects of cleft lip and palate was up to 188.2/million when maternal age over 40 years old.ConclusionsIn recent 10 years, the overall rate of birth defects of cleft lip and palate in Shanghai shows a decreasing trend, with cleft lip and palate declining obviously, but isolate cleft palate has an increasing tendency. Maternal age less than 20 years old or more than 40 years old will increase the risk of birth defects in newborns with cleft lip and palate.