二胎政策开放后出生缺陷发生率变化趋势分析

Tendency of birth defect incidence after cease of one-child policy

目的探讨二胎政策开放后出生缺陷发生率的变化。方法按国家监测方案,对2015年1月至2017年12月浙江大学医学院附属妇产科医院出生的孕12周至产后7d的所有缺陷儿进行登记,分析同期所有围产儿信息。结果 3年围产儿共57 366例,出生缺陷儿1625例,缺陷平均发生率2.83%。缺陷儿中死亡比例为25.60%。缺陷儿中男婴比例明显高于女婴,差异有统计学意义(P<0.01)。3年内产妇平均年龄在增加,<20岁和20~24岁组是出生缺陷发生率较高的年龄段,>35岁后发生率又有上升势。出生缺陷前5位疾病是先天性心脏病、泌尿系畸形、多指趾、唇腭裂、尿道下裂。同期<28周流产的缺陷儿997例。结论二胎政策开放后产妇平均年龄虽有增长,但总出生缺陷发生率无明显变化。其原因可能为多项预防措施的采用和产前诊断技术的进步。

Objective To explore the change in birth defects rate after cease of one-child policy change.Methods All birth defect children born or with termination of pregnancy within the period from Jan.2015 to Dec.2017 in the Women＇s Hospital School of Medicine,Zhejiang University from 12 gestation weeks to 7 days after birth were registered and all perinatal information was analyzed at the same time according to the national birth defect survey guideline.Results There were 57366 perinatal infants and 1625 defective children in this period.The average rate of defect was 2.83%.Among these defective infants boy＇s defect incidence was much more than girl＇s,the difference being significant（P〈0.01）.The average new mother＇s age increased from 2015 to 2017.The age groups under 20 and between 20 and 24 were those with higher incidence of defects.However,the incidence of defects in the group over 35 years old had a rising trend.The first five defect diseases were： congenital heart disease,urinary tract disease,polyphalangeal,cleft lip and palate and hypospadias.At the same time there were 997 women who were terminated pregnancy before 28 gestational weeks because of defective fetus.Conclusion The average age of pregnant women has increased after the implementation of the second-child policy.Total birth defect rate does not change,which may be related to the application of comprehensive prevention and improvement of prenatal diagnosis techniques.