乌鲁木齐市2016—2017年围产儿出生缺陷监测与防治现状

Monitoring perinatal birth defects and intervention status in Urumqi from 2016 to 2017

目的分析围产儿出生缺陷的监测结果,探讨围产儿出生缺陷发生情况及其影响因素,为制定干预措施提供科学依据,降低出生缺陷发生率。方法回顾性分析2016—2017年乌鲁木齐市辖区内46家医院95 154例围产儿的出生缺陷监测资料,分析不同年份及不同出生缺陷发生的情况。结果2016—2017年乌鲁木齐市围产儿出生缺陷总发生率为94.71/万(城市108.61/万,农村59.80/万),前5位出生缺陷病种占全部缺陷类型的58.24%,依次为总唇裂(占14.08%)、多指(趾)(占13.56%)、先天性心脏病(占12.51%)、马蹄内翻足(占7.57%)、外耳其他畸形(占7.25%)。出生缺陷的发生率城镇明显高于乡村(χ~2=50.112,P<0.05);男性明显高于女性(χ~2=22.976,P<0.05);产妇年龄间存在显著性差异(χ~2=24.141,P<0.05),出生缺陷发生率最高的年龄组为35岁及以上(107.74/万)和不足20岁(104.93/万)。结论部分对于干预措施敏感的致死和严重致残性出生缺陷的发生率下降,乌鲁木齐市出生缺陷防控工作重点的变化,提示应针对高危人群和因素来确定干预工作的重点。

Objective To analyze the monitoring results of perinatal birth defects（BD）and explore the incidence of BD and influencing factors so as to provide scientific basis for intervention and to reduce the incidence of BD.Methods Retrospective analysis was conducted on the BD monitoring data of 95 154 cases from 2016 to 2017 in 46 hospitals in Urumqi to analyze the incidence of BD in different years.Results During 2016-2017,the total incidence of perinatal BD was 94.71/10 000（city 108.61/10 000,village 59.80/10 000）.The top five BD diseases accounted for 58.24% of all BD,and they were cleft lip（14.08%）,synpolydactyly（13.56%）,congenital heart disease（12.51%）,clubfoot（7.57%）and external ear malformation（7.25%）in turn.The incidence of BD was significantly higher in urban area than in rural area（χ~2=50.112,P〈0.050）and higher in boys than in girls（χ~2=22.976,P〈0.05）.There was remarkable difference in maternal age（χ~2=24.141,P〈0.05）,and the highest incidence of BD was in group of age 35 and over（107.74/10 000）and under 20 years（104.93/10 000）.Conclusion Incidence of some death cases sensitive to intervention or BD causing severe disability gradually decrease.The change of BD prevention and control in Urumqi indicates that it is necessary to define the emphasis of prevention and conduct studies based on high-risk population and factors.