围产儿先天畸形发生率的变化

Study on the Changes of perinatal congenital malformation in recent ten years

1993～ 2 0 0 2年对 185 0 2例围产儿进行监测 ,先天畸形 15 7例 ,发生率为 8.4 9‰ ,前、后 5年发生率分别为 5 .6 5‰和 12 .30‰ ,后者明显高于前者 ,差异有极显著性 (χ2 =2 3.79,P<0 .0 1)。前、后 5年间唇腭裂均居第一位。后 5年单纯唇裂、足内 /外翻及多发畸形的发生率均明显升高 ,与前 5年相比 ,差异均有显著性。前 5年 2 0～ 2 4岁年龄组先天畸形比重最大 ,后 5年2 5～ 2 9岁年龄组先天畸形比重最大。 35岁以上年龄组的构成比后 5年较前 5年高。前、后 5年资料均显示 ,发生先天畸形的孕妇 ,受孕时间以第二季度最高 ,前 5年产前检出 11例 ,占总检出人数的 18.34% ,后 5年产前检出 32例 ,占总检出人数的 32 .99% ,后 5年产前检出率明显高于前 5年 ,差异有显著性 (χ2 =4 .0 0 ,P<0 .0 5 )。提示 ,近 5年本地区先天畸形的发生率明显上升 ,同时产前诊断率也在提高。除继续开展围产儿监测工作外 ,应针对高危人群重点监测 ,指导育龄妇女避开春季受孕 ,加强高龄孕妇的产前检查 ,预防先天畸形的发生 。

Objective:18 502 infants born between 1993 and 2002 were investigated.157 congenital malformation occurred.The overall incidence of congenital malformation was 8.49‰.The incidence of former five years and latter five years was 5.65‰ and 12.30‰ respectively.The incidence was significantly higher in the latter five years ( χ 2=23.79, P <0.01).Cleft lip/cleft palate occurred most frequently in the two groups.Moreover,the incidence of cleft lip,foot inversion/eversion,and multiple malformation was significantly higher during the latter five years.Congenital malformation occurred most frequently in pregnqncies aged 20~24 during the former five years,whereas it occurred most frequently in pregnancies aged 25~29 during the latter five years.The constituent ratio was higher in pregnancies aged over 35 during the latter five years.Conception occurred most frequently in spring season.The prenatal detection rate was 18.34% and 32.99% respectively during the former and latter five years.It was significantly higher during the latter five years( χ 2=4.00, P <0.05),It implies that the incidence of congenital malformation and the prenataldetection rate were both higher during the recent five years in Wuhan.Besides continuing perinatal surveillance,we should focus on the high risk pregnancy women.To prevent the occurence of congenital malformation,the staff should instruct the women to avoid the spring to become pregnancy and pay more attention on pregnancies aged over 35.