珠海市2014～2016年妊娠中期胎儿出生缺陷分析

Analysis of fetal birth defects in the second trimester of pregnancy in Zhuhai City from 2014 to 2016

目的分析珠海市妊娠中期(<28周)胎儿出生缺陷的发生情况,探讨如何提高产前筛查、诊断能力。方法对珠海市2014~2016年妊娠中期胎儿出生缺陷594例监测资料进行回顾性分析。结果珠海市妊娠中期出生缺陷发生率呈增高趋势,总发生率为63.67/万;其主要出生缺陷类型及顺位在三年内无差异,前五位依次为先天性心脏病、唇腭裂、多发畸形、胎儿水肿综合征、唐氏综合征;从诊断依据看,超声诊断一直是主要诊断方式,染色体检查确诊的出生缺陷病例增长较快;从报告医院级别看,三级医院所报告的出生缺陷病例最多,二级医院报告的出生缺陷病例逐年增加;出生缺陷常见相关因素中,城镇产妇的妊娠中期出生缺陷发生率显著高于农村(χ^2=67.35,P<0.05),年龄>35岁产妇的出生缺陷发生率也显著高于其他年龄组别(χ^2=65.59,P<0.05),而胎儿性别差异比较,差异无统计学意义(P>0.05)。结论2014~2016年珠海市妊娠中期出生缺陷发生率呈增高趋势,提高基层医院的产前筛查、诊断能力是提高全市产前筛查、诊断能力,降低全市围生儿出生缺陷率,提高出生人口素质的关键。

Objective To analyze the occurrence of fetal birth defects in the second trimester of pregnancy (<28 weeks) in Zhuhai, and to explore how to improve the ability of prenatal screening and diagnosis.Methods The monitoring data of fetal birth defects 594 cases in the second trimester of pregnancy between 2014 and 2016 in Zhuhai City were retrospectively analyzed.Results The incidence of fetal birth defects in the second trimester of pregnancy in Zhuhai increased, with a total incidence of 63.67/10 000.The main types of birth defects and their sequence were not significantly different within three years.The top five were congenital heart disease,cleft lip and palate,multiple malformation,fetal edema syndrome,and Down syndrome.With regards to the diagnostic basis,ultrasound examination has been the primary diagnostic method;the number of birth defects confirmed by chromosome examinations has increased rapidly.In light of the hospital levels for report,the birth defects reported by tertiary hospitals were most,and in secondary hospitals,the reports of birth defects increased year by year.Among the common factors related to birth defects,the incidence of birth defects in urban maternal women was significantly higher than that in rural areas (χ^2=67.35,P<0.05),and the incidence of birth defects in pregnant women aged >35 years old was also significantly higher than that at other age groups (χ^2=65.59,P<0.05),while fetal gender didn′t differ statistically significant (P>0.05).Conclusion The incidence of birth defects in Zhuhai City from 2014 to 2016 showed an increasing trend.Improving the ability of prenatal screening and diagnosis in primary hospitals is the key to enhance the prenatal screening and diagnosis ability of the whole city,reduce the birth defect rate of perinatal children in the city,and improve the quality of the birth population.