2018年广州市围生儿先天性心脏病医院监测资料分析

Analysis on hospital surveillance data of congenital heart disease of perinatal infants in Guangzhou in 2018

目的了解广州市围生儿先天性心脏病的发生水平及其相关因素,为先天性心脏病预防和干预工作提供科学依据。方法收集2018年广州市出生缺陷监测网所有产科医院上报的先天性心脏病数据,对先天性心脏病发生情况、类型和相关因素进行描述性分析。结果2018年广州市上报2015例先天性心脏病,围生期先天性心脏病发生率为81.23/万,其前3位发生顺位依次为动脉导管未闭占41.63%、房间隔缺损占26.61%和室间隔缺损占22.86%,所有患儿存活1911例占94.8%、死胎死产96例占4.8%、7 d内死亡5例占0.2%;随着产妇年龄增加患儿先天性心脏病发生率也有增加趋势(P<0.001)。结论加强宣传普及育龄妇女优生知识,做好婚前检查、孕前遗传咨询工作,提高先天性心脏病孕早期筛查能力,出生后存活的先天性心脏病患儿要加强临床转诊治疗和随访管理,达到降低先天性心脏病发生率和死亡率目的。

Objective To understand the occurrence and related factors of congenital heart disease of perinatal infants in Guangzhou,provide a scientific basis for prevention and intervention of congenital heart disease.Methods The data of congenital heart disease of perinatal infants reported by all the maternity hospitals in Guangzhou Birth Defects Monitoring Network in 2018 were collected,the occurrence,types,and related factors of congenital heart disease were analyzed.Results In 2018,2015 perinatal infants of congenital heart disease were reported in Guangzhou,the incidence rate of perinatal congenital heart disease was 81.23 per ten thousand,the top three congenital heart diseases were patent ductus arteriosus(41.63%),atrial septal defect(26.61%),and ventricular septal defect(22.86%),1911 infants were alive(94.8%),the incidence rate of stillbirth was 4.8%(96 infants),5 infants(0.2%)died within 7 days after birth.With the increase of age,the incidence rate of congenital heart disease showed an increasing trend(P<0.001).Conclusion Publicity and popularization of eugenics knowledge among the women of childbearing age should be strengthened,premarital examination and pre-pregnancy genetic counselling should be enhanced to improve screening ability for congenital heart disease during the first trimester of pregnancy,the clinical transfer,treatment,and follow-up management of alive infants with congenital heart disease should be enhanced to reduce the incidence rate of congenital heart disease and mortality rate.