2011至2018年广东省唐氏综合征流行状况分析

Prevalence of Down's syndrome in Guangdong province in years 2011-2018

目的了解近年来广东省唐氏综合征的流行状况。方法以2011至2018年在广东省58家出生缺陷监测医院产检的孕妇及其胎儿(包括活产、死胎死产及出生后7天内死亡者)为研究对象,分析广东省唐氏综合征的流行现状。结果研究期间共监测孕产妇2056992例,报告唐氏综合征患儿1718例,全省唐氏综合征发生率为8.35/万。各地市中汕尾市发生率最低,为1.04/万;韶关市最高,为18.95/万。唐氏儿活产缺陷率由2011年的1.40/万降至2018年的0.60/万,趋势性检验有统计学意义(χ^2=10.070,P<0.05)。按孕妇年龄分组,年龄≥35岁组唐氏综合征发生率最高,20~组发生率最低,分别为31.97/万、2.74/万;≥35岁组唐氏综合征发生率在2016年最高,为40.50/万。结论建议适龄妇女尽量在最佳的受孕年龄怀孕,避免高龄受孕,孕期应尽量减少不良暴露,加强产前检查。卫生服务供给改革要推进城乡医疗资源均衡配置,优化区域医疗资源布局,使广东省孕妇获得机会均等、质量一致的孕产保健服务。

Objective To acquaint prevalence of Down’s syndrome in recent years 2011~2018 in Guangdong province.Methods The pregnant women and their infants who received prenatal examination in 58 birth defects monitoring hospitals in Guangdong province(including live birth,dead fetus/stillbirth and death within 7 days after birth)over a period from 2011 to 2018 were selected as study subjects.The data of infants were analyzed to survey the prevalence of Down’s syndrome.Results In the survey period,a total of 2056992 pregnant and parturient women were monitored,1718 cases of Down’s syndrome were reported and the prevalence rate of Down’s syndrome was 8.35/10,000 pregnant women in years 2011~2018.The lowest reported prevalence of Down’s syndrome was 1.04/10000 in Shanwei city,while the highest was 18.95/10000 in Shaoguan city.The live birth defect incidence of infants with Down’s syndrome was lowered from 1.40/10000 in 2011 to 0.67/10000 in 2018,and the tendency test shown there was a significant difference(χ^2=10.070,P<0.05).Among the five age groups,the highest Down’s syndrome incidence was found in≥35 years age group,and the lowest incidence was in 20~years age group(31.97/10000 and 2.74/10000 respectively).The incidence of Down’s syndrome in≥35 years age group reached a peak of 31.97/10000 in the year 2016.Conclusion It is recommended that women should impregnate at the best age,avoid pregnancy in the elderly age,reduce adverse exposures as possible in gestational period and strengthen prenatal examination.In the reform of health service,put the stress on promoting balanced medical resources deployment between urban and rural areas,optimizing the layout of regional medical resources,making pregnant women in Guangdong province receive"equal opportunity and comparable quality"maternal health services.