广西德保县2013-2019年出生缺陷监测及诊断情况分析

Analysis of the monitoring and diagnosis of birth defects in Debao County, Guangxi from 2013 to 2019

目的了解广西德保县围生儿出生缺陷情况,为出生缺陷干预方针的制定提供依据。方法统计分析德保县2013-2019年出生缺陷监测资料。结果德保县2013-2019年监测围生儿22817例,出生缺陷229例,出生缺陷发生率为100.4/万。前5位出生缺陷发生种类是多指/趾(30.68/万)、马蹄内翻足(17.97/万)、总唇腭裂(14.90/万)、尿道下裂(4.38/万)和并指/趾(3.94/万)。围生儿出生缺陷发生率男性(113/万)高于女性(85.5/万),城镇(169/万)高于乡村(93.7/万),差异有统计学意义(P<0.05)。不同年龄组别的产妇出生缺陷发生率呈U形,<20岁最高(162/万),其次是≥35岁(125/万)、20~24岁(123/万)和30~34岁(82.3/万),25~29岁最低(76.0/万)。出生缺陷的诊断主要依据临床(55.5%)和超声(24.8%),产前诊断占45.1%,治疗性引产率38.6%。转归情况包括55.8%活产、39.8%死胎、0.885%死产和3.5%出生7 d内死亡。结论降低出生缺陷发生率需进一步加强三级预防措施,完善妇幼保健服务体系。

Objective To analyze the monitoring and diagnosis of birth defects in Debao County, Guangxi, and provide a basis for further development of three-level prevention and control measures for birth defects. Methods Statistical analysis of the monitoring data of birth defects in Debao County from 2013 to 2019. Results In Debao County, 22817 perinatal infants were monitored from 2013 to 2019, with 229 birth defects, and the rate of birth defects was 100.4/10000. The top 5 types of birth defects are polydactyly/toe(30.68/10000), clubfoot(17.97/10000), total cleft lip and palate(14.90/10000), hypospadias(4.38/10000), and combined digit/toe(3.94/10000). The incidence of birth defects in perinatal infants was higher in males(113/10000) than females(85.5/10000), urban(169/10000) was higher than rural(93.7/10000), the difference was statistically significant(P<0.05). The incidence of birth defects in different age groups is "U", with the highest rate of birth defects under 20 years old(162/10000), followed by≥35 years old(125/10000), 20–24 years old(123/10000) and 30–34 years old(82.3/10000), 25–29 years old is the lowest(76.0/10000). The diagnosis of birth defects is mainly based on clinical(55.5%) and ultrasound(24.8%). Prenatal diagnosis accounts for 45.1%, and the therapeutic induction rate is 38.6%. Outcomes include 55.8% live births, 39.8% stillbirths, 0.885% stillbirths, and 3.5% deaths within 7 days of birth. Conclusion To reduce the incidence of birth defects, it is necessary to further strengthen the three-level preventive measures and improve the maternal and child health service system.