2008—2020年江苏省淮安市围产儿出生缺陷变化趋势及影响因素分析

Trends and influencing factors of perinatal birth defects in Huai’an from 2008 to 2020

目的:分析2008—2020年淮安市围产儿出生缺陷的发生情况、变化趋势及其影响因素。方法:数据来源于江苏省淮安市妇幼卫生信息系统中2008—2020年的监测数据以及淮安市统计年鉴。以年度变化百分比和平均年度变化百分比(AAPC)为主要指标,采用JoinPoint回归描述十三年间淮安市出生缺陷发生的变化趋势。采用Spearman相关性分析探讨出生缺陷发生率与人口出生率、结婚登记率及高龄产妇分娩占比的相关性。结果:2008—2020年,淮安市共发生围产儿出生缺陷3414例,出生缺陷发生率为4.6‰(3414/736608),且表现为明显的上升趋势(AAPC=8.8%,t=3.2,P<0.01),2016年为变化转折点。在24类出生缺陷中,先天性心脏病发病率急剧上升,已成为顺位第一疾病,而无脑畸形、脑膨出、脊柱裂等神经管缺陷发病率下降明显。出生缺陷率与人口出生率呈负相关(r=–0.751,P<0.01),与结婚登记率无明显相关性(r=–0.516,P>0.05),与高龄产妇分娩占比呈正相关(r=0.726,P<0.01)。结论:2008—2020年,淮安市出生缺陷发生率整体呈上升趋势,先天性心脏病已成为第一顺位的出生缺陷,高龄产妇分娩占比与出生缺陷之间关系密切。

Objective:To analyze the incidence,trends and related factors of birth defects in Huai’an from 2008 to 2020.Methods:The surveillance data from maternal and child health system of Huai’an from 2008 to 2020 and Huai’an Statistical Yearbook were used for analysis.Taking the annual change percentage and average annual change percentage(AAPC) as the main outcome indicators,the Join Point regression analysis was performed to estimate the changing trend of birth defects from 2008 to 2020.Spearman correlation analysis was used to examine the association between birth defects and birth rate,marriage rate,proportion of women with advanced maternal age.Results:During2008 to 2020,a total of 3414 cases of neonatal birth defects occurred in Huai’an,with an incidence of 4.6‰(3414/736 608).The rate of perinatal birth defects in Huai’an showed an increasing trend(AAPC=8.8%,t=3.2,P<0.01),and the year of 2016 was a significant changing point.Among 24 types of birth defects,the incidence of congenital heart disease rose and became the most prevalent defect,while the incidence of neural tube malformations such as anencephaly,encephalocele and spina bifida was declined.The incidence of birth defect was negatively correlated with the birth rate(r=–0.751,P<0.01),not correlated with marriage rate(r=–0.516,P>0.05),and positively correlated with the proportion of women with advanced maternal age(r=0.726,P<0.01).Conclusion:The incidence of birth defects in Huai’an shows an increasing trend from 2008 to 2020 with congenital heart disease as the most common type of birth defect,and the increase of birth defects incidence is closely related with the increase of the proportion of women with advanced maternal age.