2010—2020年单中心活产新生儿出生缺陷监测结果的分析研究

Monitoring results of live birth defects in one center from 2010 to 2020

目的分析国际和平妇幼保健院(简称国妇婴)活产新生儿出生缺陷的发生情况,为降低新生儿出生缺陷发生率提供科学依据。方法回顾性分析2010年1月—2020年12月在国妇婴分娩的164960例活产新生儿资料,同时,对2015—2020年在国妇婴分娩的共96708例活产新生儿及母亲临床资料进行分析,将存在出生缺陷的1501例活产新生儿及其母亲的临床资料纳入出生缺陷组,并以剩余的95207例非出生缺陷活产新生儿及其母亲临床资料作为对照,纳入非出生缺陷组。观察活产新生儿出生缺陷发生率;活产新生儿出生缺陷疾病前10位分布情况;孕产妇年龄、孕次、产次及受孕方式,新生儿性别、胎龄、出生体重及胎数。结果2010—2020年国妇婴共上报2280例新生儿出生缺陷,总体活产新生儿出生缺陷发生率为13.822‰(2280/164960)。2014年出生缺陷率最低为10.046‰,2020年出生缺陷率最高为20.717‰。2015—2020年新生儿出生缺陷率较2010—2014年出现总体升高趋势。2015—2020年出生的活产新生儿中,出生缺陷组男性新生儿、早产儿、低出生体重儿、双胎或多胎的新生儿比例均显著高于非出生缺陷组(P值均<0.001)。2015—2020年出生的活产新生儿的母亲中,出生缺陷组母亲高龄、辅助生殖技术受孕的比例均显著高于非出生缺陷组(P值均<0.01),两组间母亲孕次的差异无统计学意义(P>0.05)。多因素logistic回归分析发现,活产新生儿男性性别(OR=1.178,95%CI为1.042~1.331,P=0.009)、低出生体重(OR=3.749,95%CI为3.238~4.342,P<0.001)、母亲高龄(OR=1.641,95%CI为1.445~1.864,P<0.001)是其发生出生缺陷的危险因素。结论男性新生儿、低出生体重、母亲高龄与活产新生儿出生缺陷发生率的增高密切相关。应加强高危因素人群产前筛查和产前诊断监测,以降低新生儿出生缺陷的发生率。

Objective To analyze the monitoring results of birth defects in the International Peace Maternal and Child Health Hospital.Methods A retrospective analysis was conducted in 164960 neonates born in International Peace Maternal and Child Health Hospital from January 2010 to December 2020.Meanwhile,the clinical data of 96708 mothers and their neonates delivered from 2015 to 2020 were analyzed,including 1501 neonates with birth defects and 95207 neonates without birth defects.The incidence and trend of neonatal birth defects were analyzed by descriptive epidemiological method,as well as the top 10 birth defects.Maternal age,number of pregnancies,number of birth,patterns of conception,infants’gender,gestational weeks at delivery,birth weight and birth count were compared between two groups with and without birth defects from 2015 to 2020.Results A total of 2280 live birth infants were reported from 2010 to 2020 in our hospital,and the incidence of birth defect was 13.822‰(2280/164960).The lowest incidence of birth defects was in 2014(10.046‰)and the highest was in 2020(20.717‰).The incidence of birth defects from 2015 to 2020 was higher than that from 2010 to 2014.Compared with non-birth defects group,birth defects group had higher proportions of male,preterm,low birth weight,twin and multiple births,advanced maternal age,conception with assisted reproductive technology from 2015 to 2020(all P<0.01).There was no statistical difference in the number of pregnancies between two groups(P>0.05).Logistic multivariate regression analysis showed that male neonates(OR=1.178,95%CI:1.042-1.331,P=0.009),low birth weight(OR=3.749,95%CI:3.238-4.342,P<0.001),and advanced maternal age(OR=1.641,95%CI:1.445-1.864,P<0.001)were high risk factors of live birth defects.Conclusion Male infants,low birth weight and advanced maternal age are closely related to the higher incidence of birth defects.Prenatal screening and prenatal diagnosis for high-risk population should be strengthened to reduce the incidence of neonatal birth defects.