2017-2021年梧州市围产儿先天性心脏病资料分析

Analysis of congenital heart disease data of perinatal infants in Wuzhou city from 2017 to 2021

目的通过对梧州市围产儿先天性心脏病(CHD)监测资料分析,了解其发生特征及变化趋势,为制订有效干预措施提供依据。方法回顾性分析梧州市所有助产机构2017年1月1日至2021年12月31日上报的在监测医院内出生的妊娠满28周至出生后7 d的围产儿出生缺陷监测资料。结果纳入分析的围产儿214537例,发现先天性心脏病575例,平均发生率为26.80/万。先天性心脏病发病率逐年上升,2017年为9.00/万,2021年为50.43/万,呈现明显上升趋势(χ^(2)=180.236,P=0.000)。城镇发生率为30.35/万,高于乡村25.08/万;出生体重<2.5 kg的围产儿先天性心脏病发生率为110.71/万,高于出生体重≥2.5 kg的先天性心脏病发生率21.31/万;<37周的围产儿先天性心脏病发生率32.19/万,高于≥37周先天性心脏病发生率21.69/万,差异有统计学意义(P<0.05)。男婴发生率为25.33/万,女婴发生率为28.45/万,差异无统计学意义(P>0.05)。先天性心脏病类型中前五位的为卵圆孔未闭、房间隔缺损、动脉导管未闭、室间隔缺损、房室间隔缺损。结论梧州市围产儿先天性心脏病发生率显著上升,城镇发生率大于乡村。应加强孕产期保健、胎儿产前诊断和新生儿先心病筛查力度,避免和减少先天性心脏病的发生。

Objective To understand the characteristics and changing trend of occurrence by analyzing the monitoring data of congenital heart disease(CHD)among perinatal infants in Wuzhou city,so as to provide basis for formulating effective intervention measures.Methods The monitoring data of perinatal birth defects of perinatal infants born in monitoring hospitals from 28 weeks of gestation to 7 days after birth reported from January 1,2017 to December 31,2021 in all midwifery institutions in the Wuzhou city were analyzed retrospectively.Results Among the 214537 perinatal infants included in the analysis,575 infants were diagnosed with CHD,with an average incidence of 26.8/ten thousand.The incidence of CHD was increasing year by year,from 9.00/ten thousand in 2017 to 50.43/ten thousand in 2021,showing an obvious upward trend(χ^(2)=180.236,P=0.000).The incidence in urban areas(30.35/ten thousand)was higher than that in rural areas(25.08/ten thousand),the incidence in perinatal infants with birth weight<2.5 kg(110.71/ten thousand)was higher than that in perinatal infants with birth weight≥2.5 kg(21.31/ten thousand),and the incidence in perinatal infants<37 weeks(32.19/ten thousand)was higher than that in perinatal infants≥37 weeks(21.69/ten thousand),with statistically significant differences(P<0.05).The incidence in male infants(25.33/ten thousand)was lower than that in female infants(28.45/ten thousand),without statistically significant difference(P>0.05).The top five types of CHDs were patent foramen ovale,atrial septal defect,patent ductus arteriosus,ventricular septal defect and atrioventrieular septal defect.Conclusion The incidence of CHD in Wuzhou city increased significantly,and was higher in urban areas than in rural areas.We should strengthen the maternal health care,prenatal diagnosis of fetus and neonatal CHD screening to avoid and reduce the occurrence of CHD.