杭州市2015—2022年新生儿肛门闭锁发生率及流行特征分析

Analysis of the incidence and epidemiological characteristics of anal atresia in newborns in Hangzhou from 2015 to 2022

目的了解杭州市2015—2022年新生儿肛门闭锁(imperforate anus)的发生率和流行病学特征。方法采用回顾性横断面研究的方法,对杭州市792031例孕妇出生缺陷监测资料进行分析,采用卡方或趋势卡方检验比较孕妇不同预产年龄、不同居住地区和不同分娩年份所生产的肛门闭锁新生儿的发生率差异。结果共随访到确诊新生儿肛门闭锁138例,肛门闭锁发生率为1.74/万。从2015年的1.77/万,上升到2022年的2.91/万,各年度间新生儿肛门闭锁发生率,组间差异有统计学意义(χ_(趋势)^(2)=20.023,P=0.006)。主城区、郊区和远郊的新生儿肛门闭锁发生率分别为:1.61/万、1.80/万和1.98/万,各城区组间差异无统计学意义(χ^(2)=0.657,P=0.720)。孕妇年龄25~29岁组的新生儿肛门闭锁发生率最低(1.21/万),≥35岁组最高(4.44/万),高龄孕妇子代发生肛门闭锁危险因素是低龄孕妇的2.89倍(OR=2.89,95%CI 1.87~4.46),不同年龄组间孕妇所生新生儿肛门闭锁发生率比较,差异有统计学意义(χ_(趋势)^(2)=30.255,P<0.001)。结论杭州市新生儿肛门闭锁的发生率为1.74/万,并有逐年上升趋势,其发生率与孕妇居住地区无关,与孕妇的预产年龄有关,产妇的预产年龄越大,新生儿肛门闭锁的发生率越高。

Objective To understand the prevalence and epidemiologic characteristics of neonatal imperforate anus in Hangzhou,2015–2022.Methods A retrospective cross-sectional study was used to analyze the birth defects surveillance data of 792031 pregnant women in Hangzhou,the chi-square and the trend chi-square tests were used to compare the differences in the incidence rates of imperforate anus in neonates born to pregnant women of different prenatal ages,different areas of residence,and different years of delivery.Results A total of 138 confirmed cases of anal atresia in newborns were followed up,and the incidence of imperforate anus was 1.74 per 10000 births.The incidence of neonatal imperforate anus increased from 1.77 per 10000 in 2015 to 2.91 per 10000 in 2022,with a statistically significant difference between groups(χ_(trend)^(2)=20.023,P=0.006).The incidence of neonatal imperforate anus in the main urban,suburban,and far suburban areas was 1.61/10000,1.80/10000 and 1.98/10000,respectively,with no statistically significant difference between groups in the urban areas(χ^(2)=0.657,P=0.720).The lowest incidence of neonatal imperforate anus was found in the maternal age group of 25-29 years(1.21/10000)and the highest in the group of≥35 years(4.44/10000),and the risk factors for imperforate anus in the offspring of advanced maternal age were 2.89 times higher than those of younger pregnant women(OR=2.89,95%CI 1.87-4.46),the difference in the incidence of imperforate anus in newborns born to pregnant women between the different age groups was statistically significant(χ_(trend)^(2)=30.255,P<0.001).Conclusion The incidence of neonatal imperforate anus in Hangzhou is 1.74per 10000,and there is a rising trend year by year.The incidence of neonatal imperforate anus has nothing to do with the area of residence of the pregnant woman,but is related to the prenatal age of the pregnant woman;the older the maternal prenatal age is,the higher the incidence of neonatal imperforate anus is.