长沙市25713例围产儿出生缺陷监测结果分析

Monitoring Result Analysis of Birth Defects in 25 713 Fetuses and Infants During Perinatal Period

目的调查长沙市围产儿出生缺陷的发生情况 ,获得准确、可靠的本地区出生缺陷资料 ,了解出生缺陷的相关因素 ,为完善围产儿出生缺陷的干预措施提供依据。方法对 2 0 0 0年 1月至 2 0 0 1年 1 2月长沙市所属 1 3所医院产科分娩的孕满 2 8周至生后 7d的 2 5 71 3例围产儿进行出生缺陷监测 ,分析出生缺陷儿的检出率、死亡率 ,出生缺陷病种的发生率、类别、构成比、分布及其相关因素。结果发现出生缺陷儿 32 5例 ,检出率为 1 2 .6‰。其中单发畸形 30 2例 ,多发畸形 2 3例。产前诊断 1 0 0例 ,B超诊断 1 2 1例。死亡 90例 ,出生缺陷儿死亡率为 2 76 .9‰。发生率最高的出生缺陷疾病前五名排序为 :外耳畸形、多指 (趾 )畸形、先天性心脏病、肢体短缩、唇裂并腭裂。其地区分布城市多于乡村 (2 .1∶1 )。与出生缺陷发生密切相关的因素有产妇年龄、孕期疾患、孕早期感冒、用药及围产儿的性别。结论产前检查可及早发现出生缺陷。B超是孕期诊断出生缺陷安全而有效的主要手段。加强孕期保健、针对高危因素采取积极的干预措施 ,能有效降低全市出生缺陷的发生率 。

ObjectivesTo Investigate the occurrence of birth defects and relevant factors in fetuses and infants of Changsha city during their perinatal period , taking aim at providing basis for improvement of intervention measures.MethodsMonitoring analysis of the birth defects in 25 713 fetuses and infants during perinatal period was carried out . They were born in obstetric wards of 13 hospitals in Changsha city from Jan., 2000 to Dec., 2001. At the time of this screening survey, majority of them were just delivered in hospital after their mother's full term pregnancy (28 wks) and some stayed there 7 days after birth. The check out rate of birth defects, mortality rate, incidence, category, constituent ratio and distribution of birth defective diseases as well as the related factors were analyzed.ResultsThree hundred and twenty five cases of birth defects were detected, with a check out rate of 12.6‰. 302 cases out of them were simplex malformation and 23 cases were multi malformation. Birth defects in 100 cases were found prenatally,121 cases were diagnosed by ultrasound. 90 cases of birth defects died, with a mortality rate of 276.9‰. Five birth defects most commonly seen were arranged in following orders : deformity of external ear, polydactyly, congenital heart disease, extremities shortness, cheiloschisis and palatoschisis. The incidence of birth defects in city was significantly higher than that in countryside(2.1∶1), The factors closely correlated with birth defects were age of parturients, diseases suffered within the period of pregnancy, flu infection at early term of pregnancy, medication and the sex of fetuses and infants .ConclusionAntenatal examination can earlier detect birth defects on time . Ultrasound is a main and safe diagnostic instrument . To strengthen preventive health care of gestation and adopt active intervention measures against high risk factors can reduce the incidence of birth defects and promote the innate quality of population in the city.