2010-2015年西安市围产儿出生缺陷的流行特征
The epidemiological characteristics of perinatal birth defects in Xi’an from 2010 to 2015

摘要：目的 了解西安市围产儿出生缺陷的动态流行特征，为今后出生缺陷预防工作的重点提供科学依据。方法 对2010-2015年西安市所有产科医院上报的出生缺陷资料进行统计描述。结果 出生缺陷平均发生率为89.62/104(87.50/104，91.74/104)，缺陷发生率逐年上升(χ2＝157.13，P<0.01)。出生缺陷发生率位于前5位的依次为：先天性心脏病(26.53/104)、多指(趾)(13.10/104)、总唇腭裂(11.42/104)、神经管缺陷(6.06/104)、先天性脑积水(5.08/104)，共占出生缺陷总数的69.39%。其中，先天性心脏病的发生率呈逐年上升趋势(χ2=837.65，P<0.01)。出生缺陷发生率城市高于农村(OR=1.108，95% CI：1.056～1.162)，男婴高于女婴(OR=1.151，95% CI：1.097～1.208)，母亲年龄<20岁(OR=1.764，95% CI：1.532～2.032)和母亲年龄≥35岁(OR=1.283，95% CI：1.179～1.395)也是缺陷儿发生的危险因素。缺陷儿以活产居多(72.54%)，通过超声和临床诊断的病例各占52.83%和46.24%，产前诊断率为33.20%。结论 西安市2010-2015年围产儿出生缺陷发生率总体有增加的趋势，应不断提高各监测点的产前诊断能力，从而降低本地区的缺陷发生水平，提高出生人口素质。
ABSTRACT: Objective To investigate the dynamic epidemiological characteristics of perinatal birth defects in Xi’an so as to provide scientific evidence for the priority of future birth defect prevention. Methods We made a statistical description of the data of perinatal birth defects from 2010 to 2015 reported by all the maternity hospitals in Xi’an. Results The incidence of birth defects in Xi’an from 2010 to 2015 was 89.62/104 (87.50/104, 91.74/104) and had an annual ascending tendency (χ2＝157.13, P<0.01). The top five main birth defects in a descending order were congenital heart disease (26.53/104), polydactyly (13.10/104), total cleft lip (11.42/104), neural tube defects (6.06 /104), and congenital hydrocephalus (5.08/104), accounting for 69.39% of the total number of birth defects. And the incidence of congenital heart diseases showed a year-by-year ascending trend (χ2=837.65, P<0.01). The incidence of birth defects was higher in urban areas than in rural areas (OR=1.108, 95% CI: 1.056-1.162). The birth defects were more frequently seen in males than in females (OR=1.151, 95% CI: 1.097-1.208). Mother’s age <20 (OR=1.764, 95% CI: 1.532-2.032) and mother’s age≥35 (OR=1.283, 95% CI: 1.179-1.395) also were risk factors for birth defects. Up to 72.54% of the defects were live births. There were 52.83% cases diagnosed by ultrasound and 46.24% ones by clinical examination. The prenatal diagnosis rate was 33.20%. Conclusion The incidence of perinatal birth defects in Xi’an from 2010 to 2015 showed an annual ascending trend. We should improve the prenatal diagnosis level of all monitored hospitals in order to reduce incidence of birth defects and increase the quality of population