摘要
目的 了解西安市出生缺陷的发生情况、分布特征及影响出生缺陷发生的有关因素，为政府部门制订预防出生缺陷决策提供依据。方法 对2003-2008年在西安市各级开设产科的医疗保健机构出生的孕28周至生后7天所有围产儿进行出生缺陷监测，采用Excel软件进行数据录入，SPSS 13.0软件包进行统计学分析。结果 2003-2008年出生缺陷率呈逐年下降趋势（χ2=23.590，P=0.000〈0.05），平均为7.90‰，低于我国平均水平，6年下降了22.01%（χ2=15.761，P=0.000〈0.05）。出生缺陷中以神经管缺陷最多，其次为多指（趾）、先天性脑积水、唇裂合并腭裂、单纯唇裂、先天性心脏病。其中神经管缺陷的发生率为15.87/万，呈逐年下降的趋势（χ2=43.651，P=0.000〈0.05）。农村的出生缺陷发生率是8.62‰，显著高于城镇出生缺陷发生率7.18‰（χ2=25.333，P=0.000〈0.05）。男童出生缺陷率为8.34‰，显著高于女童7.16‰（χ2=17.124，P=0.000〈0.05）。四季出生缺陷率无显著性差异（χ2=1.920，P=0.589〉0.05）。产母年龄在25-29岁者出生缺陷发生率最低，产母年龄〉35岁和〈20岁者出生缺陷发生率较高（χ2=64.185，P=0.000〈0.05）。缺陷儿产母有21.06%在孕早期有过致畸因素，5.81%有异常生育史，1.33%有出生缺陷家族遗传史。31.22%出生缺陷在产前通过B超等手段已确诊。出生缺陷儿中围产儿死亡率为299.24‰，显著高于非出生缺陷围产儿的死亡率4.55‰（χ2=37 972.440，P=0.000〈0.05）。结论 加强出生缺陷的一级预防即做好孕前保健、孕早期保健，二级预防即全面产前筛查与高危孕妇的产前诊断，三级预防即新生儿体检、疾病筛查等，可有效降低出生缺陷的发生,降低围产儿死亡率。
Objective To investigate prevalence rate, distribution and relevant influencing factors of birth defects of perinatal infants in Xi＇an city, so as to provide a basis for decisionmaking of the government for preventing birth defects.Methods All perinatal infants aged from 28 weeks of gestation to 7 days after birth in all levels of medical institutions including obstetric hospitals in Xi＇an city from 2003 to 2008 were monitored for birth defects. The strict quality control was conducted. The data were entered by Excel and analyzed by SPSS13.0 software. Results There was an annual descending tendency in prevalence rate of birth defects（χ2=23.590,P=0.000〈0.05）in Xi＇an city from 2003 to 2008 and the average prevalence rate of birth defects was 7.90 ‰, which was lower than the national average level. The prevalence rate of birth defects was decreased by 22.01% （χ2 =15.761,P=0.000〈0.05） in the 6year period. The major birth defects were neural tube defects, polydactylism, congenital hydrocephalus, cleft lip associated with cleft palate, simple cleft lip, congenital heart diseases in order. Of which, the incidence rate of neural tube defects was 15.87/10 000 and showed a year by year descending trend （χ2=43.651,P=0.000〈0.05）. The prevalence rate of birth defects in rural areas was 8.62‰, which was significantly higher than 7.18‰ in urban areas （χ2=25.333,P=0.000〈0.05）. The prevalence rate of birth defect rate among boys was 8.34‰, which was significantly higher than 7.16 ‰ among girls （χ2=17.124,P=0.000〈0.05）. There was no significant difference in prevalence rate of birth defects between four seasons （χ2=1.920,P=0.589〉0.05）. The prevalence rate of birth defects was the lowest among those pregnant women aged 25-29 years , while that was higher among those pregnant women aged over 35 years and under 20 years （χ2=64.185,P=0.000〈0.05）. 21.06% of mothers who delivered defective infants had exposed to teratogenic factors in their early pregnancy, 5.81% o
出处
《中国妇幼健康研究》
2009年第5期550-555,共6页
Chinese Journal of Woman and Child Health Research
关键词
围产儿
出生缺陷
围产儿死亡率
神经管缺陷
分布特征
perinatal infant
birth defect
perinatal mortality rate
neural tube defect
distribution characteristics
