摘要
目的探讨不同时期确诊出生缺陷的母婴特征、围生儿结局与不同类型出生缺陷产前确诊比例,为降低出生缺陷发生率。方法选择2013年10月-2017年9月浙江省23家助产机构报告的出生缺陷监测资料,分析不同时期确诊畸形的母婴特征、围生结局及不同类型出生缺陷产前确诊比。结果监测围生儿428125例,报告出生缺陷14335例,出生缺陷发生率为334.83/万。产前确诊出生缺陷6012例(41.94%)。与产后确诊组比较,高龄、初产妇、高孕次和单胎出生缺陷更易产前确诊,产前确诊畸形中合并畸形、胎儿性别不明具有更高比例,差异均有统计学意义(P<0.05)。产前确诊比超过90%的出生缺陷分别是无脑畸形100.00%、脑膨出96.92%、脐膨出92.9%、先天性脑积水91.15%、唐氏综合征91.03%和腹裂90.80%。产前确诊比不足10%的出生缺陷分别是多指(趾)5.96%、外耳其他畸形5.72%、并指(趾)4.97%、尿道下裂1.15%。出生缺陷活产9372例、占65.38%,死胎死产4769例、占33.27%,新生儿死亡194例、占1.35%。不同时期确诊出生缺陷转归构成比较,差异有统计学意义(χ^2=12.00,P=0.04)。结论不同时期确诊出生缺陷母婴特征存在差异。神经管畸形、唐氏综合征等严重致死、致愚畸形容易产前确诊;肢体畸形和体表畸形更易产后确诊。提高出生缺陷产前检出水平,有利改善围生儿结局。
Objective To explore the maternal and infant characteristics,perinatal outcomes and the ratio of prenatal diagnosis of dif- ferent types of birth defects in different periods,in order to reduce the incidence of birth defects. Methods The monitoring data of birth de- fects reported by 23 midwifery institutions in Zhejiang province from October 2013 to September 2017 were selected to analyze the maternal and infant characteristics,perinatal outcomes and prenatal diagnosis ratio of different types of birth defects at different stages of diagnosis.Results A total of 428 125 cases of perinatal birth were monitored,and 14 335 cases of birth defects were reported,the incidence of birth defects was 334. 83 per million. 6 012 cases ( 41. 94%) were diagnosed with birth defects. Compared with the postpartum diagnosis group, older age,first parturient women,high number of pregnancies and single birth defects were more likely to be diagnosed prenatally,and the proportion of combined malformations and unknown fetal gender was higher in the prenatal diagnosis group,with statistically significant differ- ences ( P < 0. 05 ). Birth defects with a prenatal diagnosis ratio of more than 90% were anencephaly ( 100. 00%),encephalocele ( 96. 92%), omphalocele ( 92. 9%), congenital hydrocephalus ( 91. 15%), down syndrome ( 91. 03%), and abdominal fissure ( 90. 80%),respectively. The birth defects with less than 10% of prenatal diagnosis were polydactyly ( toe) 5. 96%,other malformations in the external ear 5. 72%,syndactyly ( toe) 4. 97%,and hypospadias 1. 15%. There were 9 372 live births with birth defects,accounting for 65. 38%;4 769 stillbirths,accounting for 33. 27%;and 194 neonatal deaths,accounting for 1. 35%. The results were statistically signifi- cant (χ^2 = 12. 00,P= 0. 04). Conclusion Maternal and infant characteristics of the diagnosed birth defects were different in different peri- ods. Neural tube malformation,down syndrome and other serious death,resulting in foolhardiness deformity easy prenatal diagnosis;de- formities
作者
喻员员
黄小玲
邱丽倩
胡崇高
张晓辉
YU Yuan-Yuan;HUANG Xiao-Ling;QIU Li-Qian(Department of Women's Health Care,Gynecology and Obstetrics Hospital Affiliated to Medical College of Zhejiang University,Hangzhou,Zhejiang 310006,China)
出处
《中国妇幼保健》
CAS
2019年第12期2790-2793,共4页
Maternal and Child Health Care of China
基金
浙江省医药卫生科技计划项目(2018KY036)
关键词
出生缺陷
产前诊断
围生结局
Birth defects
Prenatal diagnosis
Perinatal outcome
