南宁市出生缺陷的发生率、流行病学特征及影响因素
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摘要
目的调查南宁市出生缺陷的发生率、流行病学特征以及影响因素。方法纳入2016年1月至2018年6月在广西南宁市出生的新生儿206 203例。统计其出生缺陷发生情况,采用Logistic回归模型分析出生缺陷发生的影响因素,并分析围产儿出生缺陷发生情况与孕妇年龄的关系。结果 2016年1月至2018年6月,南宁市出生缺陷发生率为261. 20/万人,围产儿出生缺陷发生率为183. 22/万人,出生缺陷的月发生率总体呈升高趋势。发生率位居前5位的出生缺陷分别是先天性心脏病、多指(趾)、神经管畸形、足内外翻以及重型地中海贫血。Logistic回归分析结果显示,胎儿或新生儿性别,孕妇的年龄、产次及常住地是南宁市出生缺陷的影响因素(P <0. 05)。在产次为1～2次的孕妇中,围产儿出生缺陷的发生率随其年龄的增加而升高(P <0. 05),而在产次> 2次的孕妇中,围产儿出生缺陷的发生率与其年龄无相关性(均P> 0. 05)。结论近年南宁市出生缺陷发生率高于既往水平,先天性心脏病是最常见的出生缺陷。南宁市出生缺陷的发生受新生儿或胎儿性别,以及孕妇常住地、年龄、产次的影响,但孕妇年龄对围产儿出生缺陷的影响仍需要进一步研究。
Objective To investigate the incidence,epidemiological characteristics and influencing factors of birth defect in Nanning City. Methods A total of 206 203 newborns,who were born in Nanning City from January2016 to June 2018,were enrolled. The incidence of birth defect was counted,the influencing factors of developing birth defect were analyzed by Logistic regression model,and the relationship of perinatal infant' s incidence of birth defect with maternal age was analyzed. Results From January 2016 to June 2018,the incidence rate of birth defect in Nanning City was 261. 20 per 10 000 persons,the incidence rate of birth defect in perinatal infants was 183. 22 per10 000 persons,and the monthly incidence rates of birth defect showed a tendency to increase globally. The top five incidence rates of birth defect were found in congenital heart disease,polydactyly,neural tube malformation,varus and valgus foot,and thalassemia major. The results of Logistic regression analysis showed that gender of fetus or newborn,maternal age,parity and permanent residence' location were the influencing factors of birth defect in Nanning City( P < 0. 05). Among pregnant women with a parity of 1 to 2 times,perinatal infants exhibited an increasing incidence rate of birth defect with their age( P < 0. 05),while among pregnant women with a party more than 2 times,perinatal infants showed an incidence rate of birth defect which did not correlate with their age( all P > 0. 05). Conclusion In Nanning City,the incidence rate of birth defect these years is higher than the previous rate,congenital heart disease is the most common birth defect. The occurrence of birth defect in Nanning City is affected by neonatal or fetal gender,as well as permanent residence's location,age and parity of pregnant women,however,the influence of pregnant women's age on birth defect of perinatal infants still needs further study.
Objective To investigate the incidence,epidemiological characteristics and influencing factors of birth defect in Nanning City. Methods A total of 206 203 newborns,who were born in Nanning City from January2016 to June 2018,were enrolled. The incidence of birth defect was counted,the influencing factors of developing birth defect were analyzed by Logistic regression model,and the relationship of perinatal infant' s incidence of birth defect with maternal age was analyzed. Results From January 2016 to June 2018,the incidence rate of birth defect in Nanning City was 261. 20 per 10 000 persons,the incidence rate of birth defect in perinatal infants was 183. 22 per10 000 persons,and the monthly incidence rates of birth defect showed a tendency to increase globally. The top five incidence rates of birth defect were found in congenital heart disease,polydactyly,neural tube malformation,varus and valgus foot,and thalassemia major. The results of Logistic regression analysis showed that gender of fetus or newborn,maternal age,parity and permanent residence' location were the influencing factors of birth defect in Nanning City( P < 0. 05). Among pregnant women with a parity of 1 to 2 times,perinatal infants exhibited an increasing incidence rate of birth defect with their age( P < 0. 05),while among pregnant women with a party more than 2 times,perinatal infants showed an incidence rate of birth defect which did not correlate with their age( all P > 0. 05). Conclusion In Nanning City,the incidence rate of birth defect these years is higher than the previous rate,congenital heart disease is the most common birth defect. The occurrence of birth defect in Nanning City is affected by neonatal or fetal gender,as well as permanent residence's location,age and parity of pregnant women,however,the influence of pregnant women's age on birth defect of perinatal infants still needs further study.
引文
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[3]代礼,周光萱,朱军,等.出生缺陷对中国围产儿死亡的影响[J].中华流行病学杂志,2004,25(2):138-141.
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[7] Liu QG,Sun J,Xiao XW,et al. Birth defects data from surveillance hospitals in Dalian city,China,2006-2010[J]. J Matern Fetal Neonatal Med,2016,29(22):3 615-3 621.
[8]朱茂灵,黄永全,蒋武,等. 2012-2016年南宁市围生儿出生缺陷发生率及流行病学分析[J].广西医科大学学报,2018,35(8):1 158-1 161.
[9]廖丹梅,杨梅.南宁市新生儿出生缺陷的调查分析[J].中国临床新医学,2009,2(4):400-402.
[10] Blaas HG. Detection of structural abnormalities in the first trimester using ultrasound[J]. Best Pract Res Clin Obstet Gynaecol,2014,28(3):341-353.
[11] Rayburn WF,Jolley JA,Simpson LL. Advances in ultrasound imaging for congenital malformations during early gestation[J]. Birth Defects Res A Clin Mol Teratol,2015,103(4):260-268.
[12] Tu L,Li H,Zhang H,et al. Birth defects data from surveillance hospitals in Hubei province,China,2001-2008[J].Iran J Public Health,2012,41(3):20-25.
[13] Sepulveda W,Ximenes R,Wong AE,et al. Fetal magnetic resonance imaging and three-dimensional ultrasound in clinical practice:applications in prenatal diagnosis[J]. Best Pract Res Clin Obstet Gynaecol,2012,26(5):593-624.
[14] Lara DA,Lopez KN. Public health research in congenital heart disease[J]. Congenit Heart Dis,2014,9(6):549-558.
[15]何梓静,韦萍,林琼文,等.广西婚检人群地中海贫血筛查对出生缺陷发生的影响[J].应用预防医学,2014,20(4):234-235.
[2]中华人民共和国卫生部.中国出生缺陷防治报告(2012)[EB/OL].(2012-09)[2019-01-20]. http://www. gov. cn/gzdt/att/att/site1/20120912/1c6f6506c7f811bacf9301. pdf.
[3]代礼,周光萱,朱军,等.出生缺陷对中国围产儿死亡的影响[J].中华流行病学杂志,2004,25(2):138-141.
[4] Human Genetics Programme,Management of Noncommunicable Diseases,World Health Organization. Primary health care approaches for prevention and control of congenital and genetic disorders[R/OL].(1999-12-06)[2019-01-29]. https://apps. who. int/iris/bitstream/handle/10665/66571/WHO_HGN_WG_00. 1. pdf; jsessionid=E70E0411CC4C3A18326EA1A270BAE0B4? sequence=1.
[5] Dai L,Zhu J,Liang J,et al. Birth defects surveillance in China[J]. World J Pediatr,2011,7(4):302-310.
[6]虞慧婷,蔡任之,杨青,等. 2009年上海市出生缺陷监测分析[J].中国妇幼保健,2011,26(1):44-47.
[7] Liu QG,Sun J,Xiao XW,et al. Birth defects data from surveillance hospitals in Dalian city,China,2006-2010[J]. J Matern Fetal Neonatal Med,2016,29(22):3 615-3 621.
[8]朱茂灵,黄永全,蒋武,等. 2012-2016年南宁市围生儿出生缺陷发生率及流行病学分析[J].广西医科大学学报,2018,35(8):1 158-1 161.
[9]廖丹梅,杨梅.南宁市新生儿出生缺陷的调查分析[J].中国临床新医学,2009,2(4):400-402.
[10] Blaas HG. Detection of structural abnormalities in the first trimester using ultrasound[J]. Best Pract Res Clin Obstet Gynaecol,2014,28(3):341-353.
[11] Rayburn WF,Jolley JA,Simpson LL. Advances in ultrasound imaging for congenital malformations during early gestation[J]. Birth Defects Res A Clin Mol Teratol,2015,103(4):260-268.
[12] Tu L,Li H,Zhang H,et al. Birth defects data from surveillance hospitals in Hubei province,China,2001-2008[J].Iran J Public Health,2012,41(3):20-25.
[13] Sepulveda W,Ximenes R,Wong AE,et al. Fetal magnetic resonance imaging and three-dimensional ultrasound in clinical practice:applications in prenatal diagnosis[J]. Best Pract Res Clin Obstet Gynaecol,2012,26(5):593-624.
[14] Lara DA,Lopez KN. Public health research in congenital heart disease[J]. Congenit Heart Dis,2014,9(6):549-558.
[15]何梓静,韦萍,林琼文,等.广西婚检人群地中海贫血筛查对出生缺陷发生的影响[J].应用预防医学,2014,20(4):234-235.