长沙市5年围生儿出生缺陷监测结果分析  

Perinatal birth defects in 5 years in Changsha

作　　者：陈平洋[1] 谢宗德[1] 吴勇[2] 季美君[2] 赵斯卿[2] 

机构地区：[1]中南大学湘雅二医院新生儿科,长沙410011 [2]长沙市妇幼保健院儿童保健科,长沙410007

出　　处：《中南大学学报（医学版）》2007年第3期520-523,共4页Journal of Central South University ：Medical Science

摘　　要：目的：调查长沙市2000～2004年64101名围生儿出生缺陷的发生情况并进行对比分析,了解本地区近5年来各种出生缺陷检出率、围生儿死亡率的变化趋势,探讨切实可行的有效干预措施。方法：对2000年1月至2004年12月长沙市内13所医院产科分娩的64101名围生儿进行出生缺陷监测,统计分析出生缺陷儿的检出率、围生儿死亡率、各种出生缺陷的发生率、类别、构成比并逐年进行比较。结果：共发现出生缺陷儿1050例,出生缺陷检出率为16.38‰。2000年出生缺陷检出率与2002年、2003年、2004年比较逐年增高,有统计学意义（均P〈0.05）。2001年出生缺陷检出率与2002年、2003年、2004年比较亦逐年增高,有统计学意义（均P〈0.005）。共死亡围生儿879例,围生儿死亡率为13.71‰,2001年围生儿死亡率与2002年、2003年比较亦逐年增高（P〈0.05）。5年中总发生率最高的前5种出生缺陷排序依次是肢体畸形、唇颌裂、耳畸形、先天性心脏病、消化道畸形。先天性心脏病发病率明显增高,排名逐年前移。2003年开始实施治疗性引产共177例。结论：本市5年来出生缺陷检出率、围生儿死亡率的上升趋势及严重的心、脑出生缺陷疾患发病率的增加应引起高度重视,加强环境保护及孕期保健有利于减少出生缺陷,定期常规行产前检查及新生儿筛查可及早发现出生缺陷,一旦发现严重出生缺陷病例,应及时行治疗性引产。Objective To investigate and analyze the occurrence of 64 101 perinatal birth defects from 2000 to 2004, to determine the tendency of the incidence rate of birth defects and perinatal mortality, and to explore feasible and effective intervention strategy. Methods We investigated 64 101 perinatal infants who were born in 13 hospitals in Changsha from January 2000 to December 2004. The incidence rate of all birth defects, mortality of perinatal infants, the incidence rate of various kinds of birth defects, and the component rate of birth defects were analyzed. Results Altogether 1 050 neonate birth defects were found, with the incidence rate of 16.38 ‰. The incidence rate of birth defects was increasing year-by-year in 2000 compared with that in 2002, 2003 and 2004, with significant differeces （ all P values 〈 0.05 ） ： the incidence rate of birth defects in 2001 compared with that in 2002, 2003 and 2004, also with significant differeces （P 〈 0.05 ）. Eight hundred seventy nine perinatal infants died, and the mortality was 13.71‰. The mortality perinatalof infants increased in 2001 compared with that in 2002 and in 2003, with significant differeces （ P 〈 0.05 ）. The top 5 birth defects with the highest incidence were congenital heart disease, polydactly, auricle malformation, cheiloschisis, and palatoschisis, congenital hydrocephal in turn. The incidences of congetlital heart disease and hydrocephal increased significantly. One hundred seventy seven fetuses were performed induced labor because of fetal defects from 2003. Conclusion We must pay attention to ,the increasing tendency of birth defect incidence and perinatal mortality. Strengthening environmental protection and antenatal care can decrease the birth defect incidence. Performing antenatal examination and neonatal screening regularly can discover the birth defects in time. When severe birth defects occur, the induced labor should be performed.

关 键 词：胎儿监测 畸形/流行病学 妇女卫生保健服务 

分 类 号：R174[医药卫生—妇幼卫生保健]