产前诊断对活产婴儿中出生缺陷顺位的影响  

Effect of prenatal diagnosis on the rank order of birth defects in liveborn infants

作　　者：林克萍[1] 朱宝生[2] 董旭东[1] 刘焕玲[1] 颜芳[1] 胡云英[1] 章锦曼[2] 苏洁[2] 

机构地区：[1]云南省第一人民医院产科,650032 [2]云南省第一人民医院遗传诊断中心

出　　处：《中国妇幼保健》2010年第5期622-625,共4页Maternal and Child Health Care of China

基　　金：云南省"十一五"社会发展项目〔2007CA008〕

摘　　要：目的:分析经产前诊断对确诊异常的部分胎儿进行治疗性终止妊娠后,活产婴儿中出生缺陷发生率下降及出生缺陷顺位的变化。方法:对围产保健孕妇进行产前筛查、超声产前检查、产前诊断,再监测活产婴儿中出生缺陷病例,统计描述和分析监测结果。结果:①在16602例围产儿中监测到出生缺陷儿308例,出生缺陷发生率为18.55‰;②对97例产前诊断的严重畸形胎儿终止妊娠后,活产婴儿中的出生缺陷率下降至12.71‰,差异有统计学意义(χ2=18.42,P<0.001);严重出生缺陷在活产婴儿中的排位后移;③出生缺陷发生率随产妇年龄增大而上升,双胎高于单胎,农村产妇高于城市产妇。结论:①产前诊断及治疗性终止妊娠可降低活产婴儿的出生缺陷发生率,并使出生缺陷顺位发生改变;②出生缺陷发生率与产妇年龄、居住地、多胎妊娠关系密切,而与受孕季节、围产儿性别无关。Objective： To analyze the changes of incidence and rank order of birth defects in liveborn infants after therapeutic abor tion for birth defects infants determined in prenatal diagnosis. Methods： Prenatal screening, ultrasound examination and prenatal diagnosis were offered to pregnant women in prenatal health care, and the infants with birth defects were monitored. All the results were analysed statistically. Results： 308 cases were diagnosed as birth defects among 16 602 perinatal infants, the incidence of birth defects was 18. 55%o; after therapeutic abortion for infants with birth defects, the incidence of birth defects decreased to 12. 71%o; there was significant difference （x^2 = 18.42, P 〈0. 001 ） ; the rank order of severe birth defects declined; the incidence of birth defects increased with the maternal age,. the incidences of birth defects in monocyesis, rural pregnant women were significantly higher than those in twin pregnancy, urban pregnant women. Conclusion： Prenatal diagnosis and therapeutic abortion can reduce the incidence of birth defects in liveborn infants, and change the rank order of birth defects; the incidence of birth defects is related to maternal age, living area and multiple pregnancy closely, independent of seasons of conception and genders of perinatal infants.

关 键 词：出生缺陷 产前诊断 治疗性终止妊娠 

分 类 号：R714.53[医药卫生—妇产科学]