妊娠28周以下出生缺陷儿与围生期出生缺陷儿特征比较  

Comparison of the characteristics between the birth defects under 28 weeks of gestation and perinatal birth defects

作　　者：张欢[1] 李臻 胡洋[1] 陶玉玲[1] ZHANG Huan;LI Zhen;HU Yang(Department of Health,Jiangxi Maternal and Child Health Care Hospital,Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省妇幼保健院保健部,江西南昌330006 [2]湖南省直中医医院产科,湖南株洲412000

出　　处：《中国妇幼保健》2021年第7期1642-1646,共5页Maternal and Child Health Care of China

基　　金：江西省卫生计生委科技计划项目(20195495)。

摘　　要：目的分析江西省妊娠28周以下出生缺陷儿与围生期出生缺陷儿特征的差别,探讨围生期监测对出生缺陷发生情况评估的影响。方法分析2007-2018年江西省38家出生缺陷监测医院的出生缺陷监测数据,比较妊娠28周以下出生缺陷儿与围生期出生缺陷儿在缺陷类型、诊断依据及确诊时间等方面的差别。结果2007-2018年江西省共监测出生缺陷儿18312例,出生缺陷发生率为154.35/万;妊娠28周以下出生缺陷儿在总出生缺陷儿中占19.67%,呈逐年上升趋势。神经管缺陷和唐氏综合征在妊娠28周以下出生缺陷儿缺陷类型顺位中分别排第3位和第4位,未出现在围生期出生缺陷儿缺陷类型顺位前10位。妊娠28周以下出生缺陷儿中,超声诊断占80.36%,染色体诊断占9.35%;围生期出生缺陷儿中,超声诊断和临床诊断各占约41%。先天性脑积水产前诊断比例最高,为90.66%;外耳其他畸形产前诊断比例最低,为2.63%。结论妊娠28周以下出生缺陷儿占比呈逐年上升趋势,其缺陷类型顺位、诊断依据及确诊时间等与围生期出生缺陷儿差别较大;围生期监测的方式将低估人群中出生缺陷的发生率,尤其是对神经管缺陷和唐氏综合征等早期诊断率高的缺陷类型。Objective To analyze the difference of the characteristics between the birth defects under 28 weeks ofgestationand perinatal defects in Jiangxi Province,and to explore the influence of perinatal monitoring on the assessment of birth defects.Methods The data of 38 birth defects monitoring hospitals in Jiangxi Province from 2007 to 2018 were analyzed,and the differences in defect types,diagnosis basis and diagnosis time between the birth defects under 28 weeks ofgestation and perinatal defects were compared.Results A total of 18312 cases of birth defects were monitored in Jiangxi Province from 2007 to 2018,with the incidence rate of 154.35/10000;the proportion of the birth defects under 28 weeks of gestation accounted for 19.67%,showing an increasing trend year by year.Neural tube defects and Down’s syndrome ranked the third and fourth respectively in the defect types of birth defectsunder 28 weeks of gestation,but did not appear in the top 10 of perinatal defects.Ultrasound diagnosis accounted for 80.36%and chromosomal analysis accounted for 9.35%in the birth defects under 28 weeks of gestation;ultrasound diagnosis and clinical diagnosis accounted for 41%in perinatal defects respectively.The prenatal diagnosis rate of congenital hydrocephalus was the highest(90.66%),and the other malformations of external ear were the lowest(2.63%).Conclusion Theproportion of the birth defects under 28 weeks of gestation is increasing year by year.The order of defect types,diagnosis basis and diagnosis time are different between the birth defects under 28 weeks ofgestationand perinatal defects.Perinatal monitoring will underestimate the incidence of birth defects in the population,especially for defects with high early diagnosis rate such as neural tube defects and Down’s syndrome.

关 键 词：妊娠28周以下 围生期 出生缺陷 监测 

分 类 号：R195[医药卫生—卫生统计学]