2012—2021年上海市新生儿先天性心脏畸形发生率的产妇相关年龄-时期-队列效应分析  

Maternal age-period-cohort effects on the incidence rate of neonatal congenital heart defects in Shanghai Municipality,2012-2021

作　　者：周峰[1] 虞慧婷[1] 范和玉 王春芳[1] ZHOU Feng;YU Huiting;FAN Heyu;WANG Chunfang(Information Institute,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;School of Environmental and Biological Sciences of Rutgers University,New Jersey 08901-8525,USA)

机构地区：[1]上海市疾病预防控制中心信息所,上海200336 [2]罗格斯大学环境与生物科学学院,新泽西08901-8525

出　　处：《实用预防医学》2024年第7期773-777,共5页Practical Preventive Medicine

摘　　要：目的分析和描述上海市新生儿先天性心脏畸形(简称先心)发生率的产妇年龄、产婴时期和产妇出生队列效应及其特点。方法收集覆盖全市所有接产机构报告的2012—2021年单胎新生儿出生登记信息;基于年龄-时期-队列模型,应用STATA的apc_ie模块分别估计产妇年龄、产婴时期和产妇出生队列对上海市单胎新生儿先心发生率的影响效应。先心发生率的趋势检验采用STATA的nptrend命令实施。结果上海市单胎新生儿先心发生率本地产妇的年龄效应表现为29~30岁组RR值介于0.805~0.809(P<0.05),40和42岁组RR值分别为1.503和1.956(P<0.05);非本地产妇30~32岁组RR值介于0.784~0.881(P<0.05),38、40和42岁组RR值分别为1.256、1.285和1.437(P<0.05);年龄别RR值总体上随年龄增加而增大。上海市单胎新生儿先心发生率本地产妇的产婴时期效应表现为2012—2014年RR值介于0.701~0.800(P<0.05),2017年的RR值为0.857(P<0.05),2019—2021年RR值介于1.304~2.332(P<0.05);非本地产妇的产婴时期效应表现为2012—2014年RR值介于0.671~0.898(P<0.05),2016—2017年的RR值介于0.840~0.897(P<0.05),2015年RR值为1.156(P<0.05),2019—2021年RR值介于1.189~1.767(P<0.05)。两类产妇人群时期别RR值总体上呈逐年上升趋势。上海市单胎新生儿先心发生率两类产妇的出生队列效应表现为大部分(96.43%)队列别RR值(介于0.677~2.704)的P>0.05。2012年以来两类产妇的单胎新生儿先心发生率呈上升趋势,其变化特征与时期别RR相似。结论过去近10年里上海市相关部门及机构所开展的新生儿先心筛查策略取得了显著成效,以及不断上升的高龄生育比例,是上海市新生儿先心发生率上升的主要原因。Objective To analyze and describe the effects of maternal age,period and birth cohort on the incidence rate of neonatal congenital heart defects(CHD)and their features in Shanghai Municipality.Methods We collected the birth medical records of singleton newborns from all delivery service institutes in Shanghai Municipality in 2012-2021.Based on the age-period-cohort model,apc_ie module within STATA was used to evaluate the effects of maternal age,delivery period and birth cohort on the incidence rate of CHD among singleton newborns in Shanghai Municipality.Results The effects of maternal ages on the incidence rate of CHD in the singleton newborns in Shanghai Municipality showed that Shanghai ID mothers(SID)aged 29-30,40 and 42 years had a relative risk(RR)range of 0.805-0.809(P<0.05)and RRs of 1.503(P<0.05)and 1.956(P<0.05)respectively,and non-SID mothers aged 30-32,38,40 and 42 years had a RR range of 0.784-0.881(P<0.05)and RRs of 1.256(P<0.05),1.285(P<0.05)and 1.437(P<0.05)respectively.The maternal age-specific RRs in all the mothers generally increased with the increasing age.The effects of maternal delivery periods on the incidence rate of CHD in the singleton newborns in Shanghai Municipality displayed that SID mothers had a RR range of 0.701-0.800(P<0.05)during 2012-2014,a RR of 0.857(P<0.05)in 2017 and a RR range of 1.304-2.332(P<0.05)during 2019-2021,and non-SID mothers had a RR range of 0.671-0.898(P<0.05)during 2012-2014,a RR range of 0.840-0.897(P<0.05)during 2016-2017,a RR of 1.156(P<0.05)in 2015,and a RR range of 1.189-1.767(P<0.05)during 2019-2021.The maternal period-specific RRs in all the mothers showed an ascending trend year by year.The effects of SID and non-SID mothers’birth cohorts on the incidence rate of CHD in the singleton newborns in Shanghai Municipality revealed that 96.43%of the cohort-specific RRs(ranging from 0.677 to 2.704)had p values bigger than 0.05.The incidence rates of CHD in the singleton newborns from SID and non-SID mothers showed upward trends since 2012,and their changi

关 键 词：先天性心脏畸形 年龄效应 时期效应 队列效应 年龄-时期-队列模型 

分 类 号：R722.1[医药卫生—儿科]