目的 本研究旨在调查浙江省宁波市2017—2021年新生儿先天性心脏病(CHD)流行现状以及患病率趋势变化并分析其影响因素,为预防CHD患病风险提供参考依据,降低CHD患病率。方法 采用横断面调查法方法,2022年1月研究小组成员从浙江省新生儿疾病筛查中心获取2017年3月—2021年12月宁波市上报的新生儿数据,采用线性趋势χ2检验对CHD的变化趋势进行分析;采用二元Logistic回归方法进行CHD影响因素分析。结果 本次调查时,共纳入CHD筛查阳性新生儿共13 156例,确诊为CHD的为6 300例,其中男婴3 066例(48.7%),女性3 234例(51.3%)。宁波市2017、2018、2019、2020、2021年新生儿CHD患病率分别为2.07％、1.10％、2.00％、2.04％、1.08％;2017—2021年新生儿CHD总患病率为1.69％;线性趋势χ2检验结果显示,该地区新生儿CHD患病率均随时间变化总体呈现下降趋势(χ2=178.518,P<0.001);多因素分析结果显示,产妇年龄36~45岁(OR=1.24)、>45岁(OR=1.66)、男婴(OR=1.26)、<32周(OR=1.13)、32~36周分娩(OR=1.54)以及二胎(OR=2.56)为CHD发生的独立危险因素(P＜0.05)。结论 浙江省宁波市新生儿CHD患病率高于全国及浙江省其他城市,虽该地区新生儿CHD患病率均随时间变化总体呈现下降趋势,但并不理想,仍有待采取针对性防控措施降低新生儿CHD患病率。
Abstract
Objective The purpose of this study was to investigate the prevalence status of neonatal congenital heart disease (CHD) in Ningbo City, Zhejiang Province from 2017 to 2021, and to analyze the influencing factors, so as to provide reference for preventing the risk of CHD and reduce the prevalence of CHD. Methods Using cross-sectional survey method, the neonatal data from March 2017 to December 2021 were captured from Zhenjiang Neonatal Disease Screening Center, and were analyzed by linear trend chi-square test; binary Logistic regression was used to analyze the influencing factors of CHD. Results A total of 13 156 newborns screened positive for CHD in Ningbo, Zhejiang Province, with CHD confirmed in 6 300 cases. Among these, 3 066 cases were boys (48.7%) and 3 234 cases were girls (51.3%). The prevalence rates of neonatal CHD in Ningbo city for the years 2017, 2018, 2019, 2020, and 2021 were 2.07%, 1.10%, 2.00%, 2.04% and 1.08%, respectively, with an overall prevalence from 2017 to 2021 of 1.69%. The chi-square test for the linear trend indicated a decreasing prevalence of neonatal CHD over time(χ2=178.518, P<0.001). Multivariate analysis showed that maternal age [36 to 45 years(OR=1.24), >45 years(OR=1.66)], male infants (OR=1.26), premature birth [<32 weeks (OR=1.13), 32 - 36 weeks(OR=1.54)], and being a second birth (OR=2.56) were independent risk factors for the development of CHD (P<0.05). Conclusions The prevalence of CHD in Ningbo, Zhejiang Province is higher than that of CHD in China and other cities of Zhejiang Province. Although the prevalence showed a decreasing trend over time, targeted prevention and control measures need to be implemented to reduce the prevalence of CHD.
关键词
新生儿 /
先天性心脏病 /
筛查 /
先天畸形
Key words
neonate /
congenital heart disease /
screening /
congenital malformation
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基金
浙江省医药卫生科技计划面上项目(2018KY719);宁波市医学重点扶植学科(2022-F26)
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