目的 了解2009-2011年本市1岁内活产婴儿先天性心脏病(congenital heart disease, CHD)的患病情况, 为预防和降低本市CHD的发生提供参考依据。方法 对妊娠满28周, 在本市住院分娩的活产儿进行体检后, 对可疑病例采用超声心动图(FECHO)诊断CHD。结果 2009-2011年共监测活产婴儿13 593人, 诊断CHD 108人, 发病率为0.79%。婴儿单纯性CHD类型中前三位为室间隔缺损(27.78%)、房间隔缺损(25.00%)、动脉导管未闭(12.04%)。孕周＜37周出生的婴儿CHD发病率为3.96%(19/480);37～42周出生的婴儿发病率为0.68%(89/13 113)。两组间存在显著差异(χ²=63.19, P＜0.01)。低出生体重儿CHD发病率明显高于正常体重组与巨大儿组 (χ²=123.48, P＜0.01)。孕母年龄≥35岁组其婴儿CHD发病率明显高于其他两组(χ²=28.89, P<0.01)。结论 早产、低出生体重、孕母年龄偏大等与CHD发生有一定关系, 是导致本市1岁内婴儿CHD发生的可能原因。提示加强孕前宣教及孕期保健、消除不利因素均有助于预防和降低CHD的发病率。

Objective To investigate one year old babies with congenital heart disease (CHD) during 2009 to 2011 in Haining, and to provide a reference for preventing and reducing the incidence of CHD. Method After medical examination for live birth babies with full 28 weeks of pregnancy, the suspected ones were suggested to take echocardiography (FECHO) to diagnose the CHD. Results A total of 13 593 live birth babies were monitored during 2009 to 2011, and 108 of them were diagnosed as CHD, which made the incidence rate 0.79%.The top three simple CHD types were turned out to be ventricular septal defect (27.78%), atrial septal defect (25.00%), and patent ductus arteriosus (12.04%).The incidence rate for babies diagnosed as CHD was 3.96% (19/480) with gestational age shorter than 37 weeks; meanwhile, the incidence rate was 0.68%(89/13 113)for babies whose gestational ages were within the range of 37 to 42 weeks, which showed demonstrates significant gap (χ²=63.19, P＜0.01).CHD incidence rate for low birth weight children was significantly higher than normal and huge weight children (χ²=123.48, P＜0.01).CHD incidence rate for cases that mothers' maternal age no less than 35 years old was significantly higher than the other two groups (χ²=28.89, P<0.01). Conclusions Premature birth, low birth weight, old maternal age have a certain relationships with the occurence of CHD, which might be the reason leading to CHD for one year old babies in Haining city.Publicity for progestation awareness and prenatal care as well as eliminating negative factors are all demanding to prevent and reduce the CHD incidence rate, thereby improving the quality of births in Haining city.