目的 分析西安市总出生缺陷、先天性心脏病、神经管畸形、唇腭裂的空间聚集性,为制定干预措施提供科学依据。方法 对出生缺陷进行空间分析,采用空间映射描述出生缺陷的空间分布;采用全局和局部Moran’s I分析出生缺陷的空间聚集性;采用空间统计扫描分析出生缺陷的空间聚集性及风险大小。结果 2009年10月1日-2016年9月30日期间长安区总出生缺陷、先天性心脏病、唇腭裂的发生率均最高(333.56/10⁴、68.51/10⁴、49.66/10⁴)。神经管畸形发生率最高的区县是蓝田县(50.18/10⁴)。西安市总出生缺陷、先天性心脏病、神经管畸形、唇腭裂无全局空间自相关性,但存在局部空间自相关性。空间扫描分析结果显示,在灞桥区、蓝田县、临潼区总出生缺陷的RR值为1.60,碑林区为1.10,未央区为2.00,长安区为4.14;碑林区先天性心脏病的RR值为1.96,高陵县为1.70,蓝田县为2.33,未央区为1.86,长安区为3.13;神经管畸形的RR值在灞桥区、高陵县、临潼区、未央区、阎良区为1.86,蓝田县为6.00,长安区为4.44;唇腭裂的RR值在灞桥区、高陵县、临潼区、未央区、阎良区为1.65,长安区为4.28。结论 西安市出生缺陷不存在全局空间自相关性,但存在局部空间自相关性。长安区、未央区、碑林区、灞桥区出生缺陷发生水平高于西安市平均水平。

Objective To analyze the spatial aggregation of total birth defects,congenital heart disease,neural tube defects,cleft lip and palate in Xi'an,so as to provide evidence for making intervention measures. Methods Spatial analysis of birth defects was conducted.Spatial mapping was used to describe the spatial distribution of birth defects.The spatial aggregation of birth defects was analyzed using global and local Moran's I.Spatial statistical scan was used to analyze the aggregation and risk of birth defects. Results The incidence rates of total birth defects(333.56/10⁴),congenital heart disease(68.51/10⁴) as well as cleft lip and palate(49.66/10⁴) in Chang'an district from October 1st,2009 to 30th September,2016 were the highest.The district with the highest incidence of neural tube defects was Lantian county(50.18/10⁴).There was no global spatial autocorrelation of total birth defects,congenital heart disease,neural tube defects,as well as cleft lip and palate in Xi'an,but local spatial autocorrelation existed.The RR value of total birth defects was 1.60 in Baqiao district,Lantian county and Lintong district,1.10 in Beilin district,2.00 in Weiyang district and 4.14 in Chang'an district.The RR value of congenital heart disease was 1.96 in Beilin district,1.70 in Gaoling county,2.33 in Lantian county,1.86 in Weiyang district,and 3.13 in Chang'an district.The RR value of neural tube defects was 1.86 in Baqiao district,Gaoling county,Lintong district,Weiyang district and Yanliang district,6.00 in Lantian county,4.44 in Chang'an district.The RR value of cleft lip and palate was 1.65 in Baqiao district,Gaoling county,Lintong district,Weiyang district and Yanliang district,and 4.28 in Chang'an district. Conclusions There is no global spatial autocorrelation in birth defects in Xi'an,but local spatial autocorrelation exists.The birth defects in Chang'an district,Weiyang district,Beilin district and Baqiao district are higher than the average level in Xi'an.