目的 分析巴彦淖尔市市医院和妇幼保健院两家医院出生缺陷病例的检出情况及流行病学特征,为制定预防措施提供依据。方法 选取2017年1月—2018年12月209例不良妊娠病例(包括活产、死胎、死产和生后7天内死亡)为研究对象,统计出生缺陷的一般情况,并对母亲的生育年龄、妊娠期合并症、不良孕产史、孕期服药史、既往慢病史以及胎次和产次进行分析比较。结果 在接产的11 145例孕产妇中,出生缺陷101例,发生率为90.62/104,不明原因的死胎死产108例,发生率为96.60/104。排列在前十位的出生缺陷是先天性心脏病、唇腭裂、唐氏综合征、脊柱裂、指 (趾)畸形、先天性脑积水、先天性腹壁畸形、肾发育不良(包括重复肾、肾缺如)、马蹄内(外)翻足和外耳畸形。出生缺陷儿的母亲大多居住在临河区占比37.62%,与随机纳入的273例正常对照组相比,缺陷组患妊娠合并症比例(21.78%)较低(χ2=15.391,P<0.01),且孕期服药的比例(10.89%)也低于对照组(χ2=5.254,P=0.022)。结论 巴彦淖尔市临河区的出生缺陷发生率低于内蒙古自治区以及全国的水平,先天性心脏病、多指(趾)、唇腭裂和先天性脑积水是需要重点关注的缺陷类型。该地水砷含量超标是否与出生缺陷有关还需进一步探索分析。
Abstract
Objective To analyze the detection and epidemiological characteristics of birth defects in Bayannur City Hospital and Maternal and Child Health Hospital,in order to provide a basis for the formulation of preventive measures. Methods A total of 209 cases of adverse pregnancy (including live birth,stillbirth and death within 7 days after birth) from 2017 to 2018 were selected to analyze the general situation of birth defects. Maternal childbearing ages,complications during pregnancy,adverse pregnancy history,medication history during pregnancy,previous chronic disease history and number of births and parities were analyzed and compared. Results Among the 11 145 cases of delivery,there were 101 cases of birth defects,with the incidence of birth defects of 90.62/104,and the incidence of unexplained stillbirth (108 cases) of 96.60/104. The top ten birth defects included congenital heart disease,cleft lip and palate,Down syndrome,spina bifida,finger (toe) deformity,congenital hydrocephalus,congenital abdominal wall malformation,renal dysplasia (including duplicate kidney,absence of kidney),equinovarus and external ear malformation. Most (37.62%) of the mothers whose children had birth defects lived in Linhe district. Compared with the 273 pregnant women in the control group,the proportion of pregnancy complications in the birth defect group (21.78%) was lower (χ2=15.391,P<0.001),and the proportion of taking medicine during pregnancy (10.89%) was also significantly lower than that in the control group (χ2=5.254,P=0.022). Conclusions The incidence of birth defects in Linhe district of Bayannur city is lower than that in Inner Mongolia Autonomous region and the whole country. Congenital heart disease,polydactyly (toe),cleft lip and palate and congenital hydrocephalus are the types of defects that need to be paid more attention to. Whether the excessive arsenic content in the water in this region is related to birth defects still needs to be further explored and analyzed.
关键词
出生缺陷 /
发生率 /
先天性脏病
Key words
birth defects /
incidence /
congenital heart disease
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基金
内蒙古医科大学科技百万工程项目(YKD2016,KJBWD21)
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