2017—2021年河北省出生缺陷发生率及流行病学调查

doi:10.12280/gjszjk.20220480

摘要/Abstract

摘要：

目的： 了解2017—2021年河北省围产儿出生缺陷的发生率和流行病学特点。方法： 调查研究数据来源于2017—2021年河北省妇幼保健中心出生缺陷信息监测系统，该系统包括分布在河北省各地市的22个监测点（医院）。结果： 河北省共住院分娩200 146例，其中出生缺陷儿8 908例，出生缺陷发生率为445.08/万。出生缺陷的围产儿存活率呈上升趋势。前10位依次为先天性心脏病、腭裂/唇腭裂、多指及并指、外耳其他畸形、胎儿染色体异常、多趾及并趾、脑积水、尿道下裂、消化系统先天畸形及马蹄内翻足。不同地区围产儿出生缺陷报告发生率不同，城镇出生缺陷发生率高于乡村；<18岁、≥35岁的产妇出生缺陷发生率高于18~35岁产妇；经产妇出生缺陷发生率高于初产妇；男性围产儿的出生缺陷发生率高于女性围产儿，差异均有统计学意义（P<0.001）。结论： 河北省出生缺陷发生率存在地区、城镇、年龄等差异，需加强针对存在高危因素的孕妇开展优生优育宣传工作，宣教孕前及妊娠期保健的重要性，进一步降低出生缺陷发生率。

关键词: 河北, 先天畸形, 流行病学研究, 围产儿, 发生率

Abstract:

Objective： To understand the prevalence and epidemiological characteristics of perinatal birth defects in Hebei Province from 2017 to 2021. Methods： The data were from the birth defect information monitoring system of Hebei Center for Women and Children′s Health from 2017 to 2021. The system includes 22 monitoring points (hospitals) distributed in various cities of Hebei Province. Results： There were 200 146 hospitalized deliveries in Hebei province, of which 8 908 were birth defects, and the incidence of birth defects was 445.08/10 000. The perinatal survival rate of birth defects was showed an upward trend. The top 10 reported cases were congenital heart disease, cleft palate/lip palate, polydactyls and syndactyls, other abnormalities of the outer ear, fetal chromosomal abnormalities, polydactyls and syndactyls, hydrocephalus, hypospadias, congenital malformations of the digestive system and clubfoot. The incidence of perinatal birth defects is different in different regions. The incidence of birth defects in urban areas was higher than that in rural areas; the incidences of birth defects in women aged <18 years and ≥35 years were higher than that in women aged 18-35 years; and the incidence of perinatal birth defects in menpara women was higher than that in primipara women. The incidence of perinatal birth defects in males was higher than that in females (P<0.001). Conclusions： There were the regional, urban and age differences in the incidence of birth defects in Hebei province. It is necessary to carry out eugenics′ education for pregnant women with high risk factors, and publicize the importance of health care before and during pregnancy.

Key words: Hebei, Congenital abnormalities, Epidemiologic studies, Perinatal infant, Incidence

田美玲, 杜立燕, 马国娟, 孟凡学, 肖远革. 2017—2021年河北省出生缺陷发生率及流行病学调查[J]. 国际生殖健康/计划生育杂志, 2023, 42(3): 199-202.

TIAN Mei-ling, DU Li-yan, MA Guo-juan, MENG Fan-xue, XIAO Yuan-ge. The Prevalence and Epidemiological Investigation of Birth Defects in Hebei Province from 2017 to 2021[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(3): 199-202.

图/表 5

参考文献 17

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年份	分娩例数	出生缺陷报告例数	出生缺陷发生率（/万）
2017	50 737	1 419	279.68
2018	44 907	1 371	305.30
2019	44 332	2 582	582.42
2020	33 172	2 512	757.27
2021	26 998	1 024	379.29
合计	200 146	8 908	445.08

年份	分娩例数	出生缺陷报告例数	出生缺陷发生率（/万）
2017	50 737	1 419	279.68
2018	44 907	1 371	305.30
2019	44 332	2 582	582.42
2020	33 172	2 512	757.27
2021	26 998	1 024	379.29
合计	200 146	8 908	445.08

顺序	缺陷种类	例数	发生率（/万）
1	先天性心脏病	5 440	271.80
2	腭裂/唇腭裂	455	22.73
3	多指及并指	420	20.98
4	外耳其他畸形	380	18.99
5	胎儿染色体异常	328	16.39
6	多趾及并趾	246	12.29
7	脑积水	134	6.70
8	尿道下裂	109	5.45
9	消化系统先天畸形	101	5.05
10	马蹄内翻足	89	4.45

顺序	缺陷种类	例数	发生率（/万）
1	先天性心脏病	5 440	271.80
2	腭裂/唇腭裂	455	22.73
3	多指及并指	420	20.98
4	外耳其他畸形	380	18.99
5	胎儿染色体异常	328	16.39
6	多趾及并趾	246	12.29
7	脑积水	134	6.70
8	尿道下裂	109	5.45
9	消化系统先天畸形	101	5.05
10	马蹄内翻足	89	4.45

人群特征	分娩例数	出生缺陷例数	发生率（/万）	χ²	P
城乡				135.298	<0.001
乡村	101 612	3 986	392.28
城镇	98 534	4 922	499.50
年龄				150.229	<0.001
<18岁	222	18	810.81*
18~35岁	168 399	7 086	420.79
≥35岁	31 525	1 804	572.24*
受教育程度				346.936	<0.001
大专及以上	85 295	4 624	542.12^#
高中、中专	59 496	2 072	348.26
初中及以下	55 355	2 212	399.60^#
产次				4 166.050	<0.001
初产妇	78 092	571	73.12
经产妇	122 054	8 337	683.06
新生儿性别				43.152	<0.001
女	98 140	4 065	414.20
男	102 006	4 843	474.78