摘要
目的探讨2007-2020年重庆市严重多发致残出生缺陷流行现状及变化趋势, 为严重多发致残出生缺陷综合防控措施提供依据。方法基于医院监测数据, 将2007年1月至2020年12月重庆市所有出生缺陷监测机构监测的1 103例严重多发致残出生缺陷患儿纳入研究, 分别按年份、围产儿性别、产妇常住地(城/乡)、产妇年龄、不同地域等类别分组, 采用χ^(2)检验分析不同类别严重多发致残出生缺陷发生率差异, 并通过线性趋势检验分析变化趋势。结果 2007-2020年, 重庆市共监测围产儿1 022 314例, 严重多发致残出生缺陷儿1 103例, 发生率为10.79/万, 其中城镇为11.47/万、乡村为9.48/万, 城镇发生率高于乡村(χ^(2)=8.424, P=0.004);男性为10.47/万、女性为10.97/万, 男性与女性之间差异无统计学意义(χ^(2)=0.606, P=0.436)。不同年龄段产妇严重多发致残出生缺陷发生率呈U型分布, 年龄段间发生率的差异有统计学意义(χ^(2)=59.465, P<0.001), <20岁产妇及≥35岁产妇组发生率较高, 25~29岁组发生率较低。2007年发生率为17.96/万、2020年为7.18/万, 2007—2020年下降了60.02%, 其中神经管缺陷、染色体综合征、肢体短缩、腹壁缺损发生率分别下降了78.12%、77.38%、80.55%、91.30%, 而严重先天性心脏病上升了456.16%。2007—2020年, 重庆市严重多发致残出生缺陷发生率总体呈下降趋势(χ^(2)_(趋势)=117.046, P<0.001), 除严重先天性心脏病呈上升趋势外(χ^(2)_(趋势)=8.744, P=0.003), 其余4类病种均呈下降趋势(神经管缺陷χ^(2)_(趋势)=48.618, P<0.001;染色体综合征χ^(2)趋势=50.999, P<0.001;肢体短缩χ^(2)_(趋势)=73.464, P<0.001;腹壁缺损χ^(2)_(趋势)=79.863, P<0.001)。结论 2007—2020年, 重庆市严重致残出生缺陷发生率呈下降趋势, 且存在地区和年龄差异, 严重先天性心脏病发生率呈上升趋势。
Objective To explore the prevalence and change trend of severe multiple disabling birth defects in Chongqing City from 2007 to 2020,and to provide a basis for comprehensive prevention and control measures of severe multiple disabling birth defects.Methods Based on hospital monitoring data,1103 children with severe multiple disabling birth defects monitored by all birth defects monitoring institutions in Chongqing City from January 2007 to December 2020 were included in the study.They were grouped by year,perinatal gender,maternal permanent residence(urban/rural),maternal age,different regions and other categories.Chi-square test was used to analyze the differences in the incidence of severe multiple disabling birth defects in different categories,and linear trend test was used to analyze the change trend.Results From 2007 to 2020,a total of 1022314 perinatal births and 1103 severe multiple disabling birth defects were monitored in Chongqing City,with an incidence of 10.79/10000,including 11.47/10000 in urban areas and 9.48/10000 in rural areas,with an incidence higher in urban areas than in rural areas(χ^(2)=8.424,P=0.004).Male was 10.47/10000,female was 10.97/10000,there was no significant difference between male and female(χ^(2)=0.606,P=0.436).The incidence of maternal in different age groups was u-shaped,and there was statistical difference in incidence among different age groups(χ^(2)=59.465,P<0.001).The incidence of maternal in<20 years old and≥35 years old was higher,and in 25-29 years old was lower.The incidence rate was 17.96/10000 in 2007 and 7.18/10000 in 2020,which decreased by 60.02%in 2007-2020.The incidence of neural tube defect,chromosome syndrome,limb shortening and abdominal wall defect decreased by 78.12%,77.38%,80.55% and 91.30%,respectively.Severe Congenital heart disease rose by 456.16%.From 2007 to 2020,the overall incidence of the disease showed a decreasing trend(χ^(2)_(trend)=117.046,P<0.001),except for the rise of severe congenital heart disease,(χ^(2)_(trend)=8.744,P=0.003),the other four types of diseases were on the decline(neural tube defects χ^(2)_(trend)=48.618,P<0.001;chromosome syndrome χ^(2)_(trend)=50.999,P<0.001;limb shortening χ^(2)_(trend)=73.464,P<0.001;abdominal wall defect χ^(2)_(trend)=79.863,P<0.001).Conclusion From 2007 to 2020,the incidence of severe disabling birth defects in Chongqing City showed a downward trend,and there were regional and age differences.The incidence of severe congenital heart disease is on the rise.
作者
宋清贤
杨柳
冯苗
余奇
陈亮
童琦
周维瑾
刘俊
Song Qingxian;Yang Liu;Feng Miao;Yu Qi;Chen Liang;Tong Qi;Zhou Weijin;Liu Jun(Medical Research Institute,Southwest University,Chongqing 400715,China;Chongqing Institute of Population and Family Planning Science and Technology Research Institute,Chongqing Birth Defects Prevention and Control Center,Chongqing 401120,China;Shanghai Institute for Biomedical and Pharmaceutical Technologies,Shanghai 200232,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2022年第9期1257-1262,共6页
Chinese Journal of Preventive Medicine
基金
重庆市科技局项目(cstc2017shmsA130102)
重庆市卫健委项目(2017ZDXM015, 2021FY205)
复旦大学遗传工程国家重点实验室开放课题项目(SKLGE1905)。
关键词
出生缺陷
发生率
横断面研究
Birth defects
Incidence
Cross-sectional studies
