目的 探讨出生缺陷的状况及其影响因素,为降低出生缺陷干预措施的制定提供依据.方法 回顾性监测分析我院2001年1月至2010年12月10年间分娩的围产儿出生缺陷状况.结果 10年监测17 365例围产儿,其中出生缺陷儿205例,平均出生缺陷发生率为11.81‰,总体出生缺陷的年度发生率间无显著性差异(χ2=4.303,P=0.890>0.05),但2006年至2010年与2001年至2005年相比,神经管畸形的构成比明显下降(17.09%vs29.55%,χ2=4.474,P=0.034<0.05,OR=0.492).前5位出生缺陷依次为:神经管畸形,多并指(趾),唇、腭裂,泌尿道畸形,先天性心脏病,其发生率分别为:2.66‰,2.49‰,1.22‰,1.10‰和0.98‰.前3种出生缺陷发生率之和占总出生缺陷发生率的52.69%.出生缺陷发生率与产妇年龄(χ2=14.946,P=0.000<0.05,OR=1.712)、围产儿性别(χ2=6.488,P=0.011<0.05,OR=1.440)关系密切.52.20%的出生缺陷在产前确诊.B超为主要确诊方式(57.07%).结论本地区出生缺陷发生率有待降低,特别是神经管畸形,多并指(趾),唇、腭裂畸形类型.小剂量叶酸干预对预防神经管畸形效果明显.%Objective To investigate the status of birth defect and their influencing factors so as to provide some basis for making intervention strategies to decrease birth defect. Methods The perinatal birth defect of infants born in Fourth People' s Hospital of Jinan City from January 2001 to December 2010 were retrospectively reviewed. Results During these 10 years 205 out of 17 365 perinatal infants were born with birth defect, and the average incidence rate of birth defect was 11. 81%e. There was no significant difference among annum incidence rate of overall birth defect ( χ2 = 4. 303 , P = 0. 890 > 0.05 ). But compared with the period of 2001-2005, the constituent ratio of neural tube defect at the period of 2006-2010 decreased significantly ( 17.09% vs 29. 55% ,χ2 = 4. 474,P = 0.034 <0.05,OR =0. 492 ). The first 5 types of birth defect were neural tube defect, polysyndactyly, cheilopalatognathus, urinary tract defect and congenital cardiopathy in turn, and the incidence rates of them were 2. 66 , 2.49 , 1. 22 , 1. 10 and 0. 98 , respectively. The sum of incidence of the first three types occupied 52. 69% of overall birth defect rate. The age of puerperants (x = 14. 946,P =0.000 <0. 05,OR = 1.712 ) and the gender of perinatal infants (χ2 = 6.488 ,P = 0. 011 <0. 05, OR = 1.440 ) were closely related with birth defect. There were 52. 20% of birth defect diagnosed before birth, and B-ultrasound was the main method for diagnosing ( 57. 07% ). Conclusion The incidence rate of birth defect in the area needs to be cut down, especially the types of neural tube defects, polysyndactyly and cheilopalatognathus. Low-dose of folic acid has significant effect in preventing neural tube defects.
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