文章摘要
张霆,王芳,林良明,宋新明,陈功,顾雪,吴丽华,郑晓瑛.中国出生缺陷高发地区不同监测时段结构性出生缺陷发生率的比较分析[J].中华流行病学杂志,2008,29(3):221-223
中国出生缺陷高发地区不同监测时段结构性出生缺陷发生率的比较分析
Occurrence Of structural birth defect in high-prevalent areas of China
收稿日期:2007-10-11  出版日期:2014-09-15
DOI:
中文关键词: 出生缺陷;监测;发生率;监测时段
英文关键词: Birth defect;Surveillance;Incidence;Range of monitored ages
基金项目:国家重点基础研究发展规划"973"资助项目(2001CB5103)
作者单位E-mail
张霆 首都儿科研究所 100020 北京  
王芳 首都儿科研究所 100020 北京  
林良明 首都儿科研究所 100020 北京  
宋新明 北京大学人口研究所世界卫生组织生殖健康合作中心
北京 大学中国人口健康与发展中心 
 
陈功 北京大学人口研究所世界卫生组织生殖健康合作中心
北京 大学中国人口健康与发展中心 
 
顾雪 首都儿科研究所 100020 北京  
吴丽华 首都儿科研究所 100020 北京  
郑晓瑛 北京大学人口研究所世界卫生组织生殖健康合作中心
北京 大学中国人口健康与发展中心 
xzheng@pku.edu.cn 
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中文摘要:
      目的 比较分析不同监测时段出生缺陷监测发生率的差异及不同出生缺陷的诊断时间分布特征.方法 在中国出生缺陷高发的山西省选择2个高发县作为调查现场,对调查地区2002年1月1日至2004年12月31日期间孕满20周及以上的所有胎儿及婴幼儿开展出生缺陷监测工作,调查监测出生缺陷主要包括体表和内脏畸形.结果 结构性出生缺陷监测发生率随着监测时段的延长而显著提高.从孕20周监测到孕27周、出生后7天、1周岁和3周岁的出生缺陷发生率分别为17.6‰、34.‰、43.6‰和53.7‰.如以孕28周到出生后7天作为常规监测时段,监测时段提前至孕20周,则出生缺陷监测发生率为常规监测的2.1倍;如果监测时段在提前到孕20周的同时向后延长至生后1周岁和3周岁,则出生缺陷监测发生率分别为常规监测的2.7倍和3.3倍.不同出生缺陷诊断时间分布的差异有统计学意义.绝大多数神经管畸形病例在产前或出生后7天内被发现而诊断;唇裂、唇腭裂、多指(趾)、外耳畸形等易于观察诊断的体表畸形,多在出生后7天内被诊断;内脏畸形多在7天后随年龄增长逐步被发现,相当一部分在1岁后被诊断.<>b结论 在调查地区现有诊断技术水平条件下,监测时段为孕28周到出生后7天的出生缺陷监测仅能发现1/3左右的结构性出生缺陷病例.提示:孕20周至27周、孕28周至生后7天及出生7天以后不同监测时段发现的主要畸形种类不同,对这一时段监测特征需要在今后全国同类工作中加以充分考虑.
英文摘要:
      Objective This research was to compare the occurrence levels of birth defect, to describe the distribution of primary birth defects in different range of monitored ages and to provide data to China birth-defect monitoring system. Methods A retrospective study on birth defect was conducted in two counties, Shanxi province, China, which covered birth defects among fetuses after 20 gestational age from 2002 through 2004.Data collected on birth defect cases mainly included extrinsic and visceral anomaly. Results The occurrence rates of the monitored structural birth defects significantly increased with the increase of age. The occurrence rates were 17.6,34.0, 43.6, and 53.7 per 1000 births, for different statistical range, from 20-week to 27-week gestational age, 7 days, 1 year and 3 years after birth, respectively. The range from 28-week gestational age to 7 days after birth was usually regarded as the routinely monitored range. If the occurrence rate was calculated from the 20-week gestational age, it appeared a 2. 1一time increase. However, if the range was changed to 1 or 3 years after birth, the occurrence rate increased to 2. 7 or 3.3 times high, respectively. The distribution of time when birth-defect was identified was significantly different by categories with majority of neural tube defect cases diagnosed at antepartum or 7 days after birth. Visceral defects were mainly found at 7 days after birth but increased with age, even some were diagnosed at 1 year after birth. Conclusion The routine Chinese monitoring program might detect approximately 1/3 of those structural birth defects with the base of current technique and monitoring range from 28-week gestational age to 7 days after birth. The result of our findings should be of help to other related studies.
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