中国双胎及双胎合并出生缺陷的流行病学调查

目的：调查我国围产儿双胎与双胎合并出生缺陷尤其是合并神经管缺陷的发生率及其流行病学情况。方法：于1986年10月1日－1987年9月30日,对全国原29个省,市、自治区共945所城乡医院 住院分娩围产儿,进行了双胎出生率的调查及统一标准的出生缺陷前瞻性的监测,结果：全年共生围产儿1243284名,其中双胎12715对,双胎发生率为10．23％,双胎中出生缺陷发生率为36．81‰,其中神经管缺陷最为高发,为5．27‰,双胎的发生无南北地域及城乡的差异,多发生在生育期高峰年龄（20－29）岁,初产多见,1年中10,11月份出生的发生率高,双胎合并出生缺陷亦无明显南北地域及城乡差异,多发生在20－39岁,无产次及季节的差异;双胎合并神经管缺陷多见于北方诸省及农村人口,其发生与年龄及产次无明显关系;但与季节密切相关,11月份高发。结论：双胎合并出生缺陷,尤其是合并神经管缺陷的发生率均明显高于全国总围产儿合并出生缺陷及神经管缺陷的发生率,因此对双胎妊娠应注意作产前监测。

Epidemiology of twin and twin with birth defects in China

OBJECTIVE: To investigate the incidence of twin and twin with birth defect (BD) and with neural tube defect (NTD) in China. METHODS: A prospective monitoring was conducted among the perinatal infants born in 945 hospitals in 20 provinces/municipalities/autonomous regions in China during the period from 1 October 1986 to 30 September 1987 to count up the numbers of twins and of twins with BD or NTD. RESULTS: 1 243 284 infants were born during this period. Among these perinatal infants there were 12 715 pairs of twins with an incidence of 10.23%. The incidence rates of twin with BD and of twin with NTD were 36.81% and 5.27% respectively. There was no difference in incidence rate of twin among different parts of the country and between urban area and rural area. The incidence rate of twin was the highest among the women aged 20 approximately 39, among primipara, and in October and November. The incidence rate of twin with BD showed no difference among different seasons, parities, and parts of the country and between urban area and rural area. Most of twin with BD occurred at the age 20 approximately 39. Most twins with NTD were born in the northern provinces and rural area. The incidence rate of twin with NTD was correlated with season, most twins with NTD being born in November, and was no correlated with age and parity of the mother. CONCLUSION: The incidence of BD, especially the incidence of NTD, among twins is significantly higher than that among total perinatal infants in China. Prenatal monitoring is important for twin pregnancy.