2009年长春市出生缺陷监测资料分析

目的:为更好的研究和分析长春地区国产儿出生缺陷发生的动态情况,为上级和有关部门制定预防措施提供真实数据。方法:按照中国出生缺陷监测中心制定的出生缺陷诊断及统计标准要求,采用全国统一出生缺陷儿登记卡及围产儿季报表,专人逐项填写,按季上报,并由省、市、区三级监测指导单位分级进行质控。结果:共监测国产儿55281例,出生缺陷儿538例,出生缺陷发生率97.32/万;围产儿死亡507例,围产儿死率91.71/万;出生缺陷前6位依次为总唇腭裂、先天性心脏病、多指、外耳畸形、神经管畸形、脑积水:产母年龄35岁以上为出生缺陷高发年龄。结论:应加强优生知识的宣传,定期孕检,提高产前诊断技术,降低出生缺陷儿的发生率,提高人口质量。     

安陆市2006年—2010年出生缺陷监测情况分析

目的：调查本市出生缺陷的发生情况,分析出生缺陷的高危因素,探索降低出生缺陷发生率的干预措施。方法：通过市、乡、村三级妇幼保健网络的管理,由受过培训的专业人员调查填写上报《出生缺陷报告卡》,每季度各乡镇卫生院组织一次补漏调查,市妇幼保健院每半年组织一次补漏调查,进行质量控制。结果：2006年1月1日至2010年12月31日在安陆市辖区内出生的24835例新生儿中,出生缺陷212例,出生缺陷发生率为8.54‰。孕母年龄〈25岁组、25岁～组、30岁～组之间无统计学差异。35岁～组出生缺陷发生率明显高于其他三组。出生缺陷发生率男性明显高于女性,农村明显高于城市。结论：加大宣传力度,认真落实三级预防措施,加强重点区域、重点人群的管理,控制出生缺陷发生率。     

出生缺陷儿4214例流行病学资料分析

出生缺陷是影响人口素质的主要因素之一,本文选取河南省61所县市级医院1997~2003年4214例出生缺陷儿的流行病学资料,总结出生缺陷的发生率及各种畸形的发生顺位,供临床参考。1资料与方法1.1对象调查对象为按照地理位置随机分层抽取的61所监测医院中住院分娩的孕满28周到出生后7     

10073例围产儿出生缺陷监测临床研究

１９８６年１０月至１９９６年１２月,出生围产儿共１００７３例、出生缺陷儿８５例,出生缺陷率为８．４４‰;单发畸形６８例、多发畸形１７例;畸形各系统分布顺位之前三位依次为：颌面五官、骨骼肌肉和神经系统。经统计学处理表明：农村比城市、经产比初产、早产儿与过期产儿比足月产儿、低体重儿与巨大儿比正常体重儿、女胎比男胎的畸形发生率均高,有极显性著意义（Ｐ＜０．０１）。提示：必须坚决实行计划生育,严格控制多胎妊振,做好围产期保健,对可能分娩畸形儿的孕妇做到尽早产前诊断,进行选择性流产,能有效提高人口素质。     

上海市10年出生缺陷监测情况分析

目的 了解近10年来上海市出生缺陷的发生、消长趋势及存在的问题,为采取相应的干预措施提供依据。方法 采用回顾性调查方法,以无脑儿、脑积水、脊柱裂、脑膨出、腹裂和联体双胎6种致死率高、伤残性大且孕中期大多可通过B超发现的主要形态畸形及其他畸形,进行专题回顾性个案调查。结果 上海市近10年出生缺陷发生率为8.42‰,前3位依次为先心病、多指和唇腭裂。与全国相比除先心病、21-三体、尿道下裂、唇裂、腭裂和小耳的发生率高于全国水平外,其余都较低。在198例21-三体中,产妇35岁以上者占34.34％;主要形态畸形的产前确诊率为60.64％,平均确诊时间在孕30周以上。所有出生缺陷儿的围产期死亡率为23.27％。结论 上海市出生缺陷发生率低于全国水平,但产前诊断的覆盖率和质量还需提高。     

出生缺陷儿36例情况分析

目的了解黄埔区出生缺陷儿发生状况，为制定本区预防措施提供依据。方法对1999～2003年在本区监测医院分娩的孕28周至产后7天的活产儿、死胎和死产，按照《主要先天畸形诊断手册》出生缺陷的诊断方法进行筛查、诊断，所得资料进行统计分析。结果监测了4284例围产儿，筛查、诊断了出生缺陷儿36例，本区出生缺陷儿发生率为84．03／万，低于全国水平；出生缺陷儿的发生男婴高于女婴，与产妇的年龄、城乡差异无显著性。结论普及优生优育知识，提高产前诊断水平是目前减少出生缺陷儿的有效措施。     

长春绿园区2002年出生缺陷监测

目的调查我区出生缺陷(birth defect，BD)发生情况，了解其相关危险因素，为预防决策提供依据。方法以区妇保区域内的医院产科为监测点，对2002年住院分娩的1843例围产儿进行监测。结果BD发生18例，发生率9．77％(18／1843)，BD围产儿死亡率为277．78％。(5／18)，肢体缺陷发生率居发生类别的首位。相关因素为孕龄、居住环境、婴儿性别等多因素。结论控制出生缺陷，有效的提高人口出生素质。     

河南省1996～2002年出生缺陷监测结果分析

河南省出生缺陷监测网络自 1996年正式启动 ,经过 7年运行 ,对河南省出生缺陷发生的动态变化、畸形顺位、分布特征及存在的问题有了较系统的了解。本文通过对 7年来河南省出生缺陷的动态变化情况进行总结分析 ,提出了有效降低出生缺陷率的措施 ,通过有效监控 ,降低出生缺陷儿的发生率。1　资料与方法根据河南省年出生人口数、地理位置及经济发展状况 ,采用分层抽样法 ,在全省 2 5个市县共抽取 6 1所县市级医院作为出生缺陷监测点。1 1　监测对象及内容　对监测医院住院分娩的孕满 2 8周到出生后 7天的围生儿 (包括死胎、死产及生后 7天内死…     

渭源县2009—2012年出生缺陷监测结果与分析

目的：了解我县2009年3月至2012年3月出生缺陷发生情况及影响因素,并提出相应的干预措施。方法：监测12家分娩医院孕28周至产后7天内的13598例围产儿。结果：出生缺陷的发生率2．9％0,出生缺陷前5位是多指（趾）、外耳畸形,神经管畸形,唇腭裂（含唇裂、腭裂）、唇裂,结论：加强宣教,加强婚前、孕前保健,加强产前检查和产前诊断,可降低出生缺陷发生率。,     

2009年统计年度阳曲县围产儿出生缺陷监测分析

目的:了解阳曲县2009年出生缺陷的发生情况,探讨出生缺陷的相关因素,为减少出生缺陷制定预防保健措施提供依据。方法:按照《山西省出生缺陷监测方案》对2009年统计年度15个监测医院孕28周至产后7天内分娩的围产儿出生缺陷监测资料进行分析。结果:1099例围产儿出生缺陷发生率为136.49/万(15/1099);出生缺陷发生居前5位的依次是:马蹄内翻足、脑积水、脑膜膨出、外耳畸形、脊椎裂;城镇出生缺陷发生率高于农村,男女婴出生缺陷发生比例是7:8,但其差异均无统计学意义。结论:阳曲县出生缺陷以神经管畸形为主。     

Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990-1998)

Prevalence rates of birth defects in the Federal Republic of Germany are informative to assess the general background risk of having a child with a birth defect. They provide basic figures to determine temporal and regional prevalence trends, to evaluate and initiate preventive measures and to initiate research projects. To avoid observer, definition and collection bias, active monitoring systems are required. Data collected in the active monitoring system of the Mainz Birth Defects Registry are presented. From 1990–1998, 30940 livebirths, stillbirths and abortions underwent standardized physical and sonographic examinations. Anamnestic data were collected from prenatal care records, maternity files and hospital records. Major malformations were diagnosed in 2144 (6.9%) and mild errors of morphogenesis in 11104 (35.8%) of all infants. Risk factors associated with the occurrence of major malformations were identified by comparing anamnestic data from infants with and without major malformations. Using multivariate regression models, statistically significant associations were established for 9 risk factors. Causally related risk factors were parents or siblings with malformations, parental consanguinity, more than 3 minor errors of morphogenesis in the proband, maternal diabetes mellitus and ingestion of antiallergic drugs in the first trimester of pregnancy. Conjunctional risk factors were polyhydramnios, oligohydramnios and gestational age <32 weeks at birth. Using these risk factors, populations at risk for the occurrence of major malformation can be identified. Received: 22 June 2001 / Accepted: 25 September 2001     

出生缺陷围产儿119例临床分析

目的 了解出生缺陷围产儿的发生率、发生系统及缺陷分布情况，为临床预防和治疗提供依据。方法 回顾性分析1997～2004年我院产科分娩的7720例围产儿资料，对其中119例出生缺陷围产儿逐一进行分类和统计学分析。结果 8年间出生缺陷平均发生率为15．41‰，2001～2004年间发生率为21．65‰，1997～2000年间发生率为10．65‰，两个时期比较，差异有显著性（P〈0．05）。前3位出生缺陷依次为心血管系统缺陷、多器官畸形、四肢缺陷。缺陷儿中孕妇有各种合并症者52例，占43．70％，存在可能致畸因素者75例，占63．03％。结论 孕早期是预防出生缺陷的关键，加强对高危妊娠的监测和产前诊断则是预防的重要手段，先天性心脏病的发生呈上升趋势，目前已位居我院出生缺陷的首位，应加强对其诊断及预防措施的研究。     

Predicting preterm birth: a cost-effectiveness analysis

OBJECTIVE: The objective of this study was to compare the cost-effectiveness of 9 strategies for the management of threatened preterm labor. STUDY DESIGN: We derived 6 management options from the literature. These were (1) to treat all women with tocolytics and corticosteroids ("treat all"); (2) to treat all women while awaiting results of the "traditional" fetal fibronectin test results, then discontinue treatment on those with negative results; (3) to treat only those with abnormal cervical length measurements as detected by ultrasonography; (4) to treat only those with abnormal "rapid" fetal fibronectin test results; (5) to perform rapid fetal fibronectin testing and cervical length measurements and treat those with a positive result on either or both; (6) not to treat any women ("treat none"). To assess the contributions of tocolytics and corticosteroids to our outcomes, we analyzed 3 additional treatment options: (7) to treat all women with outpatient corticosteroids but not give tocolytics, (8) to administer corticosteroids to all but give tocolytics only to those with abnormal rapid fetal fibronectin test results, and (9) to administer corticosteroids to all but give tocolytics only to those with abnormal cervical length. We used decision analytic techniques to perform a cost-effectiveness analysis. RESULTS: A decision tree was constructed on the basis of these strategies. We reviewed the literature to derive all probability information. We derived sensitivity and specificity for delivery <37 weeks for fetal fibronectin and for abnormal cervical length. Outcomes of interest were respiratory distress syndrome and neonatal death. We derived cost variables from institutional statistics and from values quoted in the literature. Total costs, cases of respiratory distress syndrome, neonatal deaths, and cost-effectiveness ratios were calculated for each of the strategies. We conducted sensitivity analyses on all variables. Universal administration of outpatient corticosteroids was the least expensive option, but it resulted in more cases of respiratory distress syndrome and deaths than "treat all." Rapid fetal fibronectin plus corticosteroids, traditional fetal fibronectin, and cervical length plus corticosteroids were the next least expensive options and resulted in numbers of cases of respiratory distress syndrome and deaths that were similar to those in the "treat all" strategy. The "rapid" fetal fibronectin test, cervical length measurement, rapid fetal fibronectin test plus cervical length measurement, and "treat none" strategies resulted in more respiratory distress syndrome, more deaths, and higher costs. Treating all patients resulted in the fewest number of cases of respiratory distress syndrome and deaths but the greatest costs. CONCLUSION: Risk prediction strategies with the fetal fibronectin assay or corticosteroids plus rapid fetal fibronectin testing or cervical length assessment may offer cost savings compared with treatment of all women with threatened preterm labor and may prevent similar numbers of cases of respiratory distress syndrome and neonatal deaths.     

Methodological issues in collecting data from traditional birth attendants

Information on the activities, practices and social context of pregnancy and delivery care provided by traditional birth attendants (TBA) is a critical requirement in planning, monitoring and evaluating maternal health programs in many countries. As a result of experimental studies in which such information was obtained by a variety of methods, and a review of alternative methodologies, a set of guidelines has been developed for the collection of such information. High-lighted are the need for good background knowledge on the local situation, involving TBAs themselves in design and collecting methods, a system of supervision to ensure adequate training and careful monitoring, and finally sharing the findings with the TBAs as well as with health officials.