出生缺陷对中国围产儿死亡的影响

目的 分析1990～2001年期间中国围产儿死亡率以及死亡围产儿中出生缺陷发生率的变化趋势,探讨出生缺陷对围产儿死亡的影响。方法 资料来源于中国出生缺陷监测网,采用以医院为基础的监测方法收集资料。调查对象为孕28周到产后7天住院分娩的围产儿。把资料按出生地分为城乡两组,按地理位置和经济发展水平分为沿海、内地、边远地区三组,调查围产儿死亡率和死亡围产儿中出生缺陷的发生率。结果 中国围产儿死亡率由1990年的22.85‰下降到2001年的13.26‰,呈下降趋势;死胎死产率和早期新生儿死亡比例也呈下降趋势。同期围产儿出生缺陷死亡专率呈下降趋势,但死亡围产儿中出生缺陷的发生率却逐年上升;在城镇和乡村以及沿海、内地、边远三类地区中都观察到同样变化趋势,1996～2001年间趋势更为明显。死亡围产儿中出生缺陷发生率城镇高于乡村,沿海和内地高于边远地区。结论 出生缺陷在死亡围产儿中的比例逐年上升,成为导致围产儿死亡的主要原因。

Impacts of birth defects on perinatal deaths in Chinese population

Objective To examine the time trends of perinatal mortality and the frequency of birthdefects occurring in perinatal deaths, and to provide a national perspective on the impacts of congenitalanomalies on perinatal mortality from 1990 through 2001. Methods Data were from Chinese Birth DefectsMonitoring network--a hospital--based congenital anomalies registry system. During 1990--2001, all live orstill births with 28 weeks of gestation or more, born in monitoring units, were studied within 7 day afterdelivery. The proportion of perinatal deaths due to birth defects, which was defined as the number ofperinatal deaths asociated with congenital anomalies per 100 perinatal deaths,was calculated by birth area(urban versus rural), geographic--economic status (coast areas, inner land areas and remote areas), toevaluate the impacts of birth defects on perinatal motality. Results Perinatal mortality declined from22. 85 per 1000 in 1990 to 13. 26 Per 1000 in 2001, which showed a significant downward trend. Similartrend was also observed in the rate of stillbirth and the ratio of early neonatal death. However, theproportion of perinatal deaths due to birth defects had an increasing trend although the perinatal birthdefects--specific death rate was declining, especially during 1996--2001. This result was also seen in urbanand rural area, in coast regions, in inner land regions and in remote regions of China. Higher rate of birthdefects occurring in perinatal deaths was observed in urban area than in rural area. Significant difference ofthis rate was also found among different geographic--economic regions, with the highest one in inlandregious Conclusion Birth defects were accounted for an increasing proportion of perinatal deaths inChina, and had become one of the major causes of perinatal deaths.