孕妇年龄与围产期胎儿出生缺陷关联的回顾性队列研究

目的 探究孕妇年龄与围产期胎儿发生出生缺陷的关系.方法 采用回顾性队列研究方法,对2009-2012年广东省21个地市共58家医院出生缺陷监测网络数据的孕妇年龄和胎儿出生缺陷进行分析,计算出生缺陷率及其RR值,以确定孕妇年龄与出生缺陷的关联.结果 2009-2012年共有789,319例围产期胎儿,出生缺陷有29,114例,出生缺陷发生率为369/万.孕妇年龄为＜20岁、20～24岁、25～29岁、30～34岁和＞35岁的出生缺陷率分别为365.43/万、358.02/万、355.30/万、379.41/万和439.74/万,其中25～29岁的出生缺陷率最低(RR:0.97;95％CI:0.90-1.05),＞35岁最高(RR:1.20;95％CI:1.10-1.30).结论 孕妇年龄与胎儿发生出生缺陷的关系密切,应加强孕妇尤其是高龄孕妇的孕前、孕早期保健宣传,并开展产前筛查、产前诊断和新生儿疾病筛查工作,避免和减少出生缺陷发生,提高出生人口素质.

A retrospective cohort study about the relationship between birth defects and maternal age

Objective To find out the relationship between birth defects and maternal age.Methods A retrospective cohort study was conducted to analyze the birth defects surveillance data of Guangdong province between 2009 and 2012,calculating the proportion of birth defects and its risk ratio.All the statistical analyses were conducted by Statal3.Results There were 789,319 newborns between 2009 and 2012,including 29,114 defective children,the proportion of birth defects was 369/10,000.The proportions of birth defects in pregnant woman aged ＜20,20-24,25-29,30-34,and ＞35 years old were 365.43/10,000,358.02/10,000,355.30/10,000,379.41/10,000,and 439.74/10,000 respectively.The lowest proportion was in 25-29 years old group (RR:0.97;95％CI:0.90-1.05),the highest proportion was in ＞35 years old group (RR:1.20;95％CI:1.10-1.30).Conclusions Birth defects were closely related to maternal age.In order to avoid and reduce the occurrence of birth defects and improve the quality of the newborns,relevant departments should strengthen early-pregnancy health care of pregnant women,especially older pregnant women,and carry out prenatal screening and diagnosis of diseases among the newborns.