宁波市江北区2010-2015年基于孕产人群队列的子代生后2年内出生缺陷发病率研究

目的分析在母体孕产期和出生后不同时间段对出生缺陷发病率和诊断报告案例构成,探索更合适的出生缺陷监测时段。方法利用宁波市江北区2009年10月11日-2015年9月30日全部23 054例妊娠人口,收集孕13周至子代生后2年内报告的出生缺陷个案,描述分析出生缺陷发病率、疾病谱、疾病诊断时间构成。结果基于孕产队列的人群监测中发现,2010-2015年期间,宁波市江北区共发现1 040例出生缺陷。每100名孕妇中,从孕13周至子代生后2年的时间内,子代出生缺陷累计发病率为4.51%;发病率呈逐年上升趋势。出生缺陷在死胎中发病率高。先天性心脏病在出生缺陷顺位中稳居首位。该人群在孕13周～生后7天监测到的发病率为2.70%,监测期延长至生后42天时的发病率3.61%,延长至1年时发病率4.42%,延长至2年时发病率4.51%,从孕13周～生后2年能发现的出生缺陷率是孕13周～生后7天的1.7倍,约97.88%的出生缺陷是在生后1年内被发现。结论延长出生缺陷监测时限,使数据更接近真实值,建议扩大监测期至2年。

Incidence rates of birth defects within 2 years after birth based on the maternal population cohort in Jiangbei District,Ningbo during 2010-2015

Objective To investigate incidence rates of birth defects and diagnosed defect composition during pregnancy and different time period after birth, in order to explore more appropriate time period of birth defects monitoring. Methods The population-based surveillance data were retrived from reginal birth defects monitoring network, where all defects cases reported within 13 weeks of pregnancy to 2 years after birth were selected from 23 054 pregnant women who gave birth within 2010 to 2015 in Jiangbei district, Ningbo city.The incidence rates, the diagonozed defect types and the diagnosed time were descriptively analyzed. Results Totally 1 040 cases of birth defects were found from 2010 to 2015 for all registed pregnant women in the study area.From early pregnancy to 2 years after delivery, the cumulative reporting rate of birth defects was 4.51%, and there existed a year-by-year increasing trend.The incidences rate of birth defects was significantly higher in those of stillbirths.Congenital heart disease ranked the first in all types of birth defects.Calculated by different time (age) point of diagnose, the incidence rate of congenital heart disease was 2.7% from early pregnancy to 7 days after birth, 3.61% before 42 days after birth, 4.42% before 1 year old, and 4.51% before 2 years old.The detection rate of birth defects from gestation age of 13 weeks to 2 years after delivery was 1.7 times higher than that from early pregnancy to 7 days after birth.And nearly 97.88% of birth defects were found within 1 year after birth. Conclusions Prolonging the time period for birth defects surveillance would make data close to the real rate.So it is suggested that the monitoring period of birth defect should be expended to 2 years after birth.