围产儿出生缺陷危险因素监测及干预效果分析

目的 :调查广东省东莞市出生缺陷 (Birth defects,BDs)发生情况 ,了解其相关危险因素 ,对综合干预措施的效果进行评估 ,为预防决策提供依据。方法 :将 1997～ 1999年出生缺陷情况与 2 0 0 0～ 2 0 0 2年出生缺陷情况进行比较 ,对近年实施干预措施效果进行评估。结果 :全市近 6年共有围产儿 2 76 85 9人 ,发生出生缺陷 16 81人 ,出生缺陷发生率 6 .0 7‰ ;围产儿死亡率 13.5 9‰ ,唇腭裂居类别构成首位 ,巴氏水肿是出生缺陷主要构成之一。母亲年龄 35岁组出生缺陷发生率高于年龄 <35岁组 (P<0 .0 1) ,最佳生育年龄为 2 5～ 30岁。通过实施综合干预措施 ,母亲乱用药、接触化学毒物、接触放射线等危险因素暴露率较干预前明显减少 (P<0 .0 1) ;出生缺陷发生率显著下降 (P<0 .0 5 ) ,且出生缺陷顺位发生了变化。神经管畸形、唇腭裂、巴氏水肿发生减少 ,而先天性心脏病发生率增高。结论 :采取综合干预措施可达到降低出生缺陷发生率的目的。

Monitoring hazardous factors of BDs and analyzing the effect of prevention from BDs

Objective:To find out the status of BDs incidence and the related hazardous factors in dongguan area, to valuate the effect of the measures of integrative intervention and to provide the basis of intervention measures and decisions-making Methods: According to retrospective epidemiology studies,compare the occurrence of BDs in 1997-1999 with in 2000-2002, to valuate the effect of the measures of integrative intervention in latter years Results:There were 276 859 perinatal babies in latter six years, BDs come forth 1 681 cases, BDs incidence rate was 6 07‰, perinatal mortality rate was 13 59‰, The constituent ratio of cleft lip with cleft palate ranked first, Bart's hydrops syndrome is a main portion of the BDs The BDs incidence rate of the group which the mother's age _35 was higher than the mother's age <35 ones( P <0 01), the best reproductive age ranges from 25 to 30 years old, through the measures of integrative intervention, the exposure rate of hazardous factors such as mother abusing medince, contacting chemical poison and contacting radiation was strongly lowered than before taking integrative intervention measures( P <0 01),the incidence of BDs remarkably lowered(P<0 05),the ranking procedure was also changed, the incidence of NTD,cleft lip with cleft palate and Bart's hydrops syndrome reduced ,while the incidence of congenital heart disease increased Conclusion:Taking serial integrative intervention measures can reach the purpose of reducing the incidence of BDs