珠海市围产儿出生缺陷危险因素及干预措施研究

目的调查珠海市围产儿出生缺陷的发生情况,了解围产儿出生缺陷发生的危险因素,为围产儿出生缺陷的预防和干预提供依据。方法收集珠海市2006～2010年出生缺陷资料,对先天畸形儿的双亲进行了病例对照研究,调查其危险因素,并对其综合干预措施的效果进行对比评估。结果干预后,珠海市出生缺陷发生率下降,出生缺陷顺位及构成发生变化,神经管畸形发生率降低。出生缺陷的主要影响因素有：流产史及流产次数、孕期接触化学制剂、生产畸胎史、父亲吸烟史、母亲孕期营养不良、母亲孕期情绪不良。结论影响出生缺陷的相关危险因素较多,降低出生缺陷发生率,应建立多种形式的综合措施,做好三级预防工作。

Relating Factors and Effects of Intervention on Birth Defects in Zhuhai City

Objectives To find out the status of birth defects and the relating factors in Zhuhai city,to valuate the effect of the measures of integrated intervention and to provide evidence for intervention measures and decisions-making.Methods Data was collected from the Zhuhai birth defects surveillance system from 2007 to 2010.And a case-control study was carried out on congenital malformations to evaluate the risk factor and the effect of the measures of integrative intervention.Results The incidence of birth defects reduced after the integrative intervention,top birth defects ranking changed,the incidence of NTD reduced.The main risk factors of congenital malformations were the history of abortion,times of abortion,exposure to chemical substances before or during pregnancy,the history of birth defect,the father＇s smoking history,maternal malnutrition during pregnancy,and maternal bad feelings during pregnancy.Conclusions Some risk factors were identified as having important effect on preinstall congenital malformations.Taking serial integrative intervention measures and strengthening three-level prevention will be beneficial to the reduction of birth defects.