2014-2024年上海市某医院围产儿出生缺陷情况分析

Analysis of perinatal birth defects in a hospital in Shanghai from 2014 to 2024

摘要

目的 了解上海市某中心城区 H 区某产科医院出生缺陷检出率变化趋势、流行特征及影响因素,为当地出生缺陷防控提供数据支撑。方法 采用回顾性横断面研究方法,利用2014-2024 年 H 区某产科医院数据进行统计学分析,对2022-2024年数据采用卡方检验比较组间率,多因素Logistic回归分析探究影响因素。结果 H 区2014-2024年共监测围产儿70 825例,其中检出出生缺陷1 496例,检出率为21.12‰。进一步基于 H 区某产科医院2014-2024年数据分析发现,51 417例围产儿中有1 367例发生出生缺陷,排名前列出生缺陷类型为先天性心脏病、多指/趾及并指/趾、唇裂和腭裂、神经管畸形、唐氏综合征。对该医院2022-2024年9 265围产儿中495例出生缺陷的统计分析发现,男性(58.41‰)出生缺陷率高于女性(42.99‰);非本地户籍(93.34‰)高于本地户籍(29.35‰);<20岁组产妇所生围产儿(230.77‰)高于其他年龄组;辅助生殖受孕围产儿(77.61‰)高于自然受孕(50.80‰),各组间差异均有统计学意义(χ² 值分别为48.42、299.45、8.13、4.05,P<0.05)。多因素 Logistic回归分析发现,男性围产儿(aOR =1.39,95%CI:1.14~1.71)、胎龄<37 周(aOR =2.28,95%CI:1.62~3.22)、体重<2 500 g(aOR=4.24,95%CI:2.99~6.00)、产妇年龄<20岁(aOR=5.15,95%CI:1.19~22.29)、产次大于1次(2次:aOR=7.63,95%CI:5.72~10.16;3次及以上:aOR=5.60,95%CI:2.67~11.77)是围产儿出生缺陷的危险因素(P 均<0.05)。结论 2014-2024年 H 区某产科医院出生缺陷检出率与 H 区变化趋势基本一致,但高于上海平均水平。需重点关注先天性心脏病、多指/趾及并指/趾、唐氏综合征、神经管畸形等出生缺陷的产前筛查与诊断,重视高龄和多产妇的孕期保健,加强对低龄孕产妇、非本地户籍人口等重点人群的宣教与防治。

Abstract

Objective To understand the changing trend,epidemiological characteristics and influencing factors of birth defects in a certain obstetric hospital in District H of a central urban area in Shanghai,and to provide data support for local birth defect prevention and control. Methods A retrospective cross-sectional study was conducted using data from 2014 to 2024 of a certain obstetric hospital in District H.Chi-square test was used to compare the rates between groups for the data from 2022 to 2024,and multivariate Logistic regression analysis was used to explore the influencing factors. Results From 2014 to 2024 in District H,70 825 perinatal infants were monitored,with 1 496 birth defects (21.12‰).Further analysis based on the data of a certain obstetric hospital in District H from 2014 to 2024 showed that among 51 417 perinatal infants,1 367 cases of birth defects occurred,with the top-ranked types being congenital heart disease,polydactyly/syndactyly,cleft lip and cleft palate,neural tube defects,and Down syndrome.Statistical analysis of 495 cases of birth defects among 9 265 perinatal infants in the hospital from 2022 to 2024 revealed that the birth defect rate was higher in males (58.41‰) than in females (42.99‰);higher in non-local residents (93.34‰) than in local residents (29.35‰);higher in the <20-year-old age group of mothers (230.77‰) than in other age groups;and higher in perinatal infants conceived through assisted reproduction (77.61‰) than in those conceived naturally (50.80‰).The differences between groups were statistically significant (χ²=48.42,299.45,8.13,and 4.05,respectively,P<0.05).Multivariate Logistic regression analysis found that male perinatal infants (aOR=1.39,95%CI:1.14-1.71),gestational age < 37 weeks (aOR=2.28,95%CI:1.62-3.22),weight < 2 500 g (aOR=4.24,95%CI:2.99-6.00),maternal age < 20 years (aOR=5.15,95%CI:1.19-22.29),and parity > 1 (2 times:aOR=7.63,95% CI:5.72-10.16;3 times or more:aORO=5.60,95%CI:2.67-11.77) were risk factors for birth defects in perinatal infants (all P<0.05). Conclusion The detection rate of birth defects in a certain obstetric hospital in District H from 2014 to 2024 was basically consistent with the changing trend in District H,but higher than the average level in Shanghai.It is necessary to focus on prenatal screening and diagnosis of birth defects such as congenital heart disease,polydactyly,syndactyly Down syndrome,and neural tube defects,pay attention to the prenatal care of elderly and multiparous women,and strengthen the education and prevention of key populations such as young pregnant women and non-local residents.

关键词

围产儿 / 出生缺陷 / 医院监测 / 检出率 / 影响因素

Key words

perinatal infant / birth defect / hospital surveillance / detection rate / influencing factor

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基金资助

国家自然科学基金项目(71974037)

人口高质量发展研究揭榜项目(营造生育友好社会氛围)()

2025年度上海市健康科普专项(重点项目)(JKKPZD-2025-B20)

我国妇女儿童健康研究(20241H03219)