Monitoring of birth defects and analysis of influencing factors of congenital heart disease in perinatal infants in Ankang from 2017 to 2021
Objective To understand the incidence and change trends of birth defects among perinatal infants in Ankang city,Shaanxi Province,from 2017 to 2021,and analyze the influencing factors of congenital heart disease(CHD).This aims to provide a scientific basis for developing effective prevention and control strategies for birth defects.Methods Based on data from the Maternal and Child Health Information System of Shaanxi Province,a retrospective analysis was conducted on the data of perinatal infants with birth defects in Ankang City from 2017 to 2021 across various midwifery medical institutions.A case-control study design was adopted,and the perinatal infants diagnosed with CHD from 28 weeks of gestation to 7 days after birth were selected as the case group(200 cases),while infants diagnosed with non-CHD birth defects during the same period were selected as the control group(400 cases).Univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of CHD.Results From 2017 to 2021,a total of 126 077 perinatal infants were monitored in Ankang City.Among them,there were 1,116 cases of birth defects,with an overall incidence rate of 88.52 per 10 000.The top five birth defects among perinatal infants were CHD(29.90 per 10 000),polydactyly(13.72 per 10 000),cleft lip and palate(7.54 per 10 000),other external ear anomalies(6.11 per 10 000),and clubfoot(5.79 per 10 000).From 2017 to 2021,the incidence rate of birth defects in Ankang City increased from 63.89 per 10 000 to 131.96 per 10 000.In 2021,it was approximately 2.07 times higher than that in 2017,showing a significant upward trend(x2trend=106.074,P＜0.001).Specifically,the incidence rate of CHD showed a significant increase(x2trend=81.109,P＜0.001).Among the 377 cases of CHD birth defects monitored from 2017 to 2021,the most common types of CHD were patent ductus arteriosus,atrial septal defect,ventricular septal defect,and tetralogy of Fallot,accounting for 32.10％,24.14％,13.79％,and 9.02％,respectively.Additionally,there were 12 infants with complex CHD subtypes(atrial septal defect+patent ductus arteriosus,atrial septal defect+ventricular septal defect,atrial septal defect+pulmonary valve stenosis),accounting for 3.18％.Univariate analysis showed statistically significant differences in the distribution of gestational age and maternal history of spontaneous abortion and tobacco exposure between the case group and the control group(x2 values were 13.187,5.280 and 12.927,respectively,all with P＜0.05).Multivariate logistic regression analysis revealed that preterm birth(gestational age＜37 weeks)(OR=1.834,95％CI:1.196,2.812)and maternal history of tobacco exposure(OR=1.914,95％CI:1.081,3.387)were both risk factors for CHD in perinatal infants(P＜0.05).Conclusion Strengthening health education,improving pregnancy healthcare,staying away from tobacco and other adverse exposures,and actively participating in beneficial programs are all effective strategies for preventing the occurrence of birth defects.
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