摘要
目的 了解南京市秦淮区新生儿结构性出生缺陷检出情况及影响因素,为制定相关干预措施提供依据.方法 收集2021-2023年南京市秦淮区4家出生缺陷监测医院上报的新生儿结构性出生缺陷相关数据,采用多因素logistic回归分析新生儿结构性出生缺陷的影响因素.结果 2021-2023年,共监测新生儿65 045人,发现结构性出生缺陷1 951例,发生率为29.99‰,3年出生缺陷发生率26.22‰～34.29‰,差异有统计学意义(x2=25.55,P＜0.05).结构性出生缺陷中,循环系统缺陷占64.33％,其次为眼、耳、面和颈部(占11.89％)、肌肉骨骼系统(占11.53％).多因素logistic结果显示:小于胎龄儿(SGA)、中收入家庭、孕早期患发热或病毒感染、孕早期患其他疾病、早产、未服用叶酸、未做婚孕前检查的出生缺陷发生风险较高(OR值分别为1.88、4.97、4.16、2.39、1.75、10.30、3.82,P值均＜0.05);大于胎龄儿(LGA)、产次≥2次、多胎出生缺陷发生风险较低(OR值分别为0.48、0.70、0.70、0.72,P值均＜0.05).结论 应针对高危人群做好新生儿结构性出生缺陷干预工作,降低出生缺陷发生风险.
Abstract
Objective To investigate the incidence of structural birth defects and influencing factors among neonates in Qinhuai District,Nanjing City,so as to provide insights into formulation of birth defect control measure.Methods Data pertaining to neonatal structural birth defects reported by four birth defect monitoring hospitals in Qinhuai District,Nanjing City were collected from 2021 to 2023,and factors affecting the risk of neonatal structural birth defects were identified using a multivariate logistic regression model.Results A total of 65 045 neonates were monitored from 2021 to 2023,and a total of 1 951 neonates with structural birth defects were detected,with an incidence rate of 29.99‰.The incidence of neonatal structural birth defects was 26.22‰ to 34.29‰ from 2021 to 2023(x2=25.55,P＜0.05).Structural birth defects predominantly occurred in the circulatory system(64.33％),followed by in the eye/ear/face/neck(11.89％)and muscular/skeletal system(11.53％).Multivariate logistic regression analysis showed that small-for-gestational age(SGA),middle-income family,development of fever and viral infections at the first trimester,other diseases,premature birth,without administration of folic acid and without healthy examinations prior to marriage or pregnancy resulted in a high risk of birth defects(OR=1.88,4.97,4.16,2.39,1.75,10.30 and 3.82,all P values＜0.05),and large-for-gestational age(LGA).parity of two and more and multifetal pregnancy resulted in a low risk of birth defects(OR=0.48,0.70,0.70 and 0.72,all P values＜0.05).Conclusions Targeted interventions are required for neonatal structural birth defects among high-risk populations to reduce the risk of birth defects.
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