Maternal age-period-cohort effects on the incidence rate of neonatal congenital heart defects in Shanghai Municipality,2012-2021
Objective To analyze and describe the effects of maternal age,period and birth cohort on the incidence rate of neonatal congenital heart defects(CHD)and their features in Shanghai Municipality.Methods We collected the birth medical records of singleton newborns from all delivery service institutes in Shanghai Municipality in 2012-2021.Based on the age-period-cohort model,apc_ie module within STATA was used to evaluate the effects of maternal age,delivery period and birth cohort on the incidence rate of CHD among singleton newborns in Shanghai Municipality.Results The effects of maternal ages on the incidence rate of CHD in the singleton newborns in Shanghai Municipality showed that Shanghai ID mothers(SID)aged 29-30,40 and 42 years had a relative risk(RR)range of 0.805-0.809(P＜0.05)and RRs of 1.503(P＜0.05)and 1.956(P＜0.05)respectively,and non-SID mothers aged 30-32,38,40 and 42 years had a RR range of 0.784-0.881(P＜0.05)and RRs of 1.256(P＜0.05),1.285(P＜0.05)and 1.437(P＜0.05)respectively.The maternal age-specific RRs in all the mothers generally increased with the increasing age.The effects of maternal delivery periods on the incidence rate of CHD in the singleton newborns in Shanghai Municipality displayed that SID mothers had a RR range of 0.701-0.800(P＜0.05)during 2012-2014,a RR of 0.857(P＜0.05)in 2017 and a RR range of 1.304-2.332(P＜0.05)during 2019-2021,and non-SID mothers had a RR range of 0.671-0.898(P＜0.05)during 2012-2014,a RR range of 0.840-0.897(P＜0.05)during 2016-2017,a RR of 1.156(P＜0.05)in 2015,and a RR range of 1.189-1.767(P＜0.05)during 2019-2021.The maternal period-specific RRs in all the mothers showed an ascending trend year by year.The effects of SID and non-SID mothers'birth cohorts on the incidence rate of CHD in the singleton newborns in Shanghai Municipality revealed that 96.43％of the cohort-specific RRs(ranging from 0.677 to 2.704)had p values bigger than 0.05.The incidence rates of CHD in the singleton newborns from SID and non-SID mothers showed upward trends since 2012,and their changing characteristics were similar to those of the period-specific RRs.Conclusion The main causes for the increase of incidence rate of neonatal CHD in Shanghai Municipality include remarkable results from the screening strategies for neonatal CHD carried out by relevant departments and institutions in Shanghai Municipality in the past 10 years and the constant increased proportion of advanced maternal age.
congenital heart defectage effectperiod effectcohort effectage-period-cohort model
NETL
NSTL
万方数据
