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目的:了解2008～2010年武汉市出生缺陷发生的情况,弄清对出生缺陷发生有影响的相关因素,为进一步研究提供基础。方法:收集武汉市11家省级出生缺陷监测点的产科机构的数据,以上报的出生缺陷儿933例为病例组;从武汉市妇幼信息系统中随机抽取933例于2008～2010年分娩正常新生儿的产妇为对照组,通过出生缺陷报告卡和妇幼信息系统获得相关信息进行统计分析。结果:武汉市2008～2010年出生缺陷的发生率为17.77%,远城区出生缺陷的发生率高于中心城区,差异有统计学意义(P<0.01);产妇年龄<25岁和≥35岁时出生缺陷儿的发生率高于产妇年龄在25岁～35岁产妇的发生率,年龄段之间的差异有统计学意义(P<0.01)。将孕产次、胎儿性别、孕早期患病等11个因素作为自变量进行Logistic回归分析的结果表明孕期常住地址、孕早期患病、有自然流产史进入模型。居住地为远城区、孕早期有病毒感染、妊娠剧吐等病史、既往有自然流产史2次以上提高了出生缺陷的发生风险。结论:应重视出生缺陷发生的一级预防,开展大规模以人群为基础的病例-对照研究,弄清楚引起出生缺陷的流行病学因素,从而制定相应的干预措施,降低出生缺陷的发生。
OBJECTIVE: To understand the occurrence of birth defects in Wuhan from 2008 to 2010, find out the related factors that have an impact on birth defects, and provide the basis for further research. Methods: The data of obstetric institutions in 11 provincial-level birth defect monitoring sites in Wuhan were collected, and 933 cases of birth defects were reported as cases. A total of 933 cases of normal births from 2008 to 2010 were collected from Wuhan Women and Children Information System Children’s mothers as control group, through the birth defect report card and information system for women and children access to relevant information for statistical analysis. Results: The incidence of birth defects in Wuhan from 2008 to 2010 was 17.77%. The incidence of birth defects in far urban areas was higher than that in central urban areas (P <0.01). When maternal age was less than 25 and ≥35 The incidence of birth defects was higher than the incidence of maternal age in the 25-35 years old males, the difference was statistically significant (P <0.01). The results of Logistic regression analysis of 11 factors including maternal age, sex of the fetus, and the disease in the first trimester of pregnancy showed that the pregnancy address, the first trimester of pregnancy, and the history of spontaneous abortion entered the model. Residence for the far urban areas, early pregnancy virus infection, hyperemesis gravidarum and other medical history, past history of spontaneous abortion more than 2 times to improve the risk of birth defects. CONCLUSIONS: Primary prevention of birth defects should be emphasized. A large population-based case-control study should be conducted to find out the epidemiological factors that cause birth defects and to make corresponding interventions to reduce birth defects.