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[目的]分析承德市出生缺陷发生情况、流行病学特征及影响因素,为制定干预措施提供依据。[方法]对2004～2008年承德市全人群出生缺陷监测报告病例进行流行病学分析。[结果]5年监测218300例围产儿,其中出生缺陷儿1792例,平均出生缺陷发生率为8.21/‰,5年的出生缺陷发生率分别为7.04/‰、7.91/‰、7.66/‰、9.23/‰、9.42/‰,呈上升趋势。前6位出生缺陷依次为神经管畸形、总唇裂、先天性脑积水、多指、先天性心脏病、马蹄内翻足;出生缺陷发生率与性别无关(χ2=2.452,P﹥0.05);乡村发生率明显高于城市(χ2=8.52,P﹤0.01);产妇年龄≤20岁和≥35岁组高于平均发生率(P﹤0.01)。[结论]加强优生遗传工作力度,广泛开展宣传教育,增强出生缺陷防范意识,加强婚检、孕前、孕期保健、产前筛查与产前诊断是减少出生缺陷发生的根本措施,而贫困农村是当前工作重点,应加大政府对农村妇幼保健工作投入,保障预防保健措施实施。
[Objective] To analyze the occurrence, epidemiological characteristics and influencing factors of birth defects in Chengde City and provide the basis for making intervention measures. [Methods] The epidemiological analysis of the monitoring reports of birth defects among the whole population in Chengde from 2004 to 2008 was conducted. [Results] A total of 218300 cases of perinatal children were monitored in 5 years, including 1792 cases of birth defects, the average incidence of birth defects was 8.11 / ‰, the incidence of birth defects in 5 years were 7.04 / ‰, 7.91 / ‰, 7.66 / ‰ 9.23 / ‰, 9.42 / ‰, showing an upward trend. The first six birth defects were neural tube defects, total cleft lip, congenital hydrocephalus, multiple fingers, congenital heart disease and clubfoot. The incidence of birth defects was not related to gender (χ2 = 2.452, P> 0.05). The prevalence rate in rural area was significantly higher than that in urban areas (χ2 = 8.52, P <0.01). The average incidence of maternal age ≤20 years and ≥35 years was higher than the average (P <0.01). [Conclusion] To strengthen the genetic work of eugenics, widely carry out publicity and education to enhance awareness of birth defects prevention, strengthen premarital, pre-pregnancy, prenatal care, prenatal screening and prenatal diagnosis is the fundamental measure to reduce the birth defects, and poor rural is the current Work priorities should be increased government investment in rural maternal and child health work to ensure the implementation of preventive health measures.