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目的:比较同一地区两种出生缺陷监测系统监测结果差异。方法:分析2009-2012年宁波奉化市和嘉兴南湖区出生缺陷医院监测和人群监测数据,比较出生缺陷发生率和相关因素的差异。结果:医院监测缺陷发生率(360.71/万),显著高于人群监测(210.60/万),差异有统计学意义(χ2=128.40,P<0.01)。两种监测系统监测孕产妇年龄分布、城乡分布及出生人口结局构成差异有统计学意义(P<0.01)。医院监测30岁以上年龄比例高于人群监测,25岁以下低于人群监测(P<0.01)。医院监测以城镇居民为主(55.40%),人群监测以乡村为主差异有统计学意义(61.89%,P<0.01)。乡村人群医院监测畸形发生率高于人群监测(P<0.01)。医院监测缺陷儿平均出生孕周(36.95±3.31)孕周,早于人群监测(37.45±3.01)孕周;平均出生体重(2 860.58±816.79)g,低于人群监测(2 973.12±759.07)g;多发畸形、死胎/死产比例高于人群监测,以上差异均有统计学意义(P<0.01)。结论:两种出生缺陷监测系统监测人群、畸形发生率及缺陷儿特征均有差异。流动人口较多的地区性研究,人群监测不能完全代替医院监测。
Objectives: To compare the monitoring results of two birth defects monitoring systems in the same area. Methods: The surveillance data and monitoring data of birth defects in Fenghua City and Nanhu District of Jiaxing City from 2009 to 2012 were analyzed. The incidence of birth defects and related factors were compared. Results: The incidence of hospital surveillance defects (360.71 / 10000) was significantly higher than that of the population monitoring (210.60 / 10 000). The difference was statistically significant (χ2 = 128.40, P <0.01). The two monitoring systems to monitor maternal age distribution, urban-rural distribution and birth population outcome were significantly different (P <0.01). The proportion of patients aged over 30 who were monitored by the hospital was higher than that of the population and below 25 years of age (P <0.01). The majority of urban residents were monitored by the hospital (55.40%). The main difference between the two groups was statistically significant (61.89%, P <0.01). The incidence rate of monitoring malformations in rural population was higher than that in population monitoring (P <0.01). The average gestational age at birth was 36.95 ± 3.31 in gestational weeks, which was earlier than the monitoring of the population (37.45 ± 3.01) gestational weeks; the average birth weight (2860.58 ± 816.79) g was lower than the monitoring of the population (2973.12 ± 759.07) g ; Multiple deformities, stillbirth / stillbirth rate higher than the crowd monitoring, the above differences were statistically significant (P <0.01). Conclusion: There are differences between the two monitoring systems of birth defects monitoring population, the incidence of deformity and the characteristics of defects. Regional studies with more mobile populations and population monitoring can not completely replace hospital surveillance.