Forrester M B, Merz R D
Hawaii Birth Defects Program, 76 North King Street, #208, Honolulu, HI 96817-5157, USA.
Public Health. 2003 Mar;117(2):128-34. doi: 10.1016/S0033-3506(02)00024-0.
Information on residence, delivery and referral patterns is useful to a birth defects program for allocation of resources, predicting where deliveries may have occurred, and estimating the impact of altering geographic inclusion criteria. The purpose of this study was to describe the residence, delivery and referral patterns for infants and fetuses with birth defects delivered in Hawaii. Data were obtained from the Hawaii Birth Defects Program and included birth defects cases delivered between 1986 and 1999 with known delivery residence and place of delivery. Of 12,873 total cases, 171 (1%) were delivered to out-of-state residents. Of the remaining 12,702 cases delivered to residents in the four Counties of Hawaii, 9905 (78%) were to City and County of Honolulu residents and 2797 (22%) were to residents of Hawaii, Kauai and Maui Counties. Of the cases delivered to City and County of Honolulu residents, 9903 were delivered in that County. Of the cases delivered to residents of the other three Counties, 591 (21%) were referred to the City and County of Honolulu for delivery, and 1602 (57%) were referred to the City and County of Honolulu for any reason. Honolulu delivery referral rates and total referral rates for cases delivered to Hawaii, Kauai and Maui County residents were higher with prenatal diagnosis of a birth defect (59 and 87%, respectively) and elective termination (70 and 85%, respectively), and varied among 53 different types of birth defect (0-83% and 23-100%, respectively).
关于居住、分娩和转诊模式的信息，对于出生缺陷项目在资源分配、预测分娩可能发生的地点以及评估改变地理纳入标准的影响方面很有用。本研究的目的是描述在夏威夷分娩的患有出生缺陷的婴儿和胎儿的居住、分娩和转诊模式。数据来自夏威夷出生缺陷项目，包括1986年至1999年间分娩的已知分娩居住地和分娩地点的出生缺陷病例。在总共12,873例病例中，171例（1%）是外州居民分娩的。在其余12,702例分娩给夏威夷四个县居民的病例中，9905例（78%）是檀香山市县居民分娩的，2797例（22%）是夏威夷、考艾岛和毛伊岛县居民分娩的。在分娩给檀香山市县居民的病例中，9903例在该县分娩。在分娩给其他三个县居民的病例中，591例（21%）因分娩被转诊至檀香山市县，1602例（57%）因任何原因被转诊至檀香山市县。对于分娩给夏威夷、考艾岛和毛伊岛县居民的病例，出生缺陷产前诊断（分别为59%和87%）和选择性终止妊娠（分别为70%和85%）时，檀香山的分娩转诊率和总转诊率更高，并且在53种不同类型的出生缺陷中有所不同（分别为0 - 83%和23 - 100%）。
