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[中国出生缺陷高发地区的流行病学研究]

[Epidemiology of birth defects in high-prevalence areas of China].

作者信息

Zheng Xiao-ying, Song Xin-ming, Chen Gong, Chen Jia-peng, Ji Ying, Wu Ji-lei, Liu Ju-fen, Zhang Lei, Fan Xiang-hua

机构信息

Institute of Population Research ,Peking University, Beijing 100871, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Jan;28(1):5-9.

Abstract

OBJECTIVE

To study the levels of prevalence and to describe the epidemiological features of birth defects in high-prevalence areas in China.

METHODS

A population-based retrospective study was conducted in two counties of Shanxi province that including birth defects among fetuses and live births born after 20 weeks' gestational age in the study areas from 2002 through 2004.

RESULTS

During 2002 - 2004, the prevalence of birth defects was 844.2 per 10 000 births in study areas and the first five main birth defects were inguinal hernia (182.2 per 10,000 births), anencephaly (104.4 per 10 000 births), congenital mental retardation (79.4 per 10,000 births), congenital heart diseases (73.2 per 10,000 births) and spina bifida (63.9 per 10,000 births). These five main birth defects accounted for about 60% of total birth defect cases. Inguinal hernia, undescended testicle, congenital mental retardation were usually not included for statistical analysis on birth defect. Excluding these birth defects, the prevalence of birth defects in study areas was 537.2 per 10,000 births and the first five main birth defects were anencephaly, congenital heart diseases, spina bifida, hydrocephaly (40.5 per 10 000 births) and encephalocele (31.2 per 10 000 births). The male prevalence of birth defects was 966.2 per 10 000 births, which was significantly higher than prevalence in females. The prevalence rates of birth defects for maternal age groups under 20 years old and over 30 years old were remarkably higher than those for 20-24 year and 25-29 year old mothers. The teenage mothers were at higher risk of having a child with neural tube defects(NTDs) or congenital heart diseases. Prevalence rates under 20 year maternal age group were 408.8 and 188.7 per 10 000 births for NTDs and congenital heart diseases respectively, whereas corresponding rates were 204.8 and 91.0 per 10 000 births for groups over 30 years of age. The prevalence rates increased with increasing gravidity or parity.

CONCLUSION

This study showed that the patterns of birth defects in study areas were very different from those of other areas, with an unusually high prevalence of NTDs. The study also suggested that both young and advanced mothers were at increased risk of having a child with a birth defect.

摘要

目的

研究中国出生缺陷高发地区的患病率水平并描述其流行病学特征。

方法

在山西省两个县开展了一项基于人群的回顾性研究,研究对象包括2002年至2004年研究地区孕龄20周后出生的死胎和活产儿中的出生缺陷情况。

结果

2002 - 2004年期间,研究地区出生缺陷患病率为每10000例出生844.2例,前五位主要出生缺陷为腹股沟疝(每10000例出生182.2例)、无脑儿(每10000例出生104.4例)、先天性智力低下(每10000例出生79.4例)、先天性心脏病(每10000例出生73.2例)和脊柱裂(每10000例出生63.9例)。这五种主要出生缺陷约占出生缺陷总病例数的60%。腹股沟疝、隐睾、先天性智力低下通常不纳入出生缺陷统计分析。排除这些出生缺陷后,研究地区出生缺陷患病率为每10000例出生537.2例,前五位主要出生缺陷为无脑儿、先天性心脏病、脊柱裂、脑积水(每10000例出生40.5例)和脑膨出(每10000例出生31.2例)。出生缺陷男性患病率为每10000例出生966.2例,显著高于女性患病率。20岁以下和30岁以上孕产妇年龄组的出生缺陷患病率明显高于20 - 24岁和25 - 29岁孕产妇年龄组。青少年母亲生育神经管缺陷(NTDs)或先天性心脏病患儿的风险较高。20岁以下孕产妇年龄组NTDs和先天性心脏病的患病率分别为每10000例出生408.8例和188.7例,而30岁以上年龄组相应患病率分别为每10000例出生204.8例和91.0例。患病率随妊娠次数或产次增加而升高。

结论

本研究表明,研究地区的出生缺陷模式与其他地区非常不同,神经管缺陷患病率异常高。该研究还表明,年轻和高龄母亲生育出生缺陷患儿的风险均增加。

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