Campaña Hebe, Pawluk Mariela S, López Camelo Jorge S
Instituto Multidisciplinario de Biología Celular, CONICET, La Plata, Argentina.
Arch Argent Pediatr. 2010 Oct;108(5):409-17. doi: 10.1590/S0325-00752010000500006.
The aim of the present work was to estimate the frequency of 27 birth defects in 7 geographical regions of Argentina.
Observational, cross-sectional, descriptive design. A sample of 21,844 new born with birth defects was selected, ascertained from 855,220 births, between 1994 and 2007, in 59 hospitals belonging to the ECLAMC network. In order to identify regions of high frequency a Poisson regression was used, adjusted by different hospitals from the same region. The model included a time variable to detect secular trends and 6 dummy variables for 7 predefined geographical regions: Metropolitana (MET); Pampa (PAM); Centro (CEN); Cuyo (CUY); Noroeste (NOA); Nordeste (NEA) and Patagonia (PAT).
High frequencies regional analysis showed the following significant results: PAM: severe hypospadias; CEN: spina bifida, microtia, cleft lip with cleft palate, polycystic kidney, postaxial polydactyly and Down syndrome; CUY: postaxial polydactyly; NOA: omphalocele, gastroschisis, cleft lip without cleft palate, cleft lip with cleft palate, anorectal atresia/stenosis, indeterminate sex, preaxial polydactyly and pectoral agenesis; PAT: cleft lip without cleft palate.
Out of the 27 congenital anomalies analyzed, fourteen showed a frequency significatively higher in one or more regions.
本研究旨在估算阿根廷7个地理区域中27种出生缺陷的发生率。
采用观察性、横断面、描述性设计。从1994年至2007年期间ECLAMC网络所属的59家医院的855,220例出生病例中,选取了21,844例有出生缺陷的新生儿作为样本。为了确定高频率区域,使用了泊松回归,并根据同一区域的不同医院进行了调整。该模型包括一个时间变量以检测长期趋势,以及7个预定义地理区域的6个虚拟变量:大都会区(MET);潘帕区(PAM);中心区(CEN);库约区(CUY);西北区(NOA);东北区(NEA)和巴塔哥尼亚区(PAT)。
区域高频率分析显示了以下显著结果:PAM:重度尿道下裂;CEN:脊柱裂、小耳畸形、唇腭裂、多囊肾、轴后多指畸形和唐氏综合征;CUY:轴后多指畸形;NOA:脐膨出、腹裂、单纯唇裂、唇腭裂、肛门直肠闭锁/狭窄、性别不确定、轴前多指畸形和胸肌发育不全;PAT:单纯唇裂。
在分析的27种先天性异常中,有14种在一个或多个区域的发生率显著更高。