The Neonatal Intensive Care Unit, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
World J Pediatr. 2011 Nov;7(4):331-6. doi: 10.1007/s12519-011-0328-y. Epub 2011 Oct 20.
One of the challenges that pediatricians face when examining birth defects is to understand the trends in its occurrence and provide clues to etiology. This study was undertaken to retrospectively assess the prevalence of 10 common neonatal congenital malformations by reviewing a database of all deliveries from 28 weeks up until 7 days of birth from January 1998 to December 2009 in Zhejiang Province, China.
Ten common neonatal congenital malformations were selected for analysis. The incidence and the Cochran-Armitage Trend were assessed via SAS9.2. A P value ≤0.05 was considered statistically significant.
Of 83 888 perinatals, 374 (4.46‰) suffered from congenital heart diseases (CHD), 77 (0.92‰) from congenital hydrocephalus, 32 (0.38‰) from intestinal atresia/stenosis, 36 (0.43‰) from anorectal malformations, 149 (1.78‰) from kidney malformations, 139 (3.31‰) from hypospadias (male), 178 (2.12‰) from orofacial clefts (OFC), 188 (2.24‰) from polydactyly, 62 (0.74‰) from syndactyly, and 269 (3.21‰) from accessory auricle anomaly. Their trend of prevalence varied as follows: CHD, P=0.0026; hydrocephalus, P=0.0042; intestinal atresia/stenosis, P=0.0103; anorectal malformations, P=0.4332; kidney malformations, P<0.0001; hypospadias, P=0.0021; OFC, P=0.005; polydactyly, P=0.0867; syndactyly, P=0.1941; and accessory auricle anomaly, P=0.0011. The upward trend was as follows: CHD (P=0.0026), intestinal atresia/stenosis (P=0.0103), kidney malformations (P<0.0001), hypospadias (P=0.0021), OFC (P=0.005), and accessory auricle anomaly (P=0.0011). The incidence of hydrocephalus (P=0.0042) showed a downward trend. No statistical significant trend was found in anorectal malformations (P=0.4332), polydactyly (P=0.0867) and syndactyly (P=0.1941).
The incidences of CHD, intestinal atresia/stenosis, kidney malformations, hypospadias, OFC, and accessory auricle anomaly have increased in the last 12 years, but the incidences of anorectal malformations, polydactyly and syndactyly remain stable. The incidence of hydrocephalus shows a downward trend.
儿科医生在检查出生缺陷时面临的挑战之一是了解其发生趋势,并为病因提供线索。本研究回顾性评估了从 1998 年 1 月至 2009 年 12 月浙江省所有 28 周至 7 天出生的分娩数据,分析了 10 种常见新生儿先天性畸形的患病率。
选择 10 种常见新生儿先天性畸形进行分析。采用 SAS9.2 评估发病率和 Cochran-Armitage 趋势。P 值≤0.05 认为有统计学意义。
83888 例围产儿中,374 例(4.46‰)患先天性心脏病(CHD),77 例(0.92‰)患先天性脑积水,32 例(0.38‰)患肠闭锁/狭窄,36 例(0.43‰)患肛门直肠畸形,149 例(1.78‰)患肾畸形,139 例(3.31‰)患尿道下裂(男性),178 例(2.12‰)患唇腭裂(OFC),188 例(2.24‰)患多指(趾)畸形,62 例(0.74‰)并指(趾)畸形,269 例(3.21‰)副耳畸形。其患病率趋势如下:CHD,P=0.0026;脑积水,P=0.0042;肠闭锁/狭窄,P=0.0103;肛门直肠畸形,P=0.4332;肾畸形,P<0.0001;尿道下裂,P=0.0021;唇腭裂,P=0.005;多指(趾)畸形,P=0.0867;并指(趾)畸形,P=0.1941;副耳畸形,P=0.0011。呈上升趋势的有:CHD(P=0.0026)、肠闭锁/狭窄(P=0.0103)、肾畸形(P<0.0001)、尿道下裂(P=0.0021)、唇腭裂(P=0.005)、副耳畸形(P=0.0011)。脑积水(P=0.0042)的发病率呈下降趋势。肛门直肠畸形(P=0.4332)、多指(趾)畸形(P=0.0867)和并指(趾)畸形(P=0.1941)无统计学意义。
过去 12 年,CHD、肠闭锁/狭窄、肾畸形、尿道下裂、唇腭裂和副耳畸形的发病率有所增加,但肛门直肠畸形、多指(趾)畸形和并指(趾)畸形的发病率保持稳定。脑积水的发病率呈下降趋势。