蒙切戈尔斯克（俄罗斯西北部）新生儿心血管畸形的流行病学：一项基于登记处的研究
Epidemiology of Cardiovascular Malformations among Newborns in Monchegorsk (North-West Russia): a Register-Based Study.
作者信息
Postoev Vitaly A, Talykova Ljudmila V, Vaktskjold Arild
机构信息
International School of Public Health , Arkhangelsk, Russia.
Kola Reseach Laboratory for Occupational Health , Kirovsk, Russia.
出版信息
J Public Health Res. 2014 Aug 4;3(2):270. doi: 10.4081/jphr.2014.270. eCollection 2014 Jul 2.
BACKGROUND
Cardiovascular malformations (CVM) are one of the most prevalent groups of birth defects. Knowledge about the prevalence, distribution and survival in Russia has been limited. The aim of our study was to assess the perinatal prevalence, structure and risk factors for CVM among newborns in Monchegorsk (Murmansk Oblast, Russia) and the mortality among the affected newborns in the period 1973-2008.
DESIGN AND METHODS
A register-based study on data from the Kola and Murmansk County Birth Registers. The study included 28,511 births.
RESULTS
The registered perinatal prevalence was 3.0 per 1000 new-borns, with septal defects as the most prevalent. CVM was twenty times more prevalent among stillborn than live born, and one-third of the live born with a CVM died during the first week of life. The perinatal mortality rate with CVM was 442 per 1000 newborns. This indicator decreased over time. The mothers of newborns with a CVM were ten times more likely to have stillbirth in their anamnesis. The adjusted odds ratio between maternal smoking during pregnancy and CVM was 4.09 [95% confidence interval: 1.75-9.53].
CONCLUSIONS
The diagnosed perinatal prevalence was relatively low. A previous stillbirth by the mother was highly associated with being born with a CVM. An adjusted elevated risk was also observed among smoking mothers. Perinatal survival increased over time, but varied to a large extent between the different types of CVM. Significance for public healthCardiovascular malformation is one of the most common groups of birth defects. It is considered an important public health issue, as these malformations are the main cause of infant deaths in developed countries. Precise estimates about the prevalence and perinatal survival are needed to organise and plan health care for such newborns. Our study is the first report from the Russian Federation based on data from population-based birth registers.
背景
心血管畸形（CVM）是最常见的出生缺陷类型之一。在俄罗斯，关于其患病率、分布情况及存活率的了解一直有限。我们研究的目的是评估俄罗斯摩尔曼斯克州蒙切戈尔斯克市新生儿中CVM的围产期患病率、结构及危险因素，以及1973 - 2008年期间受影响新生儿的死亡率。
设计与方法
基于科拉和摩尔曼斯克地区出生登记数据进行的一项基于登记册的研究。该研究纳入了28,511例出生病例。
结果
登记的围产期患病率为每1000例新生儿中有3.0例，其中间隔缺损最为常见。CVM在死产儿中的患病率比活产儿高20倍，且三分之一患有CVM的活产儿在出生后第一周内死亡。患有CVM的围产儿死亡率为每1000例新生儿中有442例。这一指标随时间下降。患有CVM的新生儿母亲在既往病史中有死产的可能性高出10倍。孕期母亲吸烟与CVM之间经调整的优势比为4.09 [95%置信区间：1.75 - 9.53]。
结论
确诊的围产期患病率相对较低。母亲既往有死产史与新生儿患CVM高度相关。在吸烟母亲中也观察到经调整后的风险升高。围产期存活率随时间增加，但不同类型的CVM之间差异很大。对公共卫生的意义心血管畸形是最常见的出生缺陷类型之一。它被认为是一个重要的公共卫生问题，因为这些畸形是发达国家婴儿死亡的主要原因。需要对这类新生儿的患病率和围产期存活率进行精确估计，以便组织和规划医疗保健服务。我们的研究是俄罗斯联邦基于人群出生登记数据的首份报告。
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