Pei Leilei, Kang Yijun, Zhao Yaling, Yan Hong
Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, People's Republic of China.
BMC Pediatr. 2017 Jan 13;17(1):18. doi: 10.1186/s12887-017-0784-1.
Nearly half of the population of Northwest China live in Shaanxi province, but population-based data on the epidemiologic characteristics of congenital heart defects (CHD) in this population is limited. The study aimed to investigate the prevalence and epidemiologic characteristics of the CHD among infants born between 2010 and 2013 in Shaanxi province.
Infants born between 2010 and 2013 in Shaanxi province were surveyed using a stratified multi-stage sampling method. Participant characteristics were recorded by questionnaire, medical records were reviewed and CHD was diagnosed using a specialized neonatal echocardiography. A Poisson regression model was applied to assess the association between any CHD and possible risk factors.
A total of 29098 live infants were surveyed with an overall prevalence of 76.0 (95% CI: 66.3, 86.7) per 10000 live infants. The prevalence of major and minor CHD were 26.1 and 49.8 per 10000 live infants, respectively, in surveyed areas. Poisson regression analysis indicated that, compared with singleton infants, the prevalence rate ratio of CHD was higher in twin and multi-fetal infants (PRR:3.1, 95% CI:1.6, 6.1). Using southern Shaanxi as a reference, the PRR of CHD were lower in northern (PRR:0.4, 95% CI:0.3, 0.6) and central Shaanxi province (PRR:0.5, 95% CI:0.4, 0.7). PRR was higher in mothers over 30 years of age than in those under 25 years (PRR:1.6, 95% CI:1.0, 2.5), and in mothers with ≥3 parity than that in mothers with only one parity (PRR:2.2, 95% CI:1.2, 4.2). The risk for CHD among live infants was positively associated with family history of CHD (PRR: 9.8, 95% CI: 5.3, 18.1). Additionally, CHD was less common in the floating population than the permanent population (PRR: 0.6, 95% CI: 0.4, 0.9).
The CHD among live infants seemed to be a serious health problem in Shaanxi province as well as in Northwestern China. Our research have important policy implications for recommendations on CHD intervention in Northwest China.
中国西北地区近一半人口居住在陕西省，但该地区基于人群的先天性心脏病（CHD）流行病学特征数据有限。本研究旨在调查2010年至2013年在陕西省出生的婴儿中CHD的患病率及流行病学特征。
采用分层多阶段抽样方法对2010年至2013年在陕西省出生的婴儿进行调查。通过问卷记录参与者特征，查阅病历，并使用专门的新生儿超声心动图诊断CHD。应用泊松回归模型评估任何CHD与可能的危险因素之间的关联。
共调查了29098名活产婴儿，总体患病率为每10000名活产婴儿中有76.0例（95%CI：66.3，86.7）。在调查地区，主要CHD和次要CHD的患病率分别为每10000名活产婴儿中有26.1例和49.8例。泊松回归分析表明，与单胎婴儿相比，双胎和多胎婴儿中CHD的患病率比值较高（PRR：3.1，95%CI：1.6，6.1）。以陕南为参照，陕北（PRR：0.4，95%CI：0.3，0.6）和关中地区（PRR：0.5，95%CI：0.4，0.7）CHD的PRR较低。30岁以上母亲的PRR高于25岁以下母亲（PRR：1.6，95%CI：1.0，2.5），生育≥3胎母亲的PRR高于仅生育1胎的母亲（PRR：2.2，95%CI：1.2，4.2）。活产婴儿中CHD的风险与CHD家族史呈正相关（PRR：9.8，95%CI：5.3，18.1）。此外，流动人口中CHD的患病率低于常住人口（PRR：0.6，95%CI：0.4，0.9）。
活产婴儿中的CHD似乎是陕西省乃至中国西北地区一个严重的健康问题。我们的研究对中国西北地区CHD干预建议具有重要的政策意义。
