Bronberg Ruben, Groisman Boris, Bidondo Maria Paz, Barbero Pablo, Liascovich Rosa
Ramos Mejía Hospital, Buenos Aires, Argentina.
National Network of Congenital Anomalies of Argentina (RENAC), National Center of Medical Genetics, National Administration of Health Laboratories and Institutes, National Ministry of Health, Buenos Aires, Argentina.
J Community Genet. 2020 Jul;11(3):303-311. doi: 10.1007/s12687-019-00449-0. Epub 2020 Jan 3.
The goal of our study is to describe the prevalence of congenital anomalies (CA) in hospitals of the City of Buenos Aires, Argentina, according to two proxy variables of the socioeconomic level: health subsector, public (PUB) versus private/social security (PRI), and geographical location, northern (N) versus southern (S). The source of data was the National Network of Congenital Anomalies of Argentina (RENAC) (period 2010-2016). From a total of 228,208 births, 4872 newborns with CA were detected (2.14%). The prevalence in PRI-N, PUB-N, PRI-S, and PUB-S hospitals were 1.59%, 1.91%, 2.20%, and 2.43%, respectively. Prevalence of neural tube defects, abdominal wall defects, and oral clefts was significantly higher in PUB than in PRI hospitals. Prevalence of critical heart defects was significantly lower in PUB-N and in PRI-S hospitals. Prevalence of anencephaly, encephalocele, hydrocephalus, microcephaly, gastroschisis, cleft lip and palate, ductus arteriosus, and bilateral renal agenesis was higher in PUB hospitals, both N and S, as well as microphthalmia/anophthalmia and ambiguous genitalia, spina bifida, anotia/microtia, postaxial polydactyly, and diaphragmatic hernia had higher prevalences in PUB-S hospitals. Omphalocele was more frequent in PUB-N hospitals. Results suggest that vulnerable populations in the public and southern subsectors of the city still require a greater support to reinforce resources and strategies that lead to greater equity in access to health.
我们研究的目的是根据社会经济水平的两个替代变量,即卫生子部门(公立与私立/社会保障)和地理位置(北部与南部),描述阿根廷布宜诺斯艾利斯市各医院先天性异常(CA)的患病率。数据来源是阿根廷先天性异常国家网络(RENAC)(2010 - 2016年期间)。在总共228,208例出生病例中,检测到4872例患有先天性异常的新生儿(2.14%)。私立 - 北部、公立 - 北部、私立 - 南部和公立 - 南部医院的患病率分别为1.59%、1.91%、2.20%和2.43%。公立医院中神经管缺陷、腹壁缺陷和腭裂的患病率显著高于私立医院。公立 - 北部和私立 - 南部医院中严重心脏缺陷的患病率显著较低。无脑儿、脑膨出、脑积水、小头畸形、腹裂、唇腭裂、动脉导管未闭和双侧肾缺如在北部和南部的公立医院中患病率较高,小眼球/无眼球和生殖器模糊、脊柱裂、耳郭缺失/小耳畸形、轴后多指畸形和膈疝在公立 - 南部医院中患病率较高。脐膨出在公立 - 北部医院中更为常见。结果表明,该市公共和南部子部门中的弱势群体仍需要更多支持,以加强资源和策略,从而在获得医疗服务方面实现更大的公平性。