Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China.
The Hunan Children's Hospital, Changsha, Hunan, China.
Sci Rep. 2023 Nov 20;13(1):20257. doi: 10.1038/s41598-023-47741-1.
To define the relationship between sex, residence, maternal age, and a broad range of birth defects by conducting a comprehensive cross-analysis based on up-to-date data. Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010-2020. Prevalences of birth defects (number of cases per 10,000 fetuses (births and deaths at 28 weeks of gestation and beyond)) with 95% confidence intervals (CI) were calculated by sex, residence, maternal age, year, and 23 specific defects. Cross-analysis of sex, residence, and maternal age was conducted, and crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with birth defects. A total of 1,619,376 fetuses and 30,596 birth defects were identified. The prevalence of birth defects was 188.94/10,000 (95% CI 186.82-191.05). Birth defects were more frequent in males than females (210.46 vs. 163.03/10,000, OR = 1.30, 95% CI 1.27-1.33), in urban areas than in rural areas (223.61 vs. 162.90/10,000, OR = 1.38, 95% CI 1.35-1.41), and in mothers ≥ 35 than mothers 25-29 (206.35 vs. 187.79/10,000, OR = 1.10, 95% CI 1.06-1.14). Cross-analysis showed that the prevalence of birth defects was higher in urban females than in rural males (194.53 vs. 182.25/10,000), the difference in prevalence between males and females was more significant for maternal age < 20 compared to other age groups (OR = 1.64, 95% CI 1.37-1.95), and the prevalence difference between urban and rural areas is more significant for maternal age 25-34 compared to other age groups (OR = 1.49, 95% CI 1.43-1.57). Cleft palates were more frequent in males, and nine specific defects were more frequent in females. Five specific defects were more frequent in rural areas, and eight were more frequent in urban areas. Compared to mothers 25-29, five specific defects were more frequent in mothers < 20, seven specific defects were more frequent in mothers 20-24, two specific defects were more frequent in mothers 30-34, and ten specific defects were more frequent in mothers ≥ 35. Our data indicate that sex, residence, and maternal age differences in the prevalences of birth defects and most specific defects are common. We have found some new epidemiological characteristics of birth defects using cross-analysis, such as residence is the determining factor for the prevalence of birth defects, the difference in prevalence between males and females was more significant for maternal age < 20 compared to other age groups, the prevalence difference between urban and rural areas is more significant for maternal age 25-34 compared to other age groups. And differences in the epidemiological characteristics of some specific defects from previous studies. Future studies should examine mechanisms. Our findings contributed to clinical counseling and advancing research on the risk factors for birth defects.
为了通过基于最新数据的全面交叉分析来定义性别、居住地、产妇年龄与广泛的出生缺陷之间的关系。数据来自中国湖南省出生缺陷监测系统，时间为 2010 年至 2020 年。通过性别、居住地、产妇年龄、年份和 23 种特定缺陷计算了每 10000 名胎儿（妊娠 28 周及以上的活产和死亡）的出生缺陷患病率（病例数/10000）及其 95%置信区间。对性别、居住地和产妇年龄进行了交叉分析，并计算了粗比值比（OR）以检查每个产妇特征与出生缺陷的关联。共确定了 1619376 名胎儿和 30596 例出生缺陷。出生缺陷的患病率为 188.94/10000（95%CI 186.82-191.05）。男性的出生缺陷发生率高于女性（210.46 比 163.03/10000，OR=1.30，95%CI 1.27-1.33），城市地区高于农村地区（223.61 比 162.90/10000，OR=1.38，95%CI 1.35-1.41），产妇年龄≥35 岁高于 25-29 岁（206.35 比 187.79/10000，OR=1.10，95%CI 1.06-1.14）。交叉分析显示，城市女性的出生缺陷患病率高于农村男性（194.53 比 182.25/10000），与其他年龄组相比，产妇年龄<20 岁的男女患病率差异更为显著（OR=1.64，95%CI 1.37-1.95），与其他年龄组相比，城乡地区的患病率差异在产妇年龄 25-34 岁更为显著（OR=1.49，95%CI 1.43-1.57）。唇腭裂在男性中更为常见，而九个特定缺陷在女性中更为常见。五个特定缺陷在农村更为常见，而八个特定缺陷在城市更为常见。与 25-29 岁的产妇相比，产妇年龄<20 岁的五个特定缺陷更为常见，产妇年龄 20-24 岁的七个特定缺陷更为常见，产妇年龄 30-34 岁的两个特定缺陷更为常见，产妇年龄≥35 岁的十个特定缺陷更为常见。我们的数据表明，出生缺陷和大多数特定缺陷的患病率在性别、居住地和产妇年龄方面存在差异是普遍的。我们通过交叉分析发现了一些出生缺陷的新的流行病学特征，例如居住地是出生缺陷患病率的决定因素，与其他年龄组相比，产妇年龄<20 岁的男女患病率差异更为显著，城乡地区的患病率差异在产妇年龄 25-34 岁更为显著与其他年龄组相比。以及与以往研究中某些特定缺陷的流行病学特征存在差异。未来的研究应检查这些机制。我们的发现有助于临床咨询和推进出生缺陷危险因素的研究。
