2016 - 2020年中国湖南省先天性心脏病所致围产期死亡情况

Perinatal deaths attributable to congenital heart defects in Hunan Province, China, 2016-2020.

作者信息

Zhou Xu, He Jian, Kuang Haiyan, Fang Junqun, Wang Hua

机构信息

Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.

The Hunan Children's Hospital, Changsha, Hunan Province, China.

出版信息

PLoS One. 2024 Jun 13;19(6):e0304615. doi: 10.1371/journal.pone.0304615. eCollection 2024.

DOI:10.1371/journal.pone.0304615

PMID:38870227

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11175501/

Abstract

OBJECTIVE

To explore the association between demographic characteristics and perinatal deaths attributable to congenital heart defects (CHDs).

METHODS

Data were obtained from the Birth Defects Surveillance System of Hunan Province, China, 2016-2020. The surveillance population included fetuses and infants from 28 weeks of gestation to 7 days after birth whose mothers delivered in the surveillance hospitals. Surveillance data included demographic characteristics such as sex, residence, maternal age, and other key information, and were used to calculate the prevalence of CHDs and perinatal mortality rates (PMR) with 95% confidence intervals (CI). Multivariable logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (ORs) were used to identify factors associated with perinatal deaths attributable to CHDs.

RESULTS

This study included 847755 fetuses, and 4161 CHDs were identified, with a prevalence of 0.49% (95%CI: 0.48-0.51). A total of 976 perinatal deaths attributable to CHDs were identified, including 16 (1.64%) early neonatal deaths and 960 (98.36%) stillbirths, with a PMR of 23.46% (95%CI: 21.98-24.93). In stepwise logistic regression analysis, perinatal deaths attributable to CHDs were more common in rural areas than urban areas (OR = 2.21, 95%CI: 1.76-2.78), more common in maternal age <20 years (OR = 2.40, 95%CI: 1.05-5.47), 20-24 years (OR = 2.13, 95%CI: 1.46-3.11) than maternal age of 25-29 years, more common in 2 (OR = 1.60, 95%CI: 1.18-2.18) or 3 (OR = 1.43, 95%CI: 1.01-2.02) or 4 (OR = 1.84, 95%CI: 1.21-2.78) or > = 5 (OR = 2.02, 95%CI: 1.28-3.18) previous pregnancies than the first pregnancy, and more common in CHDs diagnosed in > = 37 gestional weeks (OR = 77.37, 95%CI: 41.37-144.67) or 33-36 gestional weeks (OR = 305.63, 95%CI: 172.61-541.15) or < = 32 gestional weeks (OR = 395.69, 95%CI: 233.23-671.33) than diagnosed in postnatal period (within 7 days), and less common in multiple births than singletons (OR = 0.48, 95%CI: 0.28-0.80).

CONCLUSIONS

Perinatal deaths were common in CHDs in Hunan in 2016-2020. Several demographic characteristics were associated with perinatal deaths attributable to CHDs, which may be summarized mainly as economic and medical conditions, severity of CHDs, and parental attitudes toward CHDs.

摘要

目的

探讨人口统计学特征与先天性心脏病（CHD）所致围产期死亡之间的关联。

方法

数据来源于中国湖南省出生缺陷监测系统2016 - 2020年的数据。监测人群包括妊娠28周的胎儿及出生后7天内的婴儿，其母亲在监测医院分娩。监测数据包括性别、居住地、母亲年龄等人口统计学特征以及其他关键信息，用于计算CHD的患病率和围产儿死亡率（PMR）及其95%置信区间（CI）。采用多变量逻辑回归分析（方法：向前法、Wald检验，α = 0.05）和调整后的优势比（OR）来确定与CHD所致围产期死亡相关的因素。

结果

本研究纳入847755例胎儿，确诊4161例CHD，患病率为0.49%（95%CI：0.48 - 0.51）。共确定976例CHD所致围产期死亡，其中包括16例（1.64%）早期新生儿死亡和960例（98.36%）死产，PMR为23.46%（95%CI：21.98 - 24.93）。在逐步逻辑回归分析中，CHD所致围产期死亡在农村地区比城市地区更常见（OR = 2.21，95%CI：1.76 - 2.78），在母亲年龄<20岁（OR = 2.40，95%CI：1.05 - 5.47）、20 - 24岁（OR = 2.13，95%CI：1.46 - 3.11）的情况比母亲年龄25 - 29岁时更常见，在既往有2次（OR = 1.60，95%CI：1.18 - 2.18）、3次（OR = 1.43，95%CI：1.01 - 2.02）、4次（OR = 1.84，95%CI：1.21 - 2.78）或≥5次（OR = 2.02，95%CI：1.28 - 3.18）妊娠的情况比首次妊娠时更常见，在妊娠≥37周（OR = 77.37，95%CI：41.37 - 144.67）、33 - 36周（OR = 305.63，95%CI：172.61 - 541.15）或≤32周（OR = 395.69，95%CI：233.23 - 671.33）诊断为CHD的情况比出生后7天内诊断的情况更常见，在多胎妊娠中的情况比单胎妊娠少见（OR = 0.48，95%CI：0.28 - 0.80）。