Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China.
Sci Rep. 2024 Jun 25;14(1):14609. doi: 10.1038/s41598-024-65072-7.
To describe the prevalence and death rate of birth defects from population-based surveillance in Hunan Province, China. Data were obtained from the population-based Birth Defects Surveillance System in Hunan Province, China (2010-2020). The surveillance population included all live births, stillbirths, infant deaths, and legal terminations of pregnancy from 28 weeks of gestation to 42 days after birth between 2010 and 2020 when the mother resided in the surveillance area (Liuyang County and Shifeng District, Hunan Province). The prevalence of birth defects is the number of birth defects per 1000 infants (‰). The death rate of birth defects is the number of deaths attributable to birth defects per 100 birth defects (%). The prevalence and death rate with 95% confidence intervals (CI) were calculated by the log-binomial method. Crude odds ratios (ORs) were calculated to examine the association of each demographic characteristic with birth defects. Our study included 228,444 infants, and 4453 birth defects were identified, with a prevalence of 19.49‰ (95%CI 18.92-20.07). Congenital heart defects were the most common specific defects (5.29‰), followed by limb defects (4.01‰). Birth defects were more common in males than females (22.34‰ vs. 16.26‰, OR = 1.38, 95%CI 1.30-1.47), in premature birth than not (91.82‰ vs. 16.14‰, OR = 6.16, 95%CI 5.72-6.65), in birth weight < 2500 g (98.26‰ vs. 16.22‰, OR = 6.61, 95%CI 6.11-7.15) or > 4000 g (19.48‰ vs. 16.22‰, OR = 1.21, 95%CI 1.03-1.42) than birth weight 2500-4000 g, in hospitalized deliveries than other institutions (22.16‰ vs. 11.74‰, OR = 1.91, 95%CI 1.76-2.07), in multiple births than singletons (28.50‰ vs. 19.28‰, OR = 1.49, 95%CI 1.27-1.76), in maternal age < 20 years (26.33‰ vs. 18.69‰, OR = 1.42, 95%CI 1.15-1.76) or > = 35 years (24.31‰ vs. 18.69‰, OR = 1.31, 95%CI 1.18-1.45) than maternal age 25-29 years, and in number of pregnancies > = 4 (22.91‰ vs. 18.92‰, OR = 1.22, 95%CI 1.10-1.35) than the first pregnancy. A total of 747 deaths attributable to birth defects were identified, including 603 (80.72%) stillbirths, 75 (10.04%) deaths within 7 days after birth, 46 (6.16%) deaths in 7-27 days after birth, 23 (3.08%) deaths in 28-42 days after birth. The death rate of birth defects was 16.78% (95%CI 15.57-17.98). Deaths attributable to birth defects accounted for 51.09% (747/1462) of all deaths. Central nervous system defects had the highest death rate (90.27%), and neonatal genetic metabolic defects had the lowest death rate (0.39%). In summary, we have described the prevalence and epidemiology of birth defects from population-based surveillance in Hunan Province, China, 2010-2020. There were differences in the prevalence and death rate of birth defects between population-based surveillance and hospital-based surveillance.
描述 2010-2020 年中国湖南省基于人群的出生缺陷监测中的流行率和死亡率。数据来自中国湖南省基于人群的出生缺陷监测系统（2010-2020 年）。监测人群包括 2010 年至 2020 年期间，在母亲居住的监测地区（湖南省浏阳市和石峰区），妊娠 28 周以上至出生后 42 天的所有活产儿、死产儿、婴儿死亡和合法终止妊娠。出生缺陷的流行率是每千名婴儿中出现的出生缺陷数量（‰）。出生缺陷的死亡率是归因于出生缺陷的死亡数量占每 100 例出生缺陷的死亡率（%）。使用对数二项式方法计算流行率和死亡率及其 95%置信区间（CI）。计算粗比值比（OR）以检验每个人口统计学特征与出生缺陷之间的关联。我们的研究包括 228444 名婴儿，发现 4453 例出生缺陷，流行率为 19.49‰（95%CI 18.92-20.07）。先天性心脏病是最常见的特定缺陷（5.29‰），其次是肢体缺陷（4.01‰）。男性的出生缺陷比女性更常见（22.34‰比 16.26‰，OR=1.38，95%CI 1.30-1.47），早产比非早产更常见（91.82‰比 16.14‰，OR=6.16，95%CI 5.72-6.65），出生体重<2500g（98.26‰比 16.22‰，OR=6.61，95%CI 6.11-7.15）或>4000g（19.48‰比 16.22‰，OR=1.21，95%CI 1.03-1.42）比出生体重 2500-4000g 更常见，在住院分娩中比在其他机构更常见（22.16‰比 11.74‰，OR=1.91，95%CI 1.76-2.07），在多胎妊娠中比单胎妊娠更常见（28.50‰比 19.28‰，OR=1.49，95%CI 1.27-1.76），母亲年龄<20 岁（26.33‰比 18.69‰，OR=1.42，95%CI 1.15-1.76）或≥35 岁（24.31‰比 18.69‰，OR=1.31，95%CI 1.18-1.45）比母亲年龄 25-29 岁更常见，以及在妊娠次数≥4 次（22.91‰比 18.92‰，OR=1.22，95%CI 1.10-1.35）比第一次妊娠更常见。共发现与出生缺陷相关的死亡 747 例，包括 603 例（80.72%）死产，75 例（10.04%）出生后 7 天内死亡，46 例（6.16%）出生后 7-27 天内死亡，23 例（3.08%）出生后 28-42 天内死亡。出生缺陷的死亡率为 16.78%（95%CI 15.57-17.98）。与出生缺陷相关的死亡占所有死亡的 51.09%（747/1462）。中枢神经系统缺陷的死亡率最高（90.27%），新生儿遗传代谢缺陷的死亡率最低（0.39%）。总之，我们描述了 2010-2020 年中国湖南省基于人群的出生缺陷监测中的流行率和发病情况。基于人群的监测与医院监测的出生缺陷流行率和死亡率存在差异。
