背景:各国先天性膈疝(CDH)的患病率各不相同,关于其在中国的流行病学信息有限。我们的研究旨在调查患病率,时间趋势,中国的CDH和围产期结局,以及其相关的畸形和与母婴特征的潜在关联。
方法:本研究包括2007年至2019年中国出生缺陷监测网络的所有出生和CDH病例,其中CDH病例分为孤立或相关。我们使用连接点回归模型来计算患病率和年度百分比变化的趋势,泊松回归用于调整后的患病率比率。P值≤0.05被认为具有统计学意义。
结果:在研究期间,在24,158,029例新生儿中发现了4397例CDH病例,总体患病率为1.82、1.13和0.69/10,000,孤立的,和相关的CDH,分别。每种类型的CDH的患病率随时间增加。总体CDH的患病率因婴儿性别而异(男性与女性,1.91/10,000vs.1.63/10,000),产妇住宅(城市与农村,2.13/10,000vs.1.45/10,000),产妇年龄(<20岁,1.31/10000;20-24年,1.63/10000;25-29年,1.80/10000;30-34年,1.87/10,000;≥35岁,2.22/10,000),和地理区域(中部,1.64/10,000;东部,2.45/10,000;西部,1.37/10000)。心血管异常是与CDH相关的最常见的畸形。与患有孤立性CDH的婴儿相比,患有相关CDH的婴儿早产和围产期死亡的风险更高。
结论:CDH的患病率增加和围产期死亡率高突出表明需要进一步的病因,流行病学,和中国人群的临床研究。视频摘要。
BACKGROUND: The prevalence of congenital diaphragmatic hernia (CDH) varies across countries, with limited information available on its epidemiology in
China. Our study aimed to investigate the prevalence, time trends, and perinatal outcomes of CDH in
China, as well as its associated malformations and potential associations with maternal and infant characteristics.
METHODS: This study included all birth and CDH cases from the Chinese Birth Defects Monitoring Network between 2007 and 2019, with CDH cases classified as either isolated or associated. We employed the joinpoint regression model to calculate the trends of prevalence and the annual percent change, with Poisson regression used for adjusted prevalence rate ratios. A P value ≤ 0.05 was considered statistically significant.
RESULTS: A total of 4397 CDH cases were identified among 24,158,029 births in the study period, yielding prevalence rates of 1.82, 1.13 and 0.69 per 10,000 for overall, isolated, and associated CDH, respectively. The prevalence of each type of CDH increased over time. The prevalence of overall CDH varied significantly by infant sex (male vs. female, 1.91/10,000 vs. 1.63/10,000), maternal residence (urban vs. rural, 2.13/10,000 vs. 1.45/10,000), maternal age (< 20 years, 1.31/10,000; 20-24 years, 1.63/10,000; 25-29 years, 1.80/10,000; 30-34 years, 1.87/10,000; ≥ 35 years, 2.22/10,000), and geographic region (central, 1.64/10,000; east, 2.45/10,000; west, 1.37/10,000). Cardiovascular anomalies were the most common malformations associated with CDH. Infants with associated CDH had a higher risk of premature birth and perinatal death than those with isolated CDH.
CONCLUSIONS: The increasing prevalence and high perinatal mortality rate of CDH highlight the need for further etiological, epidemiological, and clinical studies among the Chinese population. Video Abstract.