从基于人群的监测中描述湖南省出生缺陷的患病率和死亡率。中国。数据来自湖南省基于人群的出生缺陷监测系统,中国(2010-2020年)。监测人群包括所有活产,死产,婴儿死亡,2010年至2020年期间,母亲居住在监测区域(浏阳县和石峰区,湖南省)。出生缺陷的患病率是每1000名婴儿出生缺陷的数量(‰)。出生缺陷的死亡率是每100个出生缺陷中归因于出生缺陷的死亡人数(%)。通过对数二项法计算具有95%置信区间(CI)的患病率和死亡率。计算粗比值比(ORs)以检查每个人口统计学特征与出生缺陷的关联。我们的研究包括228,444名婴儿,并确定了4453个出生缺陷,患病率为19.49‰(95CI18.92-20.07)。先天性心脏缺损是最常见的特异性缺损(5.29‰),其次是肢体缺损(4.01‰)。出生缺陷在男性比女性更常见(22.34‰vs.16.26‰,OR=1.38,95CI1.30-1.47),在早产中(91.82‰vs.16.14‰,OR=6.16,95CI5.72-6.65),出生体重<2500g(98.26‰vs.16.22‰,OR=6.61,95CI6.11-7.15)或>4000g(19.48‰vs.16.22‰,OR=1.21,95CI1.03-1.42)比出生体重2500-4000g,住院分娩率高于其他机构(22.16‰vs.11.74‰,OR=1.91,95CI1.76-2.07),多胞胎比单胎(28.50‰与19.28‰,OR=1.49,95CI1.27-1.76),在年龄<20岁的产妇中(26.33‰vs.18.69‰,OR=1.42,95CI1.15-1.76)或>=35年(24.31‰vs.18.69‰,OR=1.31,95CI1.18-1.45)比25-29岁的产妇,怀孕次数>=4(22.91‰vs.18.92‰,OR=1.22,95CI1.10-1.35)比第一次怀孕。共发现747人死于出生缺陷,包括603例(80.72%)死胎,出生后7天内有75例(10.04%)死亡,出生后7-27天内有46例(6.16%)死亡,出生后28-42天内死亡23人(3.08%)。出生缺陷的死亡率为16.78%(95CI15.57-17.98)。出生缺陷导致的死亡占所有死亡的51.09%(747/1462)。中枢神经系统缺陷死亡率最高(90.27%),新生儿遗传代谢缺陷死亡率最低(0.39%)。总之,我们从基于人群的监测中描述了湖南省出生缺陷的患病率和流行病学,中国,2010-2020年。基于人群的监测和基于医院的监测在出生缺陷的患病率和死亡率方面存在差异。
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.