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目的了解北京市东城区围产儿出生缺陷发生及顺位情况等,为制定干预措施,降低出生缺陷发生率提供依据。方法对近13年东城区产科医院出生缺陷发生情况进行回顾性分析。结果近13年间,我区产科医院共分娩围产儿137 516例,围产儿死亡1277例,围产儿死亡率为9.29‰;出生缺陷2021例,出生缺陷发生率为14.7‰;在出生缺陷儿中,男胎1107例,占54.77%,女胎894例,占44.24%,性别不明20例,占0.99%。在围产儿死亡中,出生缺陷434例,出生缺陷占围产儿死亡的33.99%。出生缺陷前五位死因分别是:2008年前主要为先天性心脏病、肢体畸形、泌尿系统畸形、唇腭裂及神经管畸形。2008年后,耳部畸形逐渐增加,2011~2012年上升为第一位,顺位依次为耳部畸形、肢体畸形、先天性心脏病、尿道下裂、唇腭裂,神经管畸形已退出前五位。13年间出生缺陷平均产前确诊率为27.15%,远远高于全国水平。结论 2008年后,我区神经管畸形已退出前五位,说明我区通过宣传在孕前及孕早期服用叶酸降低神经管畸形方面已取得一定成效。为了降低出生缺陷发生率,就要对围孕期妇女加强优生优育知识的宣传教育,要为孕妇提供一个舒适、安全的生活环境,减少环境污染,避免在新装修的居室里孕育新生命,孕妇在孕前就应当脱离有毒有害作业,减少不良因素造成的影响。
Objective To understand the occurrence and the prevalence of birth defects in Dongcheng District of Beijing City and provide the basis for making interventions and reducing the incidence of birth defects. Methods The incidence of birth defects in Dongcheng Maternity Hospital in the past 13 years was retrospectively analyzed. Results In the past 13 years, a total of 137 516 perinatal children were delivered in the obstetrics and gynecology hospital in our district. The number of perinatal deaths was 1277 and the perinatal mortality rate was 9.29 ‰. Birth defects were 2021 and the incidence of birth defects was 14.7 ‰. Among the birth defects, 1107 cases of male fetuses, accounting for 54.77%, 894 cases of female fetuses, accounting for 44.24%, 20 cases of unknown sex, accounting for 0.99%. In the perinatal death, 434 cases of birth defects, birth defects accounted for 33.99% of perinatal deaths. The top five causes of birth defects are: pre-2008 main congenital heart disease, limb deformities, urinary system deformities, cleft lip and palate and neural tube defects. After 2008, ear deformity gradually increased from 2011 to 2012 rose to the first place, followed by ear deformity, limb deformity, congenital heart disease, hypospadias, cleft lip and palate, neural tube defects have exited the top five Bit. The average prenatal diagnosis rate of birth defects in 13 years was 27.15%, much higher than the national level. Conclusion After 2008, the neural tube defects in our district have withdrawn from the top five. This shows that some achievements have been made in our district through propaganda of taking folic acid before and during the first trimester to reduce neural tube defects. In order to reduce the incidence of birth defects, it is necessary to strengthen the knowledge of prenatal and postnatal care of pregnant women to promote publicity and education, to provide a comfortable and safe living environment for pregnant women, reduce environmental pollution, to avoid new homes in the newly renovated life, pregnant women in Before pregnancy should be separated from toxic and hazardous operations, reducing the impact of adverse factors.