2015-2020年甘肃省围产儿出生缺陷时空分布特征分析

李亮亮 杨兰 王称 黄奎奎 周艳芝

李亮亮, 杨兰, 王称, 黄奎奎, 周艳芝. 2015-2020年甘肃省围产儿出生缺陷时空分布特征分析[J]. 疾病监测, 2023, 38(4): 466-472. doi: 10.3784/jbjc.202209280428
引用本文: 李亮亮, 杨兰, 王称, 黄奎奎, 周艳芝. 2015-2020年甘肃省围产儿出生缺陷时空分布特征分析[J]. 疾病监测, 2023, 38(4): 466-472. doi: 10.3784/jbjc.202209280428
Li Liangliang, Yang Lan, Wang Chen, Huang Kuikui, Zhou Yanzhi. Spatiotemporal distribution of perinatal birth defects in Gansu, 2015−2020[J]. Disease Surveillance, 2023, 38(4): 466-472. doi: 10.3784/jbjc.202209280428
Citation: Li Liangliang, Yang Lan, Wang Chen, Huang Kuikui, Zhou Yanzhi. Spatiotemporal distribution of perinatal birth defects in Gansu, 2015−2020[J]. Disease Surveillance, 2023, 38(4): 466-472. doi: 10.3784/jbjc.202209280428

2015-2020年甘肃省围产儿出生缺陷时空分布特征分析

doi: 10.3784/jbjc.202209280428
基金项目: 甘肃省卫生健康行业科研计划项目(No. GSWSYK2021-001)
详细信息
    作者简介:

    李亮亮,男,甘肃省天水市人,硕士研究生在读,主要从事妇幼保健研究,Email:2451538613@qq.com

    通讯作者:

    杨兰,Tel:13893205529,Email:yanglan0608@126.com

  • 中图分类号: R211; R181.3+7

Spatiotemporal distribution of perinatal birth defects in Gansu, 2015−2020

Funds: This study was supported by Gansu Health Scientific Research Program (No. GSWSYK2021-001)
  • 摘要:   目的  评估甘肃省出生缺陷的时空分布特征,为公共卫生资源的合理分配以及出生缺陷的防治提供科学依据。  方法  收集2015—2020年甘肃省42家监测医院出生缺陷数据,采用泊松分布计算各年度以及不同人群的出生缺陷发生率,Joinpoint 回归评估出生缺陷发生率的时间趋势,空间自相关分析判断出生缺陷的空间分布。   结果  2015—2020年甘肃省出生缺陷发生率由2015年的150.96/万[95% 置信区间(CI): 143.95/万~162.39/万]上升至2020年的200.47/万(95%CI:190.26/万~210.68/万),出生缺陷前5顺位病种分别是先天性心脏、多指(趾)、总唇腭裂、神经管缺陷和先天性脑积水。 空间分析显示,兰州市、天水市、武威市为出生缺陷的高风险地区。  结论   2015—2020年甘肃省出生缺陷发生率呈上升趋势,在空间上存在聚集区域,应进一步加强监测水平,加强对主要病种和重点区域的防控。
  • 图  1  2015-2020年甘肃省12个市(州)出生缺陷发生率空间分布

    注:嘉峪关和甘南藏族自治州尚未建立监测医院

    Figure  1.  Spatial distribution of incidence of birth defects in 12 prefectures in Gansu, 2015−2020

    图  2  2015-2020年甘肃省出生缺陷全局空间自相关Moran's I指数

    Figure  2.  Global spatial autocorrelation Moran's I index of incidence of birth defects in Gansu, 2015−2020

    图  3  2015-2020年甘肃省出生缺陷发生率局部空间关联指标聚类

    Figure  3.  Local spatial autocorrelation analysis on incidence of birth defects in Gansu, 2015−2020

    表  1  2015-2020年甘肃省出生缺陷发生基本情况

    Table  1.   Incidence of birth defects in Gansu, 2015−2020

     变量病例数围产儿数发生率(/万)(95%CIχ2P
    年份 210.489 < 0.001
     2015 1 045 69 225 150.96(143.95~162.39)
     2016 1 043 82 047 127.12(119.46~134.79)
     2017 1 514 93 793 161.42(153.35~169.48)
     2018 1 649 82 851 199.03(189.52~208.54)
     2019 1 324 88 429 149.72(141.72~157.73)
     2020 1 452 72 429 200.47(190.26~210.68)
    性别a 43.712 < 0.001
     男性 4 358 254 718 171.48(166.44~176.53)
     女性 3 447 233 986 147.79(142.90~152.68)
    居住地 25.259 < 0.001
     城镇 3 774 243 430 155.03(150.13~159.94)
     乡村 4 253 245 344 173.35(168.18~178.51)
    分娩季节 17.058 < 0.001
     春季 1 925 121 551 158.37(151.35~165.39) 13.168 < 0.001 b
     夏季 2 030 114 266 177.66(169.99~185.32)
     秋季 1 942 120 134 161.65(154.52~168.78) 8.907 0.003 b
     冬季 2 130 132 823 160.36(153.60~167.12) 10.991 < 0.001 b
    母亲年龄(岁) 189.920 < 0.001
     <20 303 9 400 322.34(286.63~358.05) 159.770 < 0.001 b
     20~ 1 622 93 472 173.53(165.16~181.90) 11.147 < 0.001 b
     25~ 3 352 213 609 156.92(151.65~162.19)
     30~ 1 823 122 438 148.89(142.11~155.68) 3.258 0.071
     35~ 927 49 855 185.94(174.08~197.80) 25.396 < 0.001 b
    注:a. 性别不明者未纳入统计分析;b. 经Benjamini & Hochberg法校正后,与参考类别(夏季和 25~29 岁)进行比较而获得的经调整后的P值;CI. 置信区间;–. 参考类别
    下载: 导出CSV

    表  2  2015-2020年甘肃省出生缺陷各病种发生率及趋势

    Table  2.   Incidence and trend of birth defects in Gansu, 2015−2020

    出生缺陷病种不同年份发生率(/万)排名APC(%)P
    201520162017201820192020总计
    先天性心脏病 31.92 35.96 44.67 60.11 67.74 107.83 57.55 1 28.50 0.001
    多指(趾) 13.29 13.04 13.43 17.50 17.64 20.43 15.84 2 10.30 0.006
    总唇腭裂a 20.37 13.29 22.71 17.50 8.14 9.53 15.32 3 −13.20 0.194
    神经管畸形b 14.88 7.43 9.92 10.62 1.13 1.52 7.49 4 −22.70 0.174
    先天性脑积水 11.56 3.90 6.61 10.26 3.17 1.66 6.12 5 −17.30 0.284
    唐氏综合征 3.03 5.61 6.82 7.85 1.36 0.97 4.40 6 −7.10 0.758
    马蹄内翻足 5.06 2.07 4.37 4.71 3.96 3.59 3.95 7 −1.92 0.801
    外耳其他畸形 3.03 2.44 4.37 5.55 3.62 4.42 3.93 8 8.53 0.315
    并指(趾) 3.03 3.05 2.77 5.07 3.28 3.04 3.38 9 −6.10 0.596
    肢体短缩 3.47 2.19 2.77 4.47 1.47 2.07 2.72 10 3.28 0.674
    尿道下裂 2.02 1.46 2.56 3.50 3.17 3.45 2.70 11 14.99 0.052
    直肠肛门闭锁或狭窄 3.76 1.46 1.60 2.41 2.71 2.21 2.31 12 −4.42 0.626
    食道闭锁或狭窄 2.46 0.61 1.17 1.69 1.70 2.62 1.66 13 5.02 0.662
    小耳(包括无耳) 1.16 0.49 1.07 1.81 1.47 1.93 1.31 14 16.46 0.123
    脐膨出 1.01 0.73 1.49 2.29 0.23 0.69 1.08 15 0.98 0.964
    腹裂 2.31 0.98 1.39 1.09 0.34 0.41 1.06 16 27.18 0.028
    先天性膈疝 0.43 0.49 2.03 2.53 0.34 0.28 1.06 17 6.53 0.869
    联体双胎 0.14 0.37 0.11 0.24 0.00 0.00 0.14 18
    膀胱外翻 0.00 0.12 0.00 0.00 0.00 0.00 0.02 19
    注:–. 存在数据为0,无法进行趋势分析;a. 总唇腭裂包括唇裂、腭裂以及唇裂合并腭裂;b. 神经管缺陷包括无脑畸形、脑膨出和脊柱裂;APC. 年度变化百分比
    下载: 导出CSV
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  • 收稿日期:  2022-09-28
  • 网络出版日期:  2023-03-13
  • 刊出日期:  2023-04-30

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