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
  • [1] Czeizel AE. Birth defects are preventable[J]. Int J Med Sci, 2005, 2(3): 91–92. DOI:  10.7150/ijms.2.91.
    [2] Xie DH, Yang TB, Liu ZY, et al. Epidemiology of birth defects based on a birth defect surveillance system from 2005 to 2014 in Hunan province, China[J]. PLoS One, 2016, 11(1): e0147280. DOI:  10.1371/journal.pone.0147280.
    [3] Taye M, Afework M, Fantaye W, et al. Magnitude of birth defects in central and northwest Ethiopia from 2010–2014: A descriptive retrospective study[J]. PLoS One, 2016, 11(10): e0161998. DOI:  10.1371/journal.pone.0161998.
    [4] 张龙飞. 基于小区域方法的出生缺陷流行病学研究[D]. 济南: 山东大学, 2018.

    Zhang LF. Epidemiological study of birth defects based on small area study method[D]. Jinan: Shandong University, 2018.
    [5] Kancherla V, Roos N, Walani SR. Relationship between achieving sustainable development goals and promoting optimal care and prevention of birth defects globally[J]. Birth Defects Res, 2022, 114(14): 773–784. DOI:  10.1002/bdr2.2055.
    [6] Perin J, Mulick A, Yeung D, et al. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the sustainable development goals[J]. Lancet Child Adolesc Health, 2022, 6(2): 106–115. DOI: 10.1016/S2352−4642(21)00311−4.
    [7] 中华人民共和国卫生部. 中国出生缺陷防治报告(2012)[EB/OL]. (2012-09-12)[2022-10-28]. http://www.gov.cn/gzdt/att/att/site1/20120912/1c6f6506c7f811bacf9301.pdf.

    Ministry of Health of the People's Republic of China. China Birth Defect Prevention Report (2012)[EB/OL]. (2012-09-12)[2022-10-28]. http://www.gov.cn/gzdt/att/att/site1/20120912/1c6f6506c7f811bacf9301.pdf.
    [8] Guo C, Du Y, Shen SQ, et al. Spatiotemporal analysis of tuberculosis incidence and its associated factors in mainland China[J]. Epidemiol Infect, 2017, 145(12): 2510–2519. DOI:  10.1017/S0950268817001133.
    [9] 国家卫生计生委妇幼健康服务司. 中国妇幼卫生监测工作手册(2013版)[EB/OL]. (2013-08-30)[2022-10-23]. http://www.mchscn.cn/National-22/450.html.

    Department of Maternal and Child Health Service. National Health and Family Planning Commission. China's maternal and child health surveillance handbook (2013 edition)[EB/OL]. (2013-08-30)[2022-10-23]. http://www.mchscn.cn/National-22/450.html.
    [10] 彭振仁, 韦洁, 陈碧艳, 等. 基于地理信息系统的广西壮族自治区出生缺陷空间分析[J]. 疾病监测,2022,37(2):262–268. DOI: 10.3784/jbjc.202104080184.

    Peng ZR, Wei J, Chen BY, et al. Spatial analysis on birth defects in Guangxi based on geographic information system[J]. Dis. Surveill, 2022, 37(2): 262–268. DOI:  10.3784/jbjc.202104080184.
    [11] 张志力, 胡先明, 范惠霞, 等. 2012—2017年山西省围生儿出生缺陷监测结果和流行病学分析[J]. 中国全科医学,2020,23(10):1298–1304. DOI:10.12114/j.issn.1007−9572.2019.00.708.

    Zhang ZL, Hu XM, Fan HX, et al. Epidemiological analysis of the surveillance data of birth defects among perinatal infants in Shanxi province, 2012–2017[J]. Chin Gen Pract, 2020, 23(10): 1298–1304. DOI: 10.12114/j.issn.1007−9572.2019.00.708.
    [12] 梁丽芳, 韦洁, 韦慧, 等. 2013—2019年广西地区围生儿出生缺陷监测结果分析[J]. 中国妇幼保健,2022,37(1):133–136. DOI:10.19829/j.zgfybj.issn.1001−4411.2022.01.039.

    Liang LF, Wei J, Wei H, et al. Analysis on monitoring results of perinatal birth defects in Guangxi from 2013 to 2019[J]. Matern Child Health Care China, 2022, 37(1): 133–136. DOI: 10.19829/j.zgfybj.issn.1001−4411.2022.01.039.
    [13] 周天津, 何琳坤, 赵梓伶, 等. 2010至2018年四川省出生缺陷发生情况分析[J]. 重庆医科大学学报,2021,46(10):1206–1210. DOI: 10.13406/j.cnki.cyxb.002616.

    Zhou TJ, He LK, Zhao ZL, et al. Incidence of birth defects in Sichuan province from 2010 to 2018[J]. J Chongqing Med Univ, 2021, 46(10): 1206–1210. DOI:  10.13406/j.cnki.cyxb.002616.
    [14] Bhide P, Kar A. A national estimate of the birth prevalence of congenital anomalies in India: systematic review and meta-analysis[J]. BMC Pediatr, 2018, 18(1): 175. DOI: 10.1186/s12887−018−1149−0.
    [15] Silesh M, Lemma T, Fenta B, et al. Prevalence and trends of congenital anomalies among neonates at Jimma Medical Center, Jimma, Ethiopia: A three-year retrospective study[J]. Pediatric Health Med Ther, 2021, 12: 61–67. DOI:  10.2147/PHMT.S293285.
    [16] Lytzen R, Vejlstrup N, Bjerre J, et al. Live-born major congenital heart disease in denmark: Incidence, detection rate, and termination of pregnancy rate from 1996 to 2013[J]. JAMA Cardiol, 2018, 3(9): 829–837. DOI:  10.1001/jamacardio.2018.2009.
    [17] Qu YJ, Liu XQ, Zhuang J, et al. Incidence of congenital heart disease: The 9-year experience of the Guangdong registry of congenital heart disease, China[J]. PLoS One, 2016, 11(7): e0159257. DOI:  10.1371/journal.pone.0159257.
    [18] Kirby RS. The prevalence of selected major birth defects in the United States[J]. Semin Perinatol, 2017, 41(6): 338–344. DOI:  10.1053/j.semperi.2017.07.004.
    [19] 朱宝生, 苏洁, 卢晓红, 等. 降低出生缺陷关键技术及干预措施的研究[J]. 中华妇产科杂志,2011,46(9):658–663. DOI:10.3760/cma.J.issn.0529−567x.2011.09.005.

    Zhu BS, Su J, Lu XH, et al. Study on key techniques and intervention in reducing birth defects[J]. Chin J Obstet Gynecol, 2011, 46(9): 658–663. DOI: 10.3760/cma.J.issn.0529−567x.2011.09.005.
    [20] Sokal R, Tata LJ, Fleming KM. Sex prevalence of major congenital anomalies in the United Kingdom: a national population-based study and international comparison meta-analysis[J]. Birth Defects Res A Clin Mol Teratol, 2014, 100(2): 79–91. DOI:  10.1002/bdra.23218.
    [21] Kalliora C, Mamoulakis C, Vasilopoulos E, et al. Association of pesticide exposure with human congenital abnormalities[J]. Toxicol Appl Pharmacol, 2018, 346: 58–75. DOI:  10.1016/j.taap.2018.03.025.
    [22] Serunjogi R, Barlow-Mosha L, Mumpe-Mwanja D, et al. Comparative analysis of perinatal outcomes and birth defects amongst adolescent and older Ugandan mothers: evidence from a hospital-based surveillance database[J]. Reprod Health, 2021, 18(1): 56. DOI: 10.1186/s12978−021−01115−w.
    [23] 岳晓倩, 陈华. 2014—2019年常熟市围产儿出生缺陷与产妇年龄构成关系[J]. 江苏预防医学,2021,32(1):98–99. DOI:10.13668/j.issn.1006−9070.2021.01.034.

    Yue XQ, Chen H. Relationship between perinatal birth defects and maternal age in Changshu city from 2014 to 2019[J]. Jiangsu J Prev Med, 2021, 32(1): 98–99. DOI: 10.13668/j.issn.1006−9070.2021.01.034.
    [24] Benavides E, Lupo PJ, Langlois PH, et al. A comprehensive assessment of the associations between season of conception and birth defects, texas, 1999-2015[J]. Int J Environ Res Public Health, 2020, 17(19): 7120. DOI:  10.3390/ijerph17197120.
    [25] 欧艳秋, 聂志强, 刘小清, 等. 广东省流动和常住人口先天性心脏病危险因素的差异分析[J]. 中华流行病学杂志,2013,34(7):701–705. DOI:10.3760/cma.j.issn.0254−6450.2013.07.009.

    Ou YQ, Nie ZQ, Liu XQ, et al. Study on the differences of risk factors regarding congenital heart defects between floating population and permanent residents in Guangdong[J]. Chin J Epidemiol, 2013, 34(7): 701–705. DOI: 10.3760/cma.j.issn.0254−6450.2013.07.009.
    [26] 夏颖丽, 郑卫红, 陈颖, 等. 北京地区流动人口对出生缺陷发生率及检出率的影响[J]. 中国优生与遗传杂志,2008,16(6):99–100,111. DOI:10.3969/j.issn.1006−9534.2008.06.054.

    Xia YL, Zheng WH, Chen Y, et al. The effect of floating population on the incidence and detection rate of birth defect[J]. Chin J Birth Health Heredity, 2008, 16(6): 99–100,111. DOI: 10.3969/j.issn.1006−9534.2008.06.054.
    [27] Zhou Y, Mao XQ, Zhou H, et al. Epidemiology of birth defects based on a birth defect surveillance system in Southern Jiangsu, China, 2014-2018[J]. J Matern Fetal Neonatal Med, 2022, 35(4): 745–751. DOI:  10.1080/14767058.2020.1731459.
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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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