山西省出生缺陷人群监测地区全面二孩政策实施后出生人口及出生缺陷发生情况分析

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摘要目的了解“全面二孩”政策实施对山西省出生缺陷人群监测地区出生情况及出生缺陷发生情况的影响。方法资料来源于山西省出生缺陷人群监测系统,监测对象为长治市城区(2019年改名为潞州区)和运城市万荣县两个地区居住≥1年的产妇。分析“全面二孩”实施前(2014年10月1日—2016年9月30日)和“全面二孩”实施后(2016年10月1日—2018年9月30日)出生情况、出生缺陷发生情况及影响因素的变化。结果监测地区在“全面二孩”政策实施前出生人数为17307、“全面二孩”政策实施后出生人数为19348,“全面二孩”政策实施后出生数增长了11.8%;城市、非首次妊娠、经产妇、女性婴儿、早产儿比例升高,差异均有统计学意义(P＜0.05)。与适龄产妇相比,低龄产妇比例降低,高龄产妇比例升高,差异均有统计学意义(P＜0.05)。“全面二孩”实施前后出生缺陷发生率分别均为156.58/万、162.29/万,差异无统计学意义(χ²=0.189,P=0.663)。“全面二孩”实施后,先天性心脏病仍是山西省围产儿首位高发出生缺陷,多指位列第二,并指、唇裂合并腭裂分别升至第三位,外耳其他畸形降至第五位,神经管缺陷被挤出前五。“全面二孩”政策实施前后城市的出生缺陷发生率均低于农村,早产儿、巨大儿是出生缺陷发生的危险因素。而低龄孕产妇、男性婴儿仅是“全面二孩”实施前出生缺陷发生的危险因素,“全面二孩”实施后已不再对出生缺陷的发生产生影响。结论 “全面二孩”实施后,出生数增加,经产妇、高龄产妇增加,农村、早产儿、巨大儿仍是出生缺陷发生的危险因素,低龄、男性已不再对出生缺陷发生构成威胁。

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	宋志娇
	王海青
	罗铭忠

关键词 ：全面二孩, 出生缺陷, 影响因素, 监测

Abstract：Objective To explore the impacts on birth situation and prevalence of birth defect associated with the implementation of "universal two-child policy" in monitoring area of birth defect population in Shanxi province.Methods Data were obtained from population-based birth defect surveillance system in Shanxi Province. The surveillance population was childbearing women living in Chengqu of Changzhi (renamed Luzhou in 2019) and Wanrong of Yuncheng no less than 1 year. The changes of birth situation, birth defects and influencing factors were compared between before the implementation of the universal two-child policy (October 1st, 2014-September 30th, 2016) and after the implementation of the universal two-child policy (October 1st, 2016 -- September 30th, 2018).Results The number of births was 17,307 before the implementation of "universal two-child policy" in monitoring area, and that was 19,348 after the implementation. The number of births after the implementation of "universal two-child policy" increased by 11.8%. The proportion of urban women, women with non-first pregnancy, parous women, female infant and premature infant increased, and the differences were statistically significant (P<0.05). Comparing with the women of the right age(older than 20 years and younger than 35 years), the proportion of younger women(younger than 20 years) decreased, and the proportion of women with advanced maternal age(35 years and older) increased, both the differences were statistically significant P＜0.05). The incidence of birth defects before and after the implementation of "universal two-child policy" was 156.58/10,000 and 162.29/10,000 respectively, with no statistical significance (χ²=0.189, P=0.663). After the implementation of "universal two-child policy", congenital heart disease was still the most common birth defect among perinatal children in Shanxi Province, with polydactyly ranking the second, syndactyly and cleft lip with cleft palate ranking the third, and other malformation of external ears falling to the fifth, neural tube defects exclusive out of the top five. Before and after the implementation of "universal two-child policy", the incidence of birth defects in urban areas was lower than that in rural areas. Premature babies and macrosomia were risk factors for birth defects. While younger women and male infants were only risk factors for birth defects before the implementation of the universal two-child policy, after the implementation of the universal two-child policy,both factors had no influences on the occurrence of birth defects.Conclusion After the implementation of "universal two-child policy", the number of births increases, and the number of parous women and women with advanced maternal age increased. Rural areas, premature infants and macrosomia were still risk factors for birth defects, while younger age and male were no longer a threat to the occurrence of birth defects.

Key words： Universal two-child policy Birth defects Influencing factors Surveillance

收稿日期: 2021-08-18

ZTFLH:

R17

基金资助:国家“十二五”科技支撑计划项目(2012BAI32B08)

引用本文:

宋志娇, 王海青, 罗铭忠. 山西省出生缺陷人群监测地区全面二孩政策实施后出生人口及出生缺陷发生情况分析[J]. 中国生育健康杂志, 2022, 33(3): 228-234. SONG Zhijiao, WANG Haiqing, LUO Mingzhong. Analysis on birth population situation and prevalence of birth defect after the implementation of the universal two-child policy in monitoring area of birth defect population in Shanxi Province. Chinese Journal of Reproductive Health, 2022, 33(3): 228-234.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2022/V33/I3/228

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