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目的:探讨降低出生缺陷的预防、监测及干预措施。方法:回顾分析出生缺陷发生情况并比较历年出生缺陷发生率的变化趋势、出生缺陷顺位特点、终止妊娠的孕周及转归。结果:2006-2012年江苏省人民医院产科住院分娩25 555例,其中有出生缺陷396例,出生缺陷发生率为15.5‰,历年趋势平稳。出生缺陷肢体畸形居首位,占畸形总数的21.7%,其次是先天性心脏病占18.2%,其他依次为泌尿系统畸形14.1%、总唇腭裂13.6%、消化系统畸形8.60%。妊娠28周前终止妊娠139例占35.1%,其中先天性心脏病37例(26.6%);而妊娠≥28周终止妊娠257例占64.9%,其中最多的是肢体畸形75例(29.2%)。出生缺陷病例中活产共157例(39.6%),其中肢体畸形69例(43.9%)居首位;而死胎及治疗性引产239例(60.4%),其中最多的是先天性心脏病57例(23.8%)。结论:出生缺陷顺位有其自身特点,严重畸形及合并多脏器畸形者往往终止妊娠孕周早且妊娠结局不良。加强孕期对出生缺陷的预防、监测并适时科学干预,有利于降低出生缺陷、改善不良预后。
Objective: To explore the prevention, monitoring and intervention to reduce birth defects. Methods: The incidence of birth defects were retrospectively analyzed. The incidence of birth defects in the past years, the characteristics of birth defects, gestational age of termination of pregnancy and outcome were compared. Results: From 2006 to 2012, 25 555 obstetric patients were hospitalized in Jiangsu Provincial People’s Hospital, among which 396 were birth defects and the incidence of birth defects was 15.5 ‰, with a steady trend over the years. The deformities of birth defects were the highest, accounting for 21.7% of the total number of deformities, followed by congenital heart disease accounting for 18.2%, followed by urinary system malformation 14.1%, total cleft lip and palate 13.6%, digestive system deformity 8.60%. 139 cases of pregnancy termination accounted for 35.1% before pregnancy, of which 37 cases were congenital heart disease (26.6%); 257 cases of termination of pregnancy ≥ 28 weeks pregnancy accounted for 64.9%, the most common of them were limb deformities (29.2%). A total of 157 live births (39.6%) were observed in birth defects, of which 69 (43.9%) were malformations, and 239 (60.4%) stillbirths and therapeutic abortion, of which 57 were congenital heart diseases (23.8%). CONCLUSION: The birth defects have their own characteristics. The patients with severe deformity and multiple organ deformities often terminate gestational gestational age earlier and have poor pregnancy outcome. To strengthen the prevention of birth defects during pregnancy, monitoring and timely scientific intervention, is conducive to reducing birth defects, improve the poor prognosis.