Study On Epidemic Characters And Influential Factors Of Major Birth Defects In Hubei

ObjectiveTo grasp the epidemic trends and distribution characteristics of birth defects in Hubei Province, analyze the risk factors of birth defects, and understand the public's recognition to birth defects, so as to propose appropriate preventive measures and explore integrated intervention model of birth defects, in order to improve the quality of the population born in China.Methods1. Survey methods(1) The birth defects surveillance data of Hubei province was obtained from the Hubei Provincial Maternal and Child Health Hospital to grasp the prevalence of total birth defects and the occurence of major birth defects.(2) A 1:1 pairwized case-control study method was applied to select 108 children with cleft lip with or without cleft palate (CL/P) as well as 108 healthy chilren without any congenital malformations. By using the self-made questionnaire. which was discussed and revised after the pilot survey, standardized demographic and periconceptional exposure data were collected from their parents (3) Qualitative research method was used to interview the local leaders in charge of prevention and control of birth defects, including the occurence information and species distribution of birth defects in this area and the need for improvement of intervention measures, etc.2.Statistical methodsAfter check and verification, the data was input into the computer to establish a database with Excel 2007 and then made statistical analysis with SPSS 16.0, including descriptive analysis,χ2 test, paired t test, paired MecNemar test, univariate Cox regression analysis, multivariate conditional logistic regression analysis, etc.Results1. Analysis on birth defects surveillance data of Hubei provinceThe overall prevalence of birth defects in Hubei province was 12.36%o, which was at a higher level and showed an upward trend from 2001 to 2009. The average incidence of birth defects among rural area was 14.01‰, higher than that of urban area (13.71‰), but the difference of which was not statistically significant (χ2=0.32, P=0.57); The average incidence of birth defects of male was 14.71‰, obviously higher than that of female (12.97‰), which had statistical significance (χ2=14.11, P＜0.01); There was seasonal variation in the incidence of birth defects, ranked as summer first (15.79%o) and winter last (12.68‰); In terms of incidence of birth defects among the offspring, the highest was in the group of women aged more than 35 years, followed by the group of less than 20 years, the difference of which was statistically significant (χ2=13.43, P=0.01); The CL/P had been ranked as the first of all types of birth defects for a long time, the incidence of which increased year by year.2. Study on influential factors of CL/PUnivariate analysis showed that the differences of case group and control group in these factors, including paternal family history, paternal reproductive diseases, paternal exposure to environmental risk factors, maternal exposure to environmental risk factors, maternal abnormal pregnancy history, first-trimester maternal illness, first-trimester maternal bad mood, first-trimester sexual activity, first-trimester maternal diet of fruits and vegetables per day, were statistically significant.Multivariate conditional logistic regression analysis showed that paternal family history, paternal exposure to environmental risk factors, maternal abnormal pregnancy history, first-trimester maternal illness, first-trimester maternal bad mood, first-trimester sexual activity, first-trimester maternal intake of fruits and vegetables per day entered the logistic model. Among which, paternal exposure to environmental risk factors, maternal abnormal pregnancy history, first-trimester maternal illness, first-trimester maternal bad mood, first-trimester sexual activity were risk factors of CL/P, while first-trimester maternal high intake of fruits and vegetables per day was a protective factor of CL/P.3. The information of recognition to birth defects among parents and results of interview to leadersThe findings showed that the pregnant women in survey area neither knew much about birth defects nor take related preventive measures. Some of prenatal diagnostic equipment of the local hospitals fell behind the actual demand. The local hospitals carried out few intervention activities on birth defects. Moreover, because of high mobility, the public lacked awareness of pregestational health care and were not willing to take the initiative to acquire knowledge. Therefore, even if the intervention activities were carried out, the expected effects would not be achieved.4. Parental genetic inheritanceThere were four children with parental genetic inheritance, all of which were collateral inheritance. Three were boys and one was a girl. None of their parents had congenital deformities or were sib mating.Conclusions1. The prevalence of birth defects in Hubei province is at a relatively high level and shows an obvious upward trend, which also presents diferences in gender, season and maternal age. The incidence of CL/P ranks as the first of all types of birth defects.2. The influential factors of CL/P are paternal exposure to environmental risk factors, maternal abnormal pregnancy history, first-trimester maternal illness, first-trimester maternal bad mood, first-trimester sexual activity and first-trimester maternal intake of fruits and vegetables per day.3. The pregnant women in survey area neither know much about birth defects nor take related preventive measures. We should pay more attention to promoting their recognition to birth defects in future and encouraging them to adopt related preventive measures.4. There is parental genetic inheritance phenomenon in the occurrence of CL/P.