Study Of The Epidemic Status And Influence Factors Of Birth Defects During2003-2008in Jilin Province

Objective:To describe the epidemic trend and distribution characteristics of birth defectsin Jilin Province, and analyse the possible influence factors of birth defects, andpropose the possible effective intervention measures to prevent birth defects.Method:Using stratified multi-stage random cluster sampling, from April2009toSeptember2009we investigated the family which having fertility behavior,including normal and abnormity, during2003-2008from97townships from68countries. We collected perinatal and maternal data through household interviews bytrained interviewers, using the birth defect baseline survey designed ourself and thenational unified designed birth defects registration card. Diagnosed standard for birthdefects is China’s birth defects monitoring work manual. entered data into populationand family planning management system defects baseline survey system programdesigned by ourselves, arranged and analysed the data using SPSS13.0statisticalsoftware.Results:1. We collected127591effective perinatal questionnaires and987birth defectregistration card. The total incidence of birth defects was77.36/10000. Theincidence of birth defects decreased year by year, but the difference was notstatistically significant (χ~2＝4.62，P＞0.05).2. Of all kinds of birth defects, the incidence of the top six were: congenital heartdisease (15.91/10000), congenital hydrocephalus (4.94/10000), cleft palate(3.29/10000), other ear anomalies (3.21/10000), polydactyly (2.51/10000), Downssyndrome(2.51/10000). 3. The highest incidence of birth defects was in Liaoyuan area, which was112.22/10000. The lowest incidence of birth defects was in Tonghua area, which was51.00/10000. The incidence of birth defects was significant difference in differentarea (χ~2＝81.81，P＜0.001).4. The incidence of birth defects in male was90.25/10000, the female incidence ofbirth defects was62.68/10000. the incidence of birth defects in male was1.44timeshigher compared to that in female. The difference was statistically significant (χ~2＝30.98，P＜0.001).5. The trend chi-square test indicated that the risk of birth defects increased withincreasing maternal age (Trend χ~2=406.05，P<0.001), decreased with increasingmaternal culture (Trend χ~2=84.73，P<0.001), decreased with increasing income(Trend χ~2=13.13，P=0.004). The incidence of birth defects was different withdifferent occupation, the difference was statistically significant (χ~2=58.37，P<0.001).The incidence of birth defects was highest (89.81/10000) when mother was peasantand lowest (40.39/10000) when mother was worker.6. By chi-square test, the incidence of birth defects was different when the weight ofperinatal was different (Trend χ~2=35.22，P<0.001). The risk of birth defects thathave lower weight was1.66times than normal weight.7. Through trend chi-square test, hypertension of mid pregnancy (trend χ~2=27.06，P<0.001), hypertension of late pregnancy (Trend χ~2=19.08， P<0.001), irondeficiency anemia of mid pregnancy (Trend χ~2=22.92，P<0.001), and iron deficiencyanemia of late pregnancy (Trend χ~2=34.88，P<0.001) was the risk factors of birthdefects.8. Through chi-square test, that folic acid supplementation (χ~2=100.70，P<0.001),drink tap water (χ~2=10.04，P=0.002), and eugenic screening (χ~2=21.16，P<0.001) isthe protective factors of birth defects.Conclusion:The incidence of birth defects was lower in Jilin Province, and showeddecreasing trend. There are differences in various regions, Liaoyuan, Jilin, Yanbian area was higher than the average level, the eugenics intervention should bestrengthened in these areas to reduce the incidence of birth defects. The highestincidence of birth defects was congenital heart disease in Jilin Province, it should bestrengthened to concern and research for congenital heart disease. Elder, lowereducational level, occupation for peasants, poor economic conditions, hypertensionof mid trimester pregnancy, hypertension of late pregnancy, iron deficiency anemiaof mid trimester pregnancy, iron deficiency anemia of late pregnancy, and lowerbirth weight of perinatal infant was the risk factors of birth defects. Appropriate ageplanning, eugenic screening, premarital examination, strengthen nutrition duringpregnancy, supplement of folic acid, and gestational hypertension and anemiacontrolling can effectively prevent birth defects.