Epidemical Analysis On Congenital Anomalies In Fuzhou City

Epidemical Analysis on Congenital Anomalies Monitoring in Fuzhou CityObjectiveTo examine the time trend of congenital anomalies prevalence from 1996 to 2004 in Fuzhou, furthermore to explore the possible influence factors and their interactions in the occurrence of major congenital anomalies in Fuzhou, and evaluate the relative importance of each influence factor, then provide scientific guidelines for congenital anomalies prevention.MethodsData from 1996 to 2004 were collected through Fuzhou Birth Defect (BD) Monitoring Network a hospital based congenital anomalies registry system, during that period all live or stillbirths with 28 weeks of gestation or more were assessed within 7 days after delivery.A hospital-based 1: 2 matched case control study was designed, in which cases and controls' direct parents were retrospectively interviewed with the same questionnaire. Parents' carrier factors were required during mother pregnant. Each case was matched with two normal controls on the sex, living district, and birth date before or after one week. By means of simple and multivariable conditional Logistic regression, use analysis to test the interaction between hereditary history of BD and environmental factors.ResultsTotal 96, 700 prenatal children and 852 children with congenital anomalies were monitored in nine years, then the overall prevalence rates of congenital anomalies were 88.11/10 000. Congenital anomalies increased from 78.62/10 000 in 1996 to 118.65/10 000 in 2004; The lowest but no significant rate was found in maternal age group of 25 to 30years. the prevalence of congenital anomalies in rural was higher than that in urban. The largest number of congenital anomalies is cleft lip with or without cleft palate (CL±P), hydrocephaly, polydactyl, congenital heart disease(CHD) and hypospadias were followed. The prevalence of CL±P, congenital hydrocephaly, neural tube detects in rural areas were higher than that in urban areas. The prevalence rates of hypospadias were higher in boy than that in girl. BD was accounted for an increasing proportion of perinatal deaths in Fuzhou, and had become one of the major causes of perinatal deaths.Maternal exposure history to poisonous chemicals, illness, alcohol and maternal occupational exposure during the first trimester pregnancy, hereditary history of BD, delivery history of BD was significantly associated with congenital anomalies. Their odds ratios(OR) and 95％confidential interzone(CI) were 4.34(1.95-9.65), 2.18(1.29-3.68), 2.88(1.16-7.12), 2.08(1.24-3.47), 5.56(1.26-24.59), 10.79(1.23-94.95), respectively. Interactions have been found between hereditary and environmental factors. Hereditary factors modified the relative risk of BD.ConclusionThe prevalence rate of congenital anomalies is increasing between 1996 to 2004 in Fuzhou city. The most risk factor is Delivery history of BD according to the OR, in descending order of it, followed by hereditary history of BD, Maternal exposure, history to poisonous chemicals, alcohol, occupational exposure and illness during the first trimester pregnancy. Do more exercises, raise resistance of illness, abstinence, away from poisonous chemicals, adjust the occupation before pregnancy is an efficient and feasible way. Furthermore, monitor the pregnant during prenatal examination, do prenatal screen and diagnosis of BD, focus on the pregnant with hereditary and environmental factors, two or more high dangerous factors.