| Background & ObjectiveThe aims are to describe the distribution of birth defects;to explore the risk factors on birth defects;finally,exam the relationship of organochlorine levels in plasma and birth defects in Zhoushan Islands. Materials & MethodsThe data of the birth defects surveillance and Prenatal Health Care surveillance from Jan 2004 to Dec 2007 in Dinghai District of Zhoushan City was from women and children's hospital.A population-based surveillance system on birth defects was used to collect the data of birth defects that occurred from 20 weeks of gestation to 42 days after birth."Prenatal Health Care Booklets"was formulated by office of China-U.S. Collaborative Project for Neural Tube Defect Prevention.It is consist of"General form","Initial pregnancy check form","Pre-review form","Production to pre-discharge table",etc.The content of Birth defects registration forms included prevalence rate of birth defects and their gender composition,age structure and species composition for descriptive statistics analysis.Select Demographic characteristics,pregnant women menstrual history,past history of pregnancy,early pregnancy,assisted checks and the unhealthy lifestyle,a total of 26 variables from"Prenatal Health Care Booklets"for correlation analysis with the occurrence of birth defects.The associations of variables mentioned above with birth defects was examined,using simple and multivariable logistic regression models.Based on the incidence of birth defects in the geographical area,5ml peripheral venous blood samples were obtained from 70 womens with childbearing age who were randomly choosed in 10 representative townships from Dinghai(15～49 years old,live in this area more than 10 years,and consume the rice that was produced by themselves).The wrirren consent forms were obtained before any manipulation.The concentration of HCHs,DDTs and POPs in plasma were detected by gas chromatography.The associations of HCHs,DDTs and POPs with birth defects were analyzed.ResultsA.From 2004 to 2007,there were 9,236 fetus reported by birth defect surveillance system in Dinghai District of Zhoushan City.133 cases of birth defects were observed among 9,236 fetus.The incidenceof birth defects was 144.00 per 10,000. The incidence rates were rising year by year.The common types of birth defects in Zhoushan Islands were congenital heart defects,external ear malformation,cleft lip with or without cleft palate,hydrocephaly,polydactyl and neural tube defects. Dysmenorrhea history had a significant protective effectto birth defects [OR(95%CI)=0.45(0.21～0.96);P=0.038].Compared with farmers of their husband's occupation,the women whose husband engaged none-farmer occupation had higher risk of birth defects[OR(95%CI)=1.66(1.12～2.45);P=0.012].Compared with those with the low education,the parents with high education had higher risk of birth defects[OR(95%CI)=1.83(1.21～2.77);P=0.004],[OR(95%CI)=1.89(1.21～2.93);P=0.00 5].Compared to negative urinary protein in Early pregnancy,the positive urinary protein was lowerly associated with the risk of birth defects[OR(95%CI)=0.49 (0.27～0.92);P=0.026].But the positive syphilis test significantly increased the risk of birth defects[OR(95%CI)=3.33(1.20～9.22);P=0.021].Study shows that the pregnant women with smoking husband had higher risk of birth defects than those with non-smoking husband[OR(95%CI)=1.78(1.16～2.73);P=0.008].B.By stepwise logistic regressions model,we found that Urine protein, dysmenorrhea,husband education,husband's smoking were included in the model. Compared with their husband with junior secondary and below education level,women whose husband took higher education higherly delivered the fetus with birth defects [OR(95%CI)=1.85(1.17～2.91);P=0.008].Study shows that the pregnant women with smoking husband had higher risk of birth defects than those with non-smoking husband[OR(95%CI)=1.70(1.09～2.67);P=0.020].C.The detectable rate of all components of organochlorines in plasma was greater than 90%.Total PCBs's detectable range was 0.0472 ng/ml～20.6354 ng/ml,among them,PCB-138 was the main role,its detectable range reached 0.0067ug/kg～18.6437ug/kg.Nonparametric analysis was used for testing organochlorines in blood between six districts.Only PCB-180 concentration was significantly different between six districts.The significant associations of organochlorines concentration with birth defects were not observed in this study. ConclusionsA.From 2004 to 2007,there were 9,236 fetus were reported by birth defect surveillance system in Dinghai District of Zhoushan City,of which,133 cases were suffered form birth defects,the incidence of birth defects was 144.00 per 10,000.The incidence rate was rising with calendar year.The common types of birth defects in Zhoushan Islands were congenital heart defects,external ear malformation,cleft lip with or without cleft palate,hydrocephaly,polydactyl and neural tube defects;B.Non-agricultural employment of husband,high education level of parents, husbands smoking and syphilis test increased the risk factor of birth defects.The propaganda and health education about birth should be strengthened,and advocate a healthy lifestyle,reduce occupational exposure,strengthen the screening of high-risk groups to reduce the rate of birth defects;C.The detectable rate of organchlorines in the blood samples of Zhoushan area was high,But the levels of organochlorines in the blood of local residents were not significantly correlated with the prevalence of birth defects. |
