A Case Series Of Birth Defects In A Hospital In Changchun City During2011-2013

ObjectiveTo describe the basic situation and the incidence of birth defects amongperinatal infants in a hospital of Changchun from2011to2013, and analyze themain risk factors causing death in birth defects infants, and provide theoretical basisfor the prevention of death among birth defects infants as well as theoreticalguidance for improving population quality.MethodsPerinatal infants (from16to40weeks’ gestation) with birth defects wereidentified in our study from a hospital in Changchun City during the period from2005to2011. Information were collected by using a questionnaire formulated. Thequestionnaire was composed of three sections: general information of infants withbirth defects, general information of mother, information of early pregnancy.Epidata3.1statistical software was applicated to establish the database andSPSS16.0statistics software was carried on to do the statistical analysis. Count datawas expressed as ratio or proportion, using single and multiple Logistic regressionanalysis to do the statistical analysis.Results1. Infants with birth defects in this study, male accounting for52.9%, femalefor45.0%, others for2.1%; the Han nationality accounting for97.0%,othernationality for3.0%; gestational age (<20weeks) accounting for6.0%,gestational age from20to30weeks accounting for21.7%, gestational age (≥30 weeks) for72.1%;weight(<2500g) accounting for45.0%, weight from2500to4000g for46.2%, weight(≥4000g) for4.7%;single birth accounting for96.8%,twinsfor3.0%;the incidence of birth defects of2011is equal to that of2012(2.12%),theincidence of birth defects of2013decreased(2=24.885，p<0.001);There are518cases of live births,422cases of still birth,5cases of neonatal death,10cases ofneonatal death (died within one week after childbirth);the clinical diagnosis for birthdefects accounting for51.3%,Ultrasound diagnosis for birth defects representing47.5%,other method for0.9%;diagnosis time(before production) for birth defectsaccounting for45.4%, diagnosis time(one week after childbirth) for birth defects for54.6%.2. The age of puerperal (<20years) accounting for2.4%, the age of puerperal(from20to25years) for18.8%, the age of puerperal (from25to30years) for44.1%,the age of puerperal (from30to35years) for24.8%, the age of puerperal (from35to40years) for8.5%, the age of puerperal (>40years) for1.4%; the puerperal livingin the town or city accounting for86.4%, the puerperal living in the village for13.6%;most of puerperal’s education level are high school, secondary school,college and above; most of puerperal’s annual average income is more thanRBM4000; most of puerperal’s gravidity is once; production times with zeroaccounting for17.4%, production times with one for68.9%, production times withtwo for13.1%, production times with three and more for0.6%; pregnancy time withthe most birth defects is December, pregnancy time with the least birth defects isMay.3. The top diseases of birth defects in our study, from the highest to lowestwere as follows (proportion): congenital heart disease, external earmalformation(small ears, no ears excluded), polydactyly, congenital hydrocephalus,cleft lip; there are92cases of neurological disorders,15cases of digestivediseases,141cases of circulatory system diseases,28cases of urinary systemdiseases; Hereditary birth defects are370cases, nongenetic birth defects are227 cases,unkown-genetic birth defects are18cases,others are322cases;the topincidence of live birth is external ear malformation, the top incidence of still birth isCongenital heart disease.4. There is significant difference in gender of defects, age of puerperal,puerperal’s education level, puerperal’s annual average income, production times,diagnosis time for birth defects, diagnostic methods for birth defects and weight ofbirth defects; the result of multiple Logistic regression analysis shows thatproduction times,diagnosis time for birth defects diagnostic methods for birthdefects affect outcome of birth defects; production times increased once, death riskof birth defects fell88.6%; The higher puerperal’s educational level, the lesspossible infants with birth defects going deaed.Conclusion1. In the hospital of Changchun, the incidence of birth defects was similarbetween2011and2012(2.12%), and declined in2013(1.48%).2. It was found that the proportion of the top five birth defects were congenitalheart disease, external ear malformation (small ears, no ears excluded), polydactyly(finger), congenital hydrocephalus and cleft lip in the study of birth defects in thehospital of Changchun during2011to2013.3. It was found that the higher proportion of single deficiency birth defectswere: congenital heart disease, the other ear malformations (small ears, no earsexcluded), polydactyly (finger), congenital hydrocephalus, cleft lip and cleft palate.4. The top five disease diseases of a higher percentage of live birth of BD were:other external ear malformations (small ears, no ears excluded), polydactyly (finger),congenital heart disease, hypospadias, and toe (finger).5. The top five diseases of a higher percentage of neonatal death of BD were:congenital heart disease, congenital hydrocephalus, cleft lip, cleft lip and cleft palate,spina bifida.6. Increased maternal parity and education leve are protective factors to birth defects in children of death.