The Epidemiology Of Perinatal Birth Defects In Tianjin From2010to2013

BackgroundBirth defects are deseases that happen abnormalities in body structure, function, or metabolic before the bady is born, including congenital malformations, chromosomal abnormalities, inherited metabolic disease and dysfunction (such as blind, deaf, and mental retardation). Birth defects not only seriously affect the children’s life and the quality of life,and become public health problem which influence the population quality and the level of community health, which bring family heavy mental and economic burden, but also lead to the potential life lost in our country. In1986, we established the birth defects surveillance system which was based on the hospitals, the monitoring period is from28-weeks pregnancy to7days after birth, and we put emphasis on23kinds common birth defects in the perinatal, such as structure malformation, chromosomal abnormalities and a small number of inherited metabolic diseases. The incidence rate of perinatal birth defects which get from the surveillance system mainly reflects the level of birth defects that can be clearly clinical diagnosis at birth. The surveillance system can monitor the incidence rate of birth defects and its change trend, and describe and evaluate some obvious gathering for birth defects and its effects, including some public health functions, such as birth defects affect on the death and disability. The data can be used in health service budget and evaluation, and also used to develop and evaluate the target of prevention. Through birth defects monitoring, we can take more effective preventive intervention measures to reduce the incidence rate of birth defects, which have great significance in improving the quality of birth population, reducing the economic and psychological burden of family and society, promoting the progress of the society, reducing the infant mortality rate and improving life expectancy and maintaining social sustainable development in our country. ObjectiveThrough analyzing the perinatal birth defects monitoring results from2010to2013in Tianjin to get the perinatal birth defects’types, composition and distribution characteristics. Using the method of circular distribution to get seasonal distribution of perinatal birth defects in Tianjin. The research results can provide a scientific base for relevant departments to draft policies and implement the corresponding prevention and intervention measures.MethodsData came from the maternal and child health information system which were reported by the monitoring hospitals through birth defects report cards and perinatal death report cards, from2010to2013in Tianjin. We used the SAS9.2and Excel2010software to analyse the monitoring data. First, we did some statistical descriptions, such as family income, mother’s age and level of education, perinatal gestational age and birth weight, the total incidence rate of perinatal birth defects, the birth defects’types, composition and sequence, the annual incidence rate of birth defects, the annual birth defects’types, composition and sequence, and make some relevant charts. Second, we made statistical inference with relevant variables, such as the incidence rate of comparative and the circular distribution analysis. We used the chi-square test (or Fisher’s exact probability method) to compare the incidence rate of birth defects in different years, baby gender, mother age groups and mother regions, to find whether the incidence rate of birth defects was statistically significant in these variables. We transformed the birth defects data into angle data by birth months, and then calculated the circular distribution parameters. The quantitative data were expressed with average and qualitative data were expressed with rate.(a=0.05).ResultsAmong466770babies from on January1st,2010to December31th,2013in Tianjin,5415cases birth defects was found and the total incidence rate of perinatal birth defects was11.60per thousand. In2010～2013the number of babies is108904, 115949,130276and111641respectively, and the annual number of birth defects is1023cases (9.39‰),1397cases (12.05‰),1504(11.54‰) and1491(13.36‰) respectively. The number of towns and villages were3507cases and1908cases respectively. There were2938males,2265females and211unknown gender, accounting for54.27%,41.84%and3.90%respectively. The top ten incidence rate of birth defects from2010to2013was congenital heart disease, polydactylism, outer ear other malformation, congenital hydrocephalus, cleft lip, cleft lip with cleft palate, neural tube defects, microtia (including earless), syndactylia and cleft palate. The difference of the incidence rate indifferent years, baby gender, mother age groups and mother regions was statistically significant. After using the circular distribution method to analyse the four years’monitoring data, we could not find that the birth defects’data had the seasonal characteristics, there was not peak month, and the monthly distribution was similar. But congenital heart disease had the seasonal characteristics, and peak day was on March9th.ConclusionThe four-years birth defects’monitoring results in Tianjin show that the incidence rate of perinatal birth defects was lower than the national average level, But the incidence rate rised yarely, and male’s incidence rate was higher than female’s, city’s was higher than country’s. So as to reduce the incidence of birth defects and improve the quality of birth population, it’s necessary to take reproductive health education, genetic counseling, pre-marital medical checks and pregnancy care knowledge education among all the women of child-bearing age, and actively carry out prenatal screening and diagnosis, effective tertiary prevention measures.