Investigation Of Present Status On Congenital Malformation In A 3-A Hospital Of Changzhi City From 2011 To 2015 And Analysis Of The Related Factors

Objective:To explore the morbidity situation of congenital malformation(CM).To discusses the necessity of prenatal diagnosis in the level of cytogenetics.To analyze the influencing factors of CM.To provide reference for consultation before pregnancy ? prenatal consultation and consultation.Methods:Data from 2011 to 2015 were gathered from registration of birth in a hospital of Changzhi city,and were checked with correlated data of the medical record.The classification of CM was classified according to International Disease Code-10(ICD 10).Descriptive statistics was employed to analyze the epidemiologic feature of birth defect and the value of diagnosing CM by ultrasound.Followed ascertaining and classifying 1:2matched case-control study was used.Investigate the basic information of the maternal,including: pregnant women age,culture level,living area,whether pregnancy on feeling,if there is a microbial infection during pregnancy(serum toxoplasma,cytomegalovirus,herpes simplex virus,rubella virus infection),medication history,working environment,harmful material contact(including industrial poisons,pesticides,smoking,drinking,etc.),and whether folic acid supplementation,abnormal reproductive history,family history,history of relatives,mating,breeding history.Further screen risk factors of CM,calculate the risk factors of odds ratio(OR value)by the multi-factor logistic regression analysis.Results:1.1)We monitored 9783 women of terminating pregnancy,and 245 CM cases in five years,the whole incidence of CM was 2.50%;2)According to the system classification of ICD-10,the top 5 types of CM were the central nervous system(36.73%),head face(18.38%),cardiovascular system(16.73%),skeletal muscle system(8.98%),urogenital system(6.53%).According to parts of the body classification,the top 5 types of CM were congenital heart disease(16.7%),spina bifida(12.2%)and hydrocephalus(12.2%),cleft lip and palate(11.8%),Anencephaly(6.5%).3)The incidence of CM in men and women was 2.38% and 2.68% respectively.The ratio of sex ratio of CM to male and female was 0.89: 1,and there was no significant difference in sex between the male and female(X~2 = 0.881,P = 0.348)(X~2 = 55.730,P <0.05);5)The incidence of CM in urban and rural areas was 1.62% and 3.51%,respectively.The difference between the two groups was statistically significant(X~2 = 55.730,P <0.05);5)The incidence of fetal CM for mother aged < 25 years old,aged 25 to 29,30 to 34,? 35 years old was 2.61%,1.90%,5.43%,7.90%.There is also difference with pregnant women's age(P<0.05).6)The incidence of fetal CM for mother with diploma of primary school and elementary school was 5.73%,which is 3 times of the incidence of CM for mother with diploma of College or above(X~2= 18.421,P <0.05).7)from the time of diagnosis,in 245 cases of fetal CM children,prenatal diagnosis of 167 cases,accounting for 68.16%;postpartum confirmed 78 cases,accounting for 31.84%,the proportion of prenatal diagnosis increased from 52.63% in 2011 to 2015 of 75.81%.8)From the basis of diagnosis,CM diagnosed by ultrasound was increased from 35% in 2011 to 63.64% in 2015.2.The results of 1: 2 case-control study of CM.Multivariable logistic regression showed that,the main effective factors of embryo congenital malformation were:catching a cold or having a fever during the pregnant period(OR=2.163,95%CI: 1.025-4.563),infections with viruses(OR=3.285,95%CI: 1.146-9.411),getting diseases and taking medicine during pregnancy(OR=2.603,95%CI: 1.061-6.386),explore to toxic substances in work place(OR=6.264,95%CI:2.211-7.755),adverse delivery history(OR=1.97, 95%CI:1.058-3.667),living in rural area(OR=2.526,95%CI: 1.498-4.26),husband drink(OR=2.195,95%CI: 1.052-4.582),husband smoking(OR=2.017,95%CI: 1.067-3.811);The protective factors were intake of folic acid(OR=0.324,95%CI: 0.136-0.772).Conclusion: The risk factors of fetal malformation are as follows: fever(OR = 2.163,95% CI: 1.025-4.563),viral infection(0R =(OR = 2.643,95% CI: 1.061-6.386),exposure to harmful substances during pregnancy(OR = 6.264,95% CI: 2.211-7.755),adverse pregnancy history(OR = 6.264,95% CI: 2.21-7.755)(OR = 2.195,95% CI:1.052-4.582),smoking(OR = 2.195,95% CI: 1.052-4.582),smoking(OR = 2.195,95%CI: 1.052-4.582),smoking(OR = 2.195,95% CI: 1.052-4.582)= 2.017,95% CI:1.067-3.811),whereas folic acid supplementation(OR = 0.324,95% CI: 0.136-0.772)was a protective factor.Conclusions:From 2011 to 2015,the whole incidence of CM was 2.50%.The top 5 types of CM were Congenital heart disease,spina bifida and hydrocephalus,cleft lip and palate,Anencephaly.28 weeks ago by the ultrasound diagnosis of the fetus CM accounted for an increasing proportion,that is,to receive prenatal ultrasound diagnosis of pregnant women more and more.Pregnancy,fever,her husband drinking,smoking,etc.is a high risk factor for fetal CM.As soon as possible for pregnant women to add folic acid,enhance the quality of pregnancy care,and actively carry out prenatal screening,through early diagnosis and thus minimize the birth of CM.