上海市崇明区20092018年新生儿先天性心脏病流行特征

Epidemiological characteristics of congenital heart disease in infants from 2009 to 2018 in Chongming District, Shanghai

  • 摘要:
    目的 描述上海市崇明区2009—2018年新生儿先天性心脏病(CHD)发病情况和分布特征,分析崇明区CHD报告发生率的变化趋势。
    方法 基于上海市出生缺陷监测系统,对2009—2018年在上海市崇明区各个医疗机构分娩的新生儿进行监测(孕28周到出生后42 d),描述各类CHD的报告发生率和变化趋势。
    结果 上海市崇明区2009—2018年共报告新生儿CHD548例,报告发生率为20.11‰(95%CI: 18.47‰~21.85‰),不同年度之间差异有统计学意义(Z=10.616,P<0.001)。4种最常见的CHD类型为动脉导管未闭(PDA)、卵圆孔未闭(PFO)、房间隔缺损(ASD)和室间隔缺损(VSD),分别有313例(11.49%)、312例(11.45%)、88例(3.64%)和73例(2.68%),以可能在生长发育中进一步闭合的PDA和PFO为主,其中单纯性PDA、单纯性PFO分别占总病例的18.61%和23.18%。
    结论 上海市崇明区CHD报告发生率呈先波动下降后上升的趋势,应加强对CHD患儿,尤其是动脉导管或PFO患儿的社区随访和结局追踪。

     

    Abstract:
    Objective To describe the incidence and distribution characteristics of congenital heart disease in newborns, and to analyze the trend of the notification rate from 2009 to 2018 in Chongming District, Shanghai.
    Methods Based on the shanghai birth defects surveillance system, newborns delivered in all medical institutions in Chongming District from 2009 to 2018 were examined for congenital heart disease at birth and followed up to 42 days. The notification rate and trends of various congenital heart diseases were described.
    Results There were 548 cases of neonatal congenital heart disease in Chongming District from 2009 to 2018, and the notification rate was 20.11‰ (95%CI: 18.47‰-21.85‰), with statistically significant differences between years during the study period (Z=10.616, P<0.001). The four most common types of congenital heart disease were patent ductus arteriosus (313, 11.49%), patent foramen ovale (312, 11.45%), atrial septal defect (88, 3.64%) and ventricular septal defect (73, 2.68%). Majority of the congenital heart disease cases were patent ductus arteriosus and patent foramen ovale that could be further closed during growth and development. Isolated patent ductus arteriosus and isolated patent foramen ovale accounted for 18.61% and 23.18% respectively of the total cases.
    Conclusion The notification rate of congenital heart disease in Chongming District shows a trend of fluctuating decline followed by an increase. Community follow-up and outcome tracking should be strengthened for children with congenital heart disease, especially those with patent ductus arteriosus or patent foramen ovale.

     

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