目的 了解成都市围孕期妇女的孕前保健认知度及需求状况。 方法 2011年7月－2012年1月对成都市225名初产孕妇为调查对象，采用访谈及问卷进行调查，回收有效问卷217 份。 结果 217名中仅13名进行了孕前保健，孕前保健的参与率较低（5.99%）；孕妇的年龄和受教育程度对孕前保健的认知度、参与率比较差异有统计学意义（P＜0.05）；孕前小剂量叶酸服用率11.20%，但正确服用率仅为1.50%。48.84%（106/217）听说过孕前保健，其中36.79%（39/106）知道孕前保健的最佳时间，但不完全了解孕前保健内容；55.67%（59/106）的夫妇知道需在孕前改变不良生活方式；21.69%（23/106）知道部分孕前检查内容，44.34%（47/106）知晓孕前补充小剂量叶酸预防神经管缺陷，仅3.77%（4/106）知道孕前遗传咨询。获取知识途径依次为网络22.64%（24/106），社区宣传或讲座24.53%（26/106），朋友同事33.96%（36/106），医院15.09%（16/106），书刊和广告3.77%（4/106），但仅10.10%的妇女是通过培训渠道获取的知识。高达89.40%的妇女迫切希望参加孕前保健及相关预防出生缺陷的知识培训，并希望去社区或妇幼专科医院接受相关孕前咨询及检查。 结论 成都市围孕期妇女孕前保健认知度较低，导致孕前保健的参与率较低、依从性较差，叶酸服用率低而不规范；孕前保健知识培训及服务形式、内容急待增强。围孕妇女孕前保健需求较高，倾向价廉、便捷的社区医院和妇幼专科医院。
ObjectiveTo analyze the prenatal screening data of Longquanyi district, and evaluate the effect of prenatal screening technology in birth defects prevention. MethodsA total of 10230 serum samples in Chengdu Longquanyi District Prenatal Screening Center from November 2010 to December 2012 were tested and analyzed, and the risk rates of Down's Syndrome, Trisomy 18 Syndrome and Open Neural Tube Defects (ONTDs) were obtained by Risk2T risk calculation software. The results of prenatal screening were verified and evaluated by high risk referral, pregnancy tracing and pregnancy outcome follow-up. ResultsIn the 10 230 pregnant women, the positive rate of Down's Syndrome was 6.02%, Trisomy 18 Syndrome was 0.42% and Open Neural Tube Defects was 0.57%, and compliance rate of prenatal diagnosis was 51.56%. In the 57 high risk pregnant women of ONTDs, 53 women selected system color doppler ultrasound with a proportion of 92.98%, but in the 647 high risk pregnant women of Down's or Trisomy 18 Syndrome, only 47.30% of them chose amniocentesis for diagnosis. The χ2 analysis showed that the difference was significant compared between system color doppler ultrasound and amniocentesis group (P<0.05). By diagnosis, 3 Down's Syndrome patients were found. ConclusionSecond trimester maternal serum prenatal screening plays an important role in birth defects prevention in Longquanyi district. However, there is a great need to improve compliance rate of prenatal diagnosis of Down's and Trisomy 18 Syndrome.
ObjectiveTo determine teratogenicity of beta-blockers in early pregnancy. MethodsWe searched PubMed, EMbase, Cochrane Clinical Trials, clinicaltrials.gov, CBM, Wanfang database, and CNKI from establishment of each database to December 2014. We evaluated the quality of included literature. Statistical analysis was conducted in RevMan5.3 software. ResultsFifteen population-based case-control or cohort studies were identified. The score of included studies changed from 5-7 points. Based on meta-analysis, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies. While in analysis examining organ-specific malformations, statistically increased odds of cardiovascular (CV) defects with OR 2.21 and 95% CI 1.63 to 3.01, cleft lip/palate (CL/P) with OR 3.11 and 95% CI 1.78 to 9.89, and neural tube (NT) defects with OR 3.56 and 95% CI 1.19 to 10.67 were observed. ConclusionCausality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.
Objective To systematically review the association between prenatal exposure to dichlorodiphenyltrichloroethane (DDT) or polychlorinated biphenyls (PCBs) and the risk of congenital anomalies. Methods PubMed, EMbase, WanFang Data, VIP and CNKI databases were electronically searched to collect case-control studies on the relationship between prenatal exposure to DDT or PCBs and congenital anomalies from inception to February 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 13.0 software. Results A total of 14 studies involving 2 238 infants with defect and 2 335 infants without defect were included. The results of meta-analysis showed that: the prenatal exposure to high level of DDT increased the incidence of cryptorchidism (OR=1.12, 95% CI 1.09 to 1.15, P<0.001). However, DDT exposure had no correlation to hypospadias and neural tube defects. The associations between prenatal exposure to PCBs and cryptorchidism, hypospadias, neural tube defects were not discovered. Conclusion Prenatal exposure to high levels of DDT may be a risk factor for cryptorchidism. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
Objective To investigate the methodological characteristics of observational studies on the correlation between drug exposure during pregnancy and birth defects. Methods The PubMed database was searched from January 1, 2020 to December 31, 2020 to identify observational studies investigating the correlation between drug use during pregnancy and birth defects. Literature screening and data extraction were conducted by two researchers and statistical analysis was performed using R 3.6.1 software. Results A total of 40 relevant articles were identified, of which 8 (20.0%) were published in the four major medical journals and their sub-journals, 21 (42.5%) were conducted in Europe and the United States, and 4 were conducted (10.0%) in China. Cohort studies (30, 75.0%) and case-control studies (10, 25%) were the most commonly used study designs. Sixteen studies (40.0%) did not specify how the databases were linked. Sixteen studies (40.0%) did not report a clear definition of exposure, while 17 studies (42.5%) defined exposure as prescribing a drug that could not be guaranteed to have been taken by the pregnant women, possibly resulting in misclassification bias. Six studies (15.0%) did not report the diagnostic criteria for birth defects and 18 studies (45.0%) did not report the types of birth defects. In addition, 33 studies (82.5%) did not control for confounding factors in the study design, while only 19 studies (47.5%) considered live birth bias. Conclusion Improvements are imperative in reporting and conducting observational studies on the correlation between drug use during pregnancy and birth defects. This includes the methods for linking data sources, definition of exposure and outcomes, and control of confounding factors. Methodological criteria are needed to improve the quality of these studies to provide higher quality evidence for policymakers and researchers.
ObjectiveTo analyze the trend of disease burden changes in congenital birth defects in China from 1990 to 2019. MethodsUsing the global burden of disease study 2019 (GBD 2019), we analyzed the morbidity, mortality, and disability-adjusted life years (DALYs) of congenital birth defect diseases and their corresponding age-standardized rates and average annual percentage change (AAPC) to analyze the changes in the disease burden of congenital birth defects in China and compared them with global data from 1990 to 2019. ResultsIn 2019, the age-standardized incidence, mortality, and DALY in China were 147.41/100 000, 4.62/100 000, 480.95/100 000, respectively. Compared with 1990, the age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate increased by 12.08% and decreased by 70.38% and 66.82%, respectively. In recent years, although the age-standardized incidence of congenital birth defect disease in China is on the rise and higher than the global level, the disease burden is roughly on the decline and lower than the global level, which is closely related to earlier intervention and treatment of the disease resulting in a lower standardized mortality rate. ConclusionThe age-standardized mortality rate of children with congenital birth defects in China showed a decreasing trend from 1990 to 2019, and the burden of disease ranged from slightly higher than global to lower than global levels, but the age-standardized incidence rate was significantly higher, but the age-specific incidence rate has increased significantly.