摘要：
Objective To analyze the relevant indicators of prevention and control of birth defects in Guangxi from 2000 to 2015,thus to provide the reference for government departments to formulate the intervention measures of birth defects.Methods The relevant statistical data of the primary,secondary prevention strategies of birth defects in Guangxi from 2000 to 2015 were collected.And then the data of premarital medical examination,supplement of folic acid,prevention and control of thalassemia,and incidence of birth defects during prevention and control of birth defects in Guangxi were analyzed.Results (1) The rate of premarital medical examination in Guangxi during 2000 to 2015 was 50.67%,during 2004 to 2009 was 6.09%,the rate of free premarital medical examination in Guangxi during 2010 to 2015 was 91.67%,and the rate during 2010 to 2015 was 15.06 times as much as that during 2004 to 2009.The cases of detected diseases amounted to 524 416 during 2000 to 2015,mainly consisting of genital system diseases(3.35%) and internal medicine diseases(2.69%).(2) The persons with folic acid administration amounted to 180 564 during 2010 to 2015,the rate of folic acid administration was 64.22% in 2010,then increased to 97.58% in 2015,with an increment of 51.95%.The compliance rate and awareness rate of folic acid administration in 2010 were 39.66% and 93.58% respectively,in 2015 increased to 93.20% and 97.48% respectively,and the increments of the compliance rate and awareness rate were 135.00% and 7.62% respectively.(3) The rates of prenatal screening and prenatal diagnosis increased year by year,in 2013 were 9.61% and 0.40% respectively,during 2010 to 2015 increased to 56.83% and 20.25% respectively,5.91 times and 50.63 times as much as those in 2003 respectively,and 2.91 times and 11.57 times as much as those during 2004 to 2009 respectively.(4) The fetuses involving in a thalassemia screening during 2010 to 2015 amounts to 9 794 546,and 478 243 cases received genetic diagnosis.A total of 8 048 fetuses were diagnosed as thalassemia intermedia or heavy thalassemia.(5) The incidence rate of birth defects during 2000 to 2015 was 1.2146 per million with a descending tendency,and the most common birth defects were congenital heart disease and Bart′s syndrome.Conclusion The published policies have an effect on the prevention and control of birth defects.Since 2010,the rates of prenatal screening and prenatal diagnosis increase year by year,and the incidence rate of birth defects decreases year by year due to the full implementation of the comprehensive prevention and control strategies for birth defects which are dominated by primary and secondary prevention.%目的 对2000~2015年广西出生缺陷防控有关的指标进行分析,为政府部门制定出生缺陷干预措施提供参考依据.方法 收集2000~2015年广西出生缺陷一级、二级预防策略的相关统计资料,对广西出生缺陷防控中的婚前医学检查、增补叶酸、地中海贫血防控、出生缺陷发生情况等资料进行分析.结果 (1)婚检率:2000~2015年婚检率为50.67%,2004~2009年婚检率为6.09%,2010~2015年免费婚检率为91.67%,2010~2015年免费婚检率是2004~2009年婚检率的15.06倍.2000~2015年婚检检出疾病524 416例,以生殖系统(3.35%)和内科系统疾病(2.69%)为主.(2)叶酸服用:2010~2015年叶酸服用人数4 180 564人,2010年叶酸服用率为64.22%,2015年97.58%,增幅为51.95%;2010年叶酸服用依从率为39.66%,2015年提高至93.20%,增幅为135.00%;2010年群众对服用叶酸的知晓率为90.58%,2015年提高至97.48%,增幅为7.62%.(3)产前筛查、诊断:产前筛查率和产前诊断率逐年提高,2003年产前筛查率为9.61%,产前诊断率为0.40%,2010~2015年分别提高到56.83%、20.25%,分别是2003年、2004~2009年的5.91倍、2.91倍和50.63倍、11.57倍.(4)地贫筛查:2010~2015年进行地中海贫血筛查9 794 546人,完成基因诊断478 243人;查出中间型和重型地贫胎儿8 048例.(5)出生缺陷:2000~2015年出生缺陷发生率为121.46/万,发生率呈由高至低的变化趋势,最常见的出生缺陷是先天性心脏病和胎儿水肿综合征.结论 政策的出台对出生缺陷防控效果有影响,从2010年起全面落实以一级、二级预防为主的出生缺陷综合防控策略后,产前筛查率和产前诊断率逐年提高,出生缺陷发生率逐年下降.
