Perinatal deaths from birth defects in Hunan Province, China, 2010–2020

Abstract Objective To describe the perinatal mortality rate (PMR) of birth defects and to define the relationship between birth defects (including a broad range of specific defects) and a broad range of factors. Methods Data were obtained from the Birth Defects Surveillance System in Hunan Province,...

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Main Authors: Xu Zhou, Donghua Xie, Jian He, Yurong Jiang, Junqun Fang, Hua Wang
Format: Article
Language:English
Published: BMC 2023-11-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-023-06092-5
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author Xu Zhou
Donghua Xie
Jian He
Yurong Jiang
Junqun Fang
Hua Wang
author_facet Xu Zhou
Donghua Xie
Jian He
Yurong Jiang
Junqun Fang
Hua Wang
author_sort Xu Zhou
collection DOAJ
description Abstract Objective To describe the perinatal mortality rate (PMR) of birth defects and to define the relationship between birth defects (including a broad range of specific defects) and a broad range of factors. Methods Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010–2020. The prevalence rate (PR) of birth defects is the number of birth defects per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond). PMR is the number of perinatal deaths per 100 fetuses. PR and PMR with 95% confidence intervals (CI) were calculated using the log-binomial method. Chi-square trend tests (χ 2 trend ) were used to determine trends in PR and PMR by year, maternal age, income, education level, parity, and gestational age of termination. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with perinatal deaths attributable to birth defects. Results Our study included 1,619,376 fetuses, a total of 30,596 birth defects, and 18,212 perinatal deaths (including 16,561 stillbirths and 1651 early neonatal deaths) were identified. The PR of birth defects was 18.89‰ (95%CI: 18.68–19.11), and the total PMR was 1.12%(95%CI: 1.11–1.14). Birth defects accounted for 42.0% (7657 cases) of perinatal deaths, and the PMR of birth defects was 25.03%. From 2010 to 2020, the PMR of birth defects decreased from 37.03% to 2010 to 21.00% in 2020, showing a downward trend (χ 2 trend  = 373.65, P < 0.01). Congenital heart defects caused the most perinatal deaths (2264 cases); the PMR was 23.15%. PMR is highest for encephalocele (86.79%). Birth defects accounted for 45.01% (7454 cases) of stillbirths, and 96.16% (7168 cases) were selective termination of pregnancy. Perinatal deaths attributable to birth defects were more common in rural than urban areas (31.65% vs. 18.60%, OR = 2.03, 95% CI: 1.92–2.14) and in females than males (27.92% vs. 22.68%, OR = 1.32, 95% CI: 1.25–1.39). PMR of birth defects showed downward trends with rising maternal age (χ 2 trend  = 200.86, P < 0.01), income (χ 2 trend  = 54.39, P < 0.01), maternal education level (χ 2 trend  = 405.66, P < 0.01), parity (χ 2 trend  = 85.11, P < 0.01) and gestational age of termination (χ 2 trend  = 15297.28, P < 0.01). Conclusion In summary, birth defects are an important cause of perinatal deaths. Rural areas, female fetuses, mothers with low maternal age, low income, low education level, low parity, and low gestational age of termination were risk factors for perinatal deaths attributable to birth defects. Future studies should examine the mechanisms. Our study is helpful for intervention programs to reduce the PMR of birth defects.
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spelling doaj.art-8a66ce1aaa8244448ea5d7cb1075a03e2023-11-20T11:13:43ZengBMCBMC Pregnancy and Childbirth1471-23932023-11-012311810.1186/s12884-023-06092-5Perinatal deaths from birth defects in Hunan Province, China, 2010–2020Xu Zhou0Donghua Xie1Jian He2Yurong Jiang3Junqun Fang4Hua Wang5Hunan Provincial Maternal and Child Health Care HospitalHunan Provincial Maternal and Child Health Care HospitalHunan Provincial Maternal and Child Health Care HospitalHunan Provincial Maternal and Child Health Care HospitalHunan Provincial Maternal and Child Health Care HospitalThe Hunan Children’s HospitalAbstract Objective To describe the perinatal mortality rate (PMR) of birth defects and to define the relationship between birth defects (including a broad range of specific defects) and a broad range of factors. Methods Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010–2020. The prevalence rate (PR) of birth defects is the number of birth defects per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond). PMR is the number of perinatal deaths per 100 fetuses. PR and PMR with 95% confidence intervals (CI) were calculated using the log-binomial method. Chi-square trend tests (χ 2 trend ) were used to determine trends in PR and PMR by year, maternal age, income, education level, parity, and gestational age of termination. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with perinatal deaths attributable to birth defects. Results Our study included 1,619,376 fetuses, a total of 30,596 birth defects, and 18,212 perinatal deaths (including 16,561 stillbirths and 1651 early neonatal deaths) were identified. The PR of birth defects was 18.89‰ (95%CI: 18.68–19.11), and the total PMR was 1.12%(95%CI: 1.11–1.14). Birth defects accounted for 42.0% (7657 cases) of perinatal deaths, and the PMR of birth defects was 25.03%. From 2010 to 2020, the PMR of birth defects decreased from 37.03% to 2010 to 21.00% in 2020, showing a downward trend (χ 2 trend  = 373.65, P < 0.01). Congenital heart defects caused the most perinatal deaths (2264 cases); the PMR was 23.15%. PMR is highest for encephalocele (86.79%). Birth defects accounted for 45.01% (7454 cases) of stillbirths, and 96.16% (7168 cases) were selective termination of pregnancy. Perinatal deaths attributable to birth defects were more common in rural than urban areas (31.65% vs. 18.60%, OR = 2.03, 95% CI: 1.92–2.14) and in females than males (27.92% vs. 22.68%, OR = 1.32, 95% CI: 1.25–1.39). PMR of birth defects showed downward trends with rising maternal age (χ 2 trend  = 200.86, P < 0.01), income (χ 2 trend  = 54.39, P < 0.01), maternal education level (χ 2 trend  = 405.66, P < 0.01), parity (χ 2 trend  = 85.11, P < 0.01) and gestational age of termination (χ 2 trend  = 15297.28, P < 0.01). Conclusion In summary, birth defects are an important cause of perinatal deaths. Rural areas, female fetuses, mothers with low maternal age, low income, low education level, low parity, and low gestational age of termination were risk factors for perinatal deaths attributable to birth defects. Future studies should examine the mechanisms. Our study is helpful for intervention programs to reduce the PMR of birth defects.https://doi.org/10.1186/s12884-023-06092-5Perinatal deathsCongenital abnormalitiesRiskEpidemiologyPerinatal mortality
spellingShingle Xu Zhou
Donghua Xie
Jian He
Yurong Jiang
Junqun Fang
Hua Wang
Perinatal deaths from birth defects in Hunan Province, China, 2010–2020
BMC Pregnancy and Childbirth
Perinatal deaths
Congenital abnormalities
Risk
Epidemiology
Perinatal mortality
title Perinatal deaths from birth defects in Hunan Province, China, 2010–2020
title_full Perinatal deaths from birth defects in Hunan Province, China, 2010–2020
title_fullStr Perinatal deaths from birth defects in Hunan Province, China, 2010–2020
title_full_unstemmed Perinatal deaths from birth defects in Hunan Province, China, 2010–2020
title_short Perinatal deaths from birth defects in Hunan Province, China, 2010–2020
title_sort perinatal deaths from birth defects in hunan province china 2010 2020
topic Perinatal deaths
Congenital abnormalities
Risk
Epidemiology
Perinatal mortality
url https://doi.org/10.1186/s12884-023-06092-5
work_keys_str_mv AT xuzhou perinataldeathsfrombirthdefectsinhunanprovincechina20102020
AT donghuaxie perinataldeathsfrombirthdefectsinhunanprovincechina20102020
AT jianhe perinataldeathsfrombirthdefectsinhunanprovincechina20102020
AT yurongjiang perinataldeathsfrombirthdefectsinhunanprovincechina20102020
AT junqunfang perinataldeathsfrombirthdefectsinhunanprovincechina20102020
AT huawang perinataldeathsfrombirthdefectsinhunanprovincechina20102020