Abstract: Background　Shaanxi province has high incidence of birth defects in neonates,but information about the incidence of birth defects in each area in the province is not well recorded.Differences are present in the economic level among these areas.Thus,it is helpful to explain the incidence characteristics of birth defects in Xi’an and to provide some targeted suggestions by studying the incidence of birth defects.Objective　To analyze the incidence of birth defects among single live birth neonates in Xi’an from 2010 to 2013 and to discuss the influencing factors of birth defects in neonates.Methods　From June to November 2013,women of childbearing age （15-49 years old） in Xi’an who became pregnant from 2010 to 2013 were selected as objects of study through multistage random sampling method according to the population density and fertility level.A self-designed questionnaire survey was conducted to collect the social demographic information,marital and fertile history,life style during pregnancy,history of drugs and nutrients during pregnancy,disease history of families and eugenics counseling of subjects,age,nationality,education years,disease history of families of spouses,and gender and birth season of neonates.Results　We collected the complete information of 4 679 women.The study found 74 cases of birth defects.The incidence of birth defects was 158.2/10 000 from 2010 to 2013,the incidences of birth defects among neonates were 68.7/10 000 in 2010,160.2/10 000 in 2011,115.3/10 000 in 2012 and 214.5/10 000 in 2013.Compared with the annual incidence of birth defects,no significant difference was found （χ2=7.355，P=0.061）.Among the 74 cases of birth defects,44 cases of congenital heart disease,4 cases of hemangioma,3 cases of indirect inguinal hernia,3 cases of laryngeal cartilages dysplasia,2 cases of omphalocele,2 cases of upper eyelid ptosis,2 cases of ankyloglossia,2 cases of preauricular fistula,1 case of melanocytic nevi,1 case of congenital torticollis,1 case of left renal displacement,1 case of cerebral palsy,1 case of cleft lip,1 case of hypospadias,1 case of ankylodactylia,1 case of Down syndrome,1 case of G6PD deficiency,1 case of congenital jaundice,and 1 case of cryptorchidism and 1 case of congenital spinal meningocele.Results of multivariable Logistic regression analysis suggested that premature delivery,drinking history during pregnancy，smoking history during pregnancy,antibiotic use during pregnancy and mother’s family history of maternal diabetes were significant risk factors of birth defects（P<0.05）.Conclusion　The incidence of birth defects among single live birth neonates in Xi’an from 2010 to 2013 was high.Congenital heart disease is the dominant type of birth defects.Premature delivery,drinking and smoking history during pregnancy,antibiotic use during pregnancy,and mother’s family history of maternal diabetes may increase the risk of birth defects in neonates.

Key words: Congenital abnormalities, Premature birth, Maternal behavior, Anti-bacterial agents

摘要： 背景　陕西省是新生儿出生缺陷的高发地区，各个地区新生儿出生缺陷的资料尚不完整。由于陕西省各个地区经济水平等方面存在较大差异，故研究西安市新生儿出生缺陷发生状况有助于阐释该地区出生缺陷发生的特点，从而更有针对性地提供信息参考。目的　分析2010—2013年西安市活产单胎新生儿出生缺陷的发生状况，并探讨新生儿出生缺陷的影响因素。方法　于2013年6—11月，根据人口密集程度和生育水平，采用多阶段随机抽样方法，于陕西省西安市选取2010—2013年期间曾经妊娠的15～49岁育龄妇女为调查对象。采用自行设计的调查问卷，面对面调查妇女的社会人口学信息、婚育史、妊娠期生活方式、妊娠期疾病史、妊娠期药物及营养素服用史、家族疾病史及优生优育咨询情况，配偶年龄、民族、受教育年限、家族疾病史，以及新生儿性别、出生季节。结果　本研究共完整调查4 679例妇女，发现出生缺陷新生儿74例，出生缺陷发生率为158.2/万。2010—2013年西安市新生儿出生缺陷发生率分别为68.7/万、160.2/万、115.3/万、214.5/万,各年度出生缺陷发生率比较，差异无统计学意义（χ2=7.355，P=0.061）。74例新生儿出生缺陷分别为先天性心脏病44例，血管瘤4例，腹股沟斜疝3例，喉软骨发育不良3例，脐膨出、上睑下垂、舌系带过短、耳前瘘管各2例，黑色素痣、先天性斜颈、左肾偏移、脑性瘫痪、上唇畸形、尿道下裂、并指、唐氏综合征、葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症、先天性黄疸、隐睾、先天性脊膜膨出各1例。多因素Logistic回归分析显示，早产、妊娠期饮酒史、妊娠期吸烟史、妊娠期服用抗生素、母系糖尿病家族史是新生儿出生缺陷的危险因素（P<0.05）。结论　2010—2013年西安市活产单胎新生儿出生缺陷发生率处于较高水平，先天性心脏病为主要的出生缺陷类型。早产、妊娠期饮酒史、妊娠期吸烟史、妊娠期服用抗生素、母系糖尿病家族史可能增加新生儿出生缺陷的罹患风险。

关键词: 先天畸形, 早产, 母亲行为, 抗菌药