Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. May 10, 2017; 6(2): 8-15
Published online May 10, 2017. doi: 10.5317/wjog.v6.i2.8
Observed prevalence and risk factors of birth defects in Shanghai, China
Min Yang, Xiao-Xia An, Hui-Juan Wang, Ji-Mei Wang
Min Yang, Xiao-Xia An, Hui-Juan Wang, Ji-Mei Wang, Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
Author contributions: Yang M proposed the study and wrote the first draft; An XX analyzed the data; Wang HJ collected the data; Wang JM contributed to the design.
Institutional review board statement: The data used to fit these models were obtained from the medical record system of the Obstetrics and Gynecology Hospital of Fudan University.
Informed consent statement: All the participants for “birth defect registration card” consent to take part in the study.
Conflict-of-interest statement: The authors declare that there are no personal, organizational or financial conflicts of interest.
Data sharing statement: The data used in the study may be requested from Ji-Mei Wang (wjm8219@163.com).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ji-Mei Wang, PhD, Full Professor, Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China. wjm8219@163.com
Telephone: +86-21-33189900-8219
Received: March 2, 2017
Peer-review started: March 2, 2017
First decision: March 28, 2017
Revised: April 15, 2017
Accepted: April 16, 2017
Article in press: April 16, 2017
Published online: May 10, 2017
ARTICLE HIGHLIGHTS
Research background

In the 1980s, China implemented a birth defect surveillance system. Approximately 470 hospitals in 31 provinces, municipalities and autonomous regions in the nation participate in this monitoring network; this three-level monitoring network covers nearly 80 million people.

Research motivation

Based on continuous dynamic monitoring, the authors obtained accurate and reliable data that were vital to the health of Chinese women and their children, and provided a scientific basis for decision-making regarding maternal and neonatal health in the author’s country.

Research objectives

The objective of this study is to estimate the temporal trend and epidemiologic characteristics of birth defects at the Obstetrics and Gynecology Hospital of Fudan University in Shanghai from 2008 to 2014.

Research methods

This report describes a population-based study of all births at the Obstetrics and Gynecology Hospital of Fudan University in Shanghai, China from January 2008 to December 2014. A logistic regression analysis was used to identify the parameters that are independently associated with birth defects.

Research results

A total of 82814 births, including 824 cases of birth defects, were recorded. The rate of birth defects was 0.995 per 100 births. In the multivariable regression analysis, neonatal birth defects were likely to be associated with higher gravidity (OR = 1.099, 95%CI: 1.024-1.178), premature birth (OR = 1.905, 95%CI: 1.501-2.418), low birth weight (OR = 3.844, 95%CI: 3.004-4.919), twin births or higher order multiple pregnancies (OR = 1.477, 95%CI: 1.107-1.969), cesarean delivery (OR = 1.184, 95%CI: 1.016-1.380) and registration as part of a migrant population (OR = 1.380, 95%CI: 1.167-1.632). Female infants were less likely to have birth defects than male infants (OR = 0.710, 95%CI: 0.616-0.818).

Research conclusions

Higher gravidity, premature birth, lower birth weight, twin births or higher order multiple pregnancies, and registration as part of a migrant population are independent predictors of birth defects.

Research perspectives

Based on this result, the recommended interventions are as follows: (1) regular screening tests among pregnant women are needed at local health care sectors in Shanghai; and (2) despite the difficulty, the primary emphasis should be to enhance the management (provide more knowledge and training for pregnant women during the prenatal period) and health care (such as folic acid supplementation) of women in migrant populations in the future.