【摘要】 目的 分析2016—2022年全面开展新生儿先天性心脏病筛查项目前后，江苏省淮安市围产儿出生缺陷及先天性心脏病(CHD)的空间分布特征变化，为本地区出生缺陷防治策略的调整提供科学依据。方法 数据来源于江苏省淮安市妇幼卫生信息系统中2016—2022年的围产儿出生缺陷监测数据，以乡镇/街道为单位分别计算全面开展新生儿先天性心脏病筛查项目前后(2016—2018年vs 2019—2022年)的出生缺陷和CHD发生率。利用ArcGIS Pro 3.2软件开展全局空间自相关分析、局部空间自相关分析和Getis-Ord G~*_i热点分析。结果 2016—2022年，淮安市围产儿出生缺陷发生率为8.67‰,CHD发生率为3.67‰,2019—2022年出生缺陷和CHD发生率(13.73‰、7.42‰)均高于2016—2018年(4.68‰、0.71‰,P<0.001)。2016—2018年淮安市出生缺陷和CHD发生率在整体上无空间聚集性；2019—2022年淮安市出生缺陷和CHD发生率分布呈空间正相关分布，热点地区均为金湖县南部的黎城街道、金南镇和塔集镇。2019—2022年相较2016—2018年，四类聚集区均发生了改变。结论 淮安市应根据各地区出生缺陷和CHD发生率和聚集性的变化及时做出政策调整，重点完善CHD的筛查、诊疗、监测体系，从而优化淮安市的出生缺陷防治网络。更多还原

【Abstract】 Objective To analyze the changes in the spatial distribution characteristics of perinatal birth defects and congenital heart disease(CHD) in Huai’an City, Jiangsu Province, before and after the comprehensive newborn CHD screening program was carried out in 2018, and to provide a scientific basis for adjusting the strategy for prevention and treatment of birth defects in the region. Methods The data were obtained from the perinatal birth defects surveillance data in the Maternal and Child Health Information System of Huai’an City, Jiangsu Province, from 2016 to 2022. The incidence rates of birth defects and CHD in 2016—2018 and 2019—2022 were calculated respectively at the township-level. Global spatial autocorrelation analysis, local spatial autocorrelation analysis and Getis-Ord Gi~* hotspot analysis were carried out using ArcGIS Pro 3.2 software. Results The incidence of birth defects and CHD was 8.67‰, 3.67‰ from 2016 to 2022 in Huai’an, respectively. The incidence of birth defects and CHD in 2019—2022(13.73‰, 7.42‰) were significantly higher than those in 2016—2018(4.68‰, 0.71‰, P<0.001). There was no spatial aggregation of birth defects and CHD incidence rates in Huai’an City in 2016—2018; the distribution of birth defects and CHD incidence rates in Huai’an City in 2019—2022 showed a spatial positive correlation distribution, with the hotspot areas all being Licheng Street, Jinnan Township, and Taji Township in the southern part of Jinhu County. In 2019—2022 compared with 2016—2018, all four types of aggregation areas changed. Conclusion Policy adjustments are necessary according to the changes in the incidence and aggregation of birth defects and CHD in different counties. Improving the screening, diagnosis, treatment and monitoring system of CHD, is crucial for the birth defects prevention and control network in Huai’an.更多还原