| ObjectiveTo analyze the incidence of perinatal birth defects in Gansu Province from 2010 to 2021,explore the epidemiological characteristics and trends of birth defects,and provide reference for further exploring the potential influencing factors of birth defects in Gansu Province and determining the key diseases for the prevention and treatment of birth defects.Mathematical model were constructed to predict the incidence of birth defects in Gansu Province during 2022-2024,which would provide the basis for the adjustment of birth defect prevention and control policies and the rational allocation of health resources,as well as a theoretical reference for the construction of a prediction model for the incidence of birth defects.MethodsThe data on birth defects in neonates comes from the "Birth Defect Registration Card" and "Perinatal Quarterly Report" reported by 42 birth defect monitoring hospitals in Gansu Province.Firstly,the distribution of birth defects in different years,populations,and regions in Gansu Province was analyzed through descriptive research,and R 4.1.2 software was used for data analysis.The geographical distribution of birth defects in different regions was achieved by drawing a geographic distribution map of birth defects in each city and state in Gansu Province using Arc GIS 10.2 software.Secondly,the Joinpoint regression model was constructed using Joinpoint 4.9.0.1software to evaluate the time trend characteristics of birth defects in Gansu Province from 2010 to 2021 using the Annual Percent Change(APC)and the Average Annual Percent Change(AAPC).Finally,the ARIMA model,NAR neural network model,and ARIMA-NAR combined model were constructed using R 4.1.2 software and MATLAB2018 b software to conduct predictive research,and the Mean Absolute Error(MAE),Root Mean Square Error(RMSE),and Mean Absolute Percentage Error(MAPE)were used to evaluate the predictive performance of different models.The optimal model was used to predict the level of occurrence of birth defects in Gansu Province from 2022 to2024.Results(1)From 2010 to 2021,a total of 852,035 perinatal infants were monitored for birth defects in hospitals in Gansu Province,with 14,242 cases of birth defects identified.The incidence of birth defects increased from 122.99/10,000 in 2010 to356.66/10,000 in 2021,with an average annual incidence of 167.15/10,000.The incidence of birth defects varied among different populations,with male newborns having a significantly higher incidence(171.72/10,000)than female newborns(152.24/10,000).The incidence of birth defects was 169.91/10,000 in urban areas and164.83/10,000 in rural areas,with no clear relationship between place of residence and incidence.The incidence of birth defects among offspring of mothers aged <20 years,20-24 years,25-29 years,30-34 years,and ≥35 years were 260.15/10,000,157.82/10,000,153.34/10,000,175.31/10,000,and 216.70/10,000,respectively,showing a "U"-shaped pattern with the lowest incidence in the middle age groups.The offspring of mothers with advanced maternal age and young maternal age had a higher risk of birth defects than other age groups.The incidence of birth defects among perinatal infants in spring,summer,autumn,and winter were 165.74/10,000,175.03/10,000,176.58/10,000,and 153.02/10,000,respectively,with the lowest incidence in winter.There were regional differences in the incidence of birth defects,with Lanzhou having a higher incidence rate,Dingxi having a lower incidence rate,and the incidence rate in Wuwei increasing rapidly in recent years.(2)From 2010 to 2021,there were significant changes in the incidence ranking of birth defects among perinatal infants in Gansu Province.The top five birth defect diseases were congenital heart disease,cleft lip and palate,polydactyly(syndactyly),neural tube defects,and congenital hydrocephalus.The analysis results based on the Joinpoint regression model showed that the incidence of birth defects increased at an annual average rate of 8.74%.The trend changes of different types of defects were different.The incidence rates of congenital heart disease,polydactyly(syndactyly),external ear malformation,syndactyly,and hypospadias showed an increasing trend,with an annual average percent change(AAPC)of 32.11%,8.48%,12.21%,6.11%,and14.27%,respectively.The incidence of neural tube defects and congenital hydrocephalus showed a decreasing trend,with an AAPC of-12.15% and-11.65%,respectively.Conclusions(1)From 2010 to 2021,the incidence of birth defects in Gansu Province showed a high growth trend,and there were differences in the distribution of birth defects among different populations and regions.The trend changes of different types of defects were different.The incidence rates of congenital heart disease,polydactyly,external ear malformation,syndactyly,and hypospadias showed an increasing trend,while neural tube defects and congenital hydrocephalus showed a decreasing trend.(2)The ARIMA-NAR combined model constructed in this study can effectively extract the linear and nonlinear components of the time series of birth defects in neonates in Gansu Province from 2010 to 2021,and the predictive performance is better than that of a single ARIMA model and NAR neural network model.Applying this model to predict the incidence rate of birth defects in neonates in Gansu Province from2022 to 2024,it is still at a relatively high level and shows a fluctuating upward trend.(3)It is urgent to further strengthen the prevention and control of birth defects in Gansu Province. |
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