| ObjectiveIn this study, we used both quantitative survey and qualitative interview to find out the monitoring work on congenital defects in five counties/cities of Gansu province, and then to discuss the key intervention countermeasure of congenital defects in Gansu province, in order to provide a scientific basis for guiding prepotency and effective intervention of congenital defects.MethodsA general investigating was conducted on all the neonatus who were born in Dunhuang city, Jingchuan county, Hui county, Weiyuan county and Yongjing county in Gansu province from October1,2008to September30,2010. Compare with the birth defects incidence and constituent ratio of infant between baseline survey and terminal survey in Dunhuang, Jingchuan, Huixian, Weiyuan and Yongjing. A1:1matched case-control study was carried out to investigate176cases of birth defect children and their parents, to analyze the possible risk factors by simple and multiple factors Logistic regression. A questionnaire survey was conducted on these people who were family planning professionals and women and children health care professionals in five counties/cities. A qualitative investigation was conducted on managers, pregnant women and health technicians.Results(1) In2009, the incidence of congenital defects was7.49%o in five counties/cities, and the top three diseases were congenital heart disease, pigmented nevus and neural tube defects. The incidence of congenital defects in2010was8.35%o, and the top three diseases were congenital heart disease, neural tube defects and pigmented nevus, hydrocephalus. While each county (city) had different incidence of congenital defects, the highest congenital defects ratio was in Dun huang city, which was14.65%o, while the lowest ratio was in Hui county, which was3.28%o.(2) The risk factors of perinatal birth defects were:genetic disease in mother (OR=4.407,95%CI=0.925-21.008); influenza suffering during pregnancy (OR=1.986,95%CI=0.992-3.976); tocolytic agent usage during pregnancy (OR=2.466,95%CI=0.981-6.148) (3) In the five counties/cities, the congenital defects incidence of perinatal infants was8.35%o in the terminal survey, while baseline survey was14.02%o, the change was decreased by40.44%. The occurences and composition ratio sequences of congenital defects were different from terminal to baseline survey.(4) The rate of folic acid awareness and intake rate were93.85%and84.89%, the rate of normative intake was21.89%. Women of reproductive age were mainly educated by birth control department to know the knowledge of folic acid.(5) There was a low rate of correctly answer the questions of occurrence time of neural tube defects, diagnostic methods of neural tube defects, high-risk groups of children who had neural tube defects children, groups of folic acid supplement. The correct response rate was less than50%. Among the people who aged from35to44,36.21%had received professional training, aware of healthy women need to supplement folic acid, account for36.21%, People who thought it is necessary for reproductive women to supplement folic acid, account for37.45%, the rates of providing publicity and education for women and giving folic acid freely were both37.24%, the rate of guiding and supervising women taking folicacid was34.98%.(6) There were123(51.04%) medical personnels at the county level know that birth defects existd gender difference, while there were41(24.26%) medical personnels in township level. There were47(19.50%) medical staff in county level,42(24.85%) medical staff in township level know the high-risk groups who could give birth to children of neural tube defects.89(36.93%) medical workers in county level, and85(50.30%) medical workers in township level know that folate deficiency during pregnancy could affect pregnant woman and fetus. There were236(97.93%) medical staff in county level, and169(100.00%) people in township level who would illustrate the importance of folic acid supplement for every woman of childbearing age. There were129(53.53%) medical workers in county level, and152(89.94%) in township level who had received training about folic acid. There were169(70.12%) medical staff in county level, and92(54.44%) in township level who obtained knowledge about folic acid by lectures and trainings.ConclusionThe effect of birth defects intervention project is apparently, the cognition of self-care awareness has been further improved. Howerver, implementation efforts and propaganda work should be strengthened, the quality of comprehensive service of ordinary staff of should be improved. |
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