1 background of birth defect monitoring
The monitoring of birth defects in China began in June of 1986 and June of 10, and was led by West China University of Medical Sciences to monitor more than 20,000 perinatal infants in 29 provinces (municipalities and autonomous regions). The types, sequence and distribution of birth defects in China were basically found out, and the Atlas of Birth Defects in China was compiled and published. This is the earliest and most extensive cross-sectional survey of birth defects in China. 1988 the Ministry of health changed the monitoring of birth defects into routine work, 1996 the Ministry of health, monitoring of maternal death and monitoring of children under 5 years old "integrated three networks". China Maternal and Child Health Monitoring Project was formally implemented.
2. The object and scope of birth defect monitoring
From 2. 1. 1.986, the hospital-based monitoring method was adopted. In the selected monitoring points, some hospitals above the county level and maternal and child health centers were selected as monitoring hospitals, and the monitoring objects were perinatal infants (including live births, stillbirths and stillbirths) who were hospitalized in the monitoring hospitals for 28 weeks and 7 days after delivery. Since 2003, malformations found throughout pregnancy have been included in the monitoring scope. This hospital-based birth defect monitoring method is economical, efficient and easy to operate. Due to the number of people covered and the geographical distribution of monitoring hospitals, the results can roughly reflect the occurrence level and trend of birth defects in the monitoring area. However, it has a certain selective bias and cannot fully reflect the occurrence of birth defects in the whole population [2].
2.2 Population-based monitoring method This is the monitoring method recommended by WHO. Most member countries of the International Birth Defects Monitoring Center, such as the United States, Canada, Hungary, etc. China's "Sino-US Cooperation Prevention of Neural Tube Malformation Project" was conducted from 1993 to 1996 by crowd monitoring. In 2003, the National Maternal and Child Health Monitoring Institute carried out the pilot work of crowd monitoring in Tianjin, Liaoning, Fujian, Henan and Hubei provinces, and gained valuable work experience. In 2006, the scope of crowd monitoring was expanded on the basis of pilot projects. Crowd monitoring has also been carried out in Liuzhou and other places in Guangxi, and the monitoring targets are pregnant women living in the monitoring area. The monitoring period is from 20 weeks of pregnancy (or 500g) to one year after delivery. Population-based birth defect monitoring can overcome the limitations of hospital monitoring and fully understand the occurrence of birth defects in a certain area, but it needs more manpower, financial resources and material resources. The feasibility and cost-effectiveness of developing a population-based monitoring program in an all-round way under the current economic level in China need to be further explored.
3 birth defect monitoring system
At present, China has a three-level birth defect monitoring system:
3. 1 national birth defect monitoring system: since 1986, there has been a national birth defect monitoring network;
3.2 Provincial birth defect monitoring system: Since 1996, all provinces have expanded monitoring points on the basis of national monitoring hospitals, established birth defect monitoring points in their own provinces, and gradually formed a provincial birth defect monitoring system.
3.3 City and county birth defect monitoring system. From 2004 to now, Guangxi requires all city and county maternity hospitals as monitoring units to understand the occurrence of birth defects in municipal districts, and at the same time complete the monitoring work of autonomous region monitoring points and national monitoring points.
4 birth defects monitoring diseases
Before 1996, there were 1 13 kinds of diseases for dynamic monitoring of birth defects, so it was difficult to improve the monitoring quality. From 65438 to 0996, 23 kinds of birth defects were detected, including anencephaly, spina bifida, encephalocele, hydrocephalus, cleft palate, cleft lip with cleft palate, microtia, other malformations of external ear, esophageal atresia or stenosis, hypospadias, bladder ectropion, clubfoot, polydactyly, syndactyly and syndactyly. According to the specific situation of high incidence of thalassemia in Guangxi, the monitoring of thalassemia has been strengthened.