基于利沃夫医学遗传中心2018-2020年产前诊断先天性畸形谱的回顾性分析

O. Hnateiko, N. Kitsera, N. Helner, M. Teneta, Z. Hnateiko, I. Vijtovych
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The null hypotheses were tested using a t-test at the significance level of p-value less than 0.05. Results. A total of 11062 pregnant women were examined between 2018-2020: CM at different stages of pregnancy were diagnosed in 454 cases, which accounted for 4.1 % of cases and did not exceed the population value. There was a 2.3-fold reduction in the number of pregnant women presented to the Medical Genetics Center in 2020, probably due to the global coronavirus pandemic – from 5007 women in 2018 to 2212 females in 2020. However, the number of CM diagnosed prenatally in 2020 was not statistically significant (p-value more than 0.05) as compared to the average value for these years and 2018. In 2018, a total of 5007 pregnant women were examined at the Lviv Medical Genetics Center. In 136 (4.8 %) cases, fetal malformations were diagnosed before 22 weeks of gestation, while in 26 (1.2 %) cases, pregnancy was affected by congenital anomaly in its second half. In 2019, there were examined 3843 pregnant women. In169 (7.8 %) cases, CM were diagnosed before 22 weeks of gestation, that was statistically significant as compared to 2018 (p-value less than 0.05) and in 20 (1.2 %) cases, fetal anomalies were detected in the second half of pregnancy, that was not statistically significant as compared to the previous year (p-value more than 0.05). In 2020, we examined 2212 pregnant women. Reducing the number of visits to our medical center was probably due to the coronavirus pandemic. There were95 (5.0 %) cases of fetal malformations diagnosed before 22 weeks of gestation and 8 (2.5 %) cases of congenital anomalies detected in the second half of pregnancy. The number of CM diagnosed prenatally was the highest in 2019 – 4.9 %; however, there was no statistically significant difference (p-value more than 0.05) in the average values for these years – 4.1 % and 3.2 % in 2020 and 2018, respectively. In 2020, the incidence of congenital malformations diagnosed after 22 weeks of gestation was significantly higher (p-value less than 0.05) than in other years – 2.5 % and 1.2 %, respectively. Conclusions. Between 2018-2020, the incidence of congenital malformations diagnosed at different stages of pregnancy was 4.1 %. Congenital malformation s of the nervous system (Q00-Q07) were the most common anomalies diagnosed before 22 weeks of gestation, while after 22 weeks, the most common malformations were congenital malformations of the urinary system (Q60-Q64). 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引用次数: 0

摘要

介绍。根据世界卫生组织的数据,全世界约有3%的婴儿出生时患有先天性畸形(CM)。研究的目的。回顾性分析2018-2020年期间在利沃夫医学遗传中心诊断的妊娠期先天性畸形谱。材料和方法。收集2018-2020年间产前诊断CM的临床和流行病学以及医学和统计数据(表格49号),然后在利沃夫医学遗传中心/乌克兰国家医学科学院/遗传病理研究所/利沃夫进行分析。学生t检验用于确定算术平均值之间的差异。在p值小于0.05的显著性水平上,使用t检验对原假设进行检验。结果。2018-2020年共对11062名孕妇进行检查,诊断为不同妊娠阶段CM的454例,占4.1%,未超过人群值。可能是由于全球冠状病毒大流行,2020年向医学遗传学中心提交的孕妇人数减少了2.3倍,从2018年的5007名女性减少到2020年的2212名女性。然而,2020年产前诊断CM的数量与这些年和2018年的平均值相比,无统计学意义(p值大于0.05)。2018年,共有5007名孕妇在利沃夫医学遗传中心接受了检查。在136例(4.8%)病例中,胎儿畸形在妊娠22周之前被诊断出来,而在26例(1.2%)病例中,妊娠后半期受到先天性异常的影响。2019年,共有3843名孕妇接受了检查。妊娠22周前诊断CM的有169例(7.8%),与2018年比较有统计学意义(p值< 0.05);妊娠后半期发现胎儿异常的有20例(1.2%),与上一年比较无统计学意义(p值> 0.05)。2020年,我们对2212名孕妇进行了检查。减少我们医疗中心的就诊次数可能是由于冠状病毒大流行。在妊娠22周前诊断出胎儿畸形95例(5.0%),在妊娠后半期发现先天性异常8例(2.5%)。2019年产前诊断的CM数量最高,为4.9%;然而,这些年的平均值没有统计学上的显著差异(p值大于0.05)——2020年和2018年分别为4.1%和3.2%。2020年,妊娠22周后诊断的先天性畸形发生率显著高于其他年份(p值小于0.05),分别为2.5%和1.2%。结论。2018-2020年间,在妊娠不同阶段诊断出的先天性畸形发生率为4.1%。妊娠22周前以神经系统先天性畸形(Q00-Q07)最为常见,妊娠22周后以泌尿系统先天性畸形(Q60-Q64)最为常见。产前医学的主要任务是及时诊断可纠正的发育缺陷,以及产科医生、新生儿科医生、小儿神经科医生、儿科医生和其他卫生保健专业人员的共同努力,确保正常分娩,为婴儿提供专业护理,随后是终身康复。
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A Retrospective Analysis of the Spectrum of Congenital Malformations Diagnosed Prenatally Based on the Lviv Medical Genetics Center during 2018-2020 yy
Introduction. According to the WHO, about 3 % of infants worldwide are born with a congenital malformation (CM). The aim of the study. To conduct a retrospective analysis of the spectrum of congenital malformations diagnosed during pregnancy based on the Lviv Medical Genetics Center during 2018-2020 yy. Materials and methods. Clinical and epidemiological, as well as medical and statistical data on CM diagnosed prenatally between 2018-2020 were collected from primary source documents (Form No. 49) and then analyzed at the Lviv Medical Genetics Center ʺInstitute of Hereditary Pathology, National Academy of Medical Sciences of Ukraineʺ, Lviv. The Student’s t-test was used to determine the difference between the arithmetic means. The null hypotheses were tested using a t-test at the significance level of p-value less than 0.05. Results. A total of 11062 pregnant women were examined between 2018-2020: CM at different stages of pregnancy were diagnosed in 454 cases, which accounted for 4.1 % of cases and did not exceed the population value. There was a 2.3-fold reduction in the number of pregnant women presented to the Medical Genetics Center in 2020, probably due to the global coronavirus pandemic – from 5007 women in 2018 to 2212 females in 2020. However, the number of CM diagnosed prenatally in 2020 was not statistically significant (p-value more than 0.05) as compared to the average value for these years and 2018. In 2018, a total of 5007 pregnant women were examined at the Lviv Medical Genetics Center. In 136 (4.8 %) cases, fetal malformations were diagnosed before 22 weeks of gestation, while in 26 (1.2 %) cases, pregnancy was affected by congenital anomaly in its second half. In 2019, there were examined 3843 pregnant women. In169 (7.8 %) cases, CM were diagnosed before 22 weeks of gestation, that was statistically significant as compared to 2018 (p-value less than 0.05) and in 20 (1.2 %) cases, fetal anomalies were detected in the second half of pregnancy, that was not statistically significant as compared to the previous year (p-value more than 0.05). In 2020, we examined 2212 pregnant women. Reducing the number of visits to our medical center was probably due to the coronavirus pandemic. There were95 (5.0 %) cases of fetal malformations diagnosed before 22 weeks of gestation and 8 (2.5 %) cases of congenital anomalies detected in the second half of pregnancy. The number of CM diagnosed prenatally was the highest in 2019 – 4.9 %; however, there was no statistically significant difference (p-value more than 0.05) in the average values for these years – 4.1 % and 3.2 % in 2020 and 2018, respectively. In 2020, the incidence of congenital malformations diagnosed after 22 weeks of gestation was significantly higher (p-value less than 0.05) than in other years – 2.5 % and 1.2 %, respectively. Conclusions. Between 2018-2020, the incidence of congenital malformations diagnosed at different stages of pregnancy was 4.1 %. Congenital malformation s of the nervous system (Q00-Q07) were the most common anomalies diagnosed before 22 weeks of gestation, while after 22 weeks, the most common malformations were congenital malformations of the urinary system (Q60-Q64). Qualified timely diagnosis of correctable developmental deficiencies, as well as team efforts of obstetricians, neonatologists, pediatric neurologists, pediatricians, and other health care professionals to ensure normal childbirth and provide a baby with specialized care, followed by life-time rehabilitation are the main tasks of prenatal medicine.
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