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.