Objective To explore the trend and epidemiological features of perinatal birth defects in Liuzhou, Guangxi Zhuang Autonomous Region from 2018 to 2022, so as to provide evidence for scientific prevention and control of birth defects.

Methods Retrospective research method was used to analyze perinatal birth defect surveillance data, which were born in various midwifery institutions from 28 weeks to 7 days postpartum at Liuzhou, Guangxi Zhuang Autonomous Region, 2018 − 2022.

Results Totally, 3 406 infants with birth defects were found among 212 475 perinatal newborns from 2018 to 2022, and the incidence of birth defects was 160.30/10 000. The incidence of birth defects first declined and then rose. The average incidence of birth defects of boy was 176.06/10 000, which was significantly higher than that of girl (142.43/10 000) (χ² = 36.821, P < 0.001). Higher incidence of birth defects showed in the offspring of mothers aged ≥ 35 years (201.91/10 000) compared to younger mothers (P < 0.05). The incidence of birth defects in the offspring of mothers who had 1 pregnancy (174.44/10 000) and 1 birth (189.21/10 000) was higher than that of mothers who had ≥ 2 pregnancies and births (P < 0.05). The incidence of birth defects in multiple births (433.66/10 000) was higher than that in singleton births (152.65/10 000) (P < 0.05). The top 5 birth defects were congenital heart diseases (68.95/10 000), multiple fingers/toes (31.06/10 000), hypospadias (9.15/10 000), syndactyly (9.08/10 000) and other outer ear deformities (8.71/10 000).

Conclusion The incidence of perinatal birth defects remains at a relatively high level in Liuzhou, 2018 − 2022. Congenital heart diseases and multiple fingers/toes are the most common birth defects. It is recommended to further improve the construction of the three-tier prevention system for birth defect prevention and control.