摘要Background Although birth defects are of great concern globally,the latest national prevalence has not yet been quanti-fied in China.We conducted a systematic review and meta-analysis to estimate the perinatal prevalence of birth defects in the Mainland of China between 2000 and 2021.Methods We performed a systematic literature search of six databases for relevant articles published between January 1,2000,and March 1,2023.We included published studies that reported data on the perinatal prevalence of birth defects in the Mainland of China.The DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and its 95％confidence interval(CI).We also conducted subgroup analyses and univariable meta-regressions to explore differences in prevalence by time period,geographic region,and other characteristics.Results We included 254 studies reporting the perinatal prevalence of birth defects and 86 studies reporting only the preva-lence of specific types of birth defects.Based on 254 studies covering 74,307,037 perinatal births and 985,115 cases with birth defects,the pooled perinatal prevalence of birth defects was 122.54(95％CI 116.20-128.89)per 10,000 perinatal births in the Mainland of China during 2000-2021.Overall,the perinatal prevalence of birth defects increased from 95.60(86.51-104.69)per 10,000 in 2000-2004 to 208.94(175.67-242.22)per 10,000 in 2020-2021.There were also significant disparities among different geographical regions.Congenital heart defects(33.35 per 10,000),clefts of the lip and/or palate(13.52 per 10,000),polydactyly(12.82 per 10,000),neural tube defects(12.82 per 10,000),and inborn errors of metabolism(11.41 per 10,000)were the five most common types of birth defects.The perinatal prevalence among males was significantly higher than that among females(β=2.44x 10-3,P=0.003);a higher perinatal prevalence of birth defects was observed among perinatal births whose mothers were≥35 years(P=4.34x 10-3,P＜0.001).Conclusion Comprehensive and sustained efforts are needed to strengthen surveillance and detection of birth defects,improve prenatal and postnatal healthcare,and promote rehabilitation,especially in underdeveloped areas.