文章摘要
李智文,任爱国,张乐,郭湛英,李松,叶荣伟,翟瑞琴,贾霖涛,肖燕萍,赵买会,李印忠,朱新,周敏霞,李竹.中国2003年出生缺陷高发区和低发区重大体表畸形患病率监测[J].中华流行病学杂志,2005,26(4):252-257
中国2003年出生缺陷高发区和低发区重大体表畸形患病率监测
Prevalence of major external birth defects in high and low risk areas in China, 2003
收稿日期:2004-09-23  出版日期:2014-09-18
DOI:
中文关键词: 出生缺陷  神经管畸形  监测  患病率
英文关键词: Birth defects  Neural tube defects  Surveillance  Prevalence rate
基金项目:国家“十五”科技攻关课题资助项目(2002BA709B11)
作者单位
李智文 100083 北京大学生育健康研究所
 
任爱国 100083 北京大学生育健康研究所
 
张乐 100083 北京大学生育健康研究所
 
郭湛英 山西省卫生厅基层卫生与妇幼保健处
 
李松 100083 北京大学生育健康研究所
 
叶荣伟 100083 北京大学生育健康研究所
 
翟瑞琴 平定县妇幼保健院
 
贾霖涛 昔阳县妇幼保健院
 
肖燕萍 太谷县妇幼保健院
 
赵买会 泽州县妇幼保健院
 
李印忠 太原市妇幼保健院
 
朱新 江苏省无锡市妇幼保健院
 
周敏霞 锡山市妇幼保健院 
李竹 100083 北京大学生育健康研究所
 
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中文摘要:
      目的了解中国出生缺陷高发区目前常见体表出生缺陷的患病水平以及主要畸形种类.方法选择出生缺陷高发的山西省5个县市和出生缺陷低发的江苏省无锡地区作为研究现场,对研究地区2003年所有孕满20周以上的出生进行以人群为基础的出生缺陷监测,分析和比较高低发地区24种体表重大出生缺陷的患病情况.结果山西省4个县体表重大缺陷患病率为232.4/万,神经管畸形患病率138.7/万,显著高于太原市区相应的患病率(75.3/万和28.2/万).无锡市区和锡山区(原无锡县)之间各种出生缺陷患病率差异无统计学意义.太原市区神经管畸形(NTDs)出生患病率是无锡市区(4 6/万)的6 1倍;山西省4个县无脑儿、脊柱裂、脑膨出、脑积水、腭裂和多指畸形的出生患病率显著高于无锡市区,NTDs的出生患病率是无锡市区的30 2倍.高发地区NTDs患病率与既往监测资料相比未见明显下降趋势.如果从孕满28周开始监测,则高发地区出生患病率较孕满20周监测率下降31.8%.结论 NTDs仍然是山西省最常见的出生缺陷.山西省部分地区NTDs的患病率仍然是国内乃至世界最高的患病水平.NTDs出生患病率在部分出生缺陷高发地区未见明显的下降趋势.监测方法和产前诊断对于体表重大出生缺陷患病率具有较大影响.
英文摘要:
      Objective To study the prevalence rates of birth defects in high and low risk areas in China. Methods A population-based surveillance system on birth defects was used to obtain the prevalence rates of 24 kinds of major external birth defects from ≥20 weeks of gestation to 7 days of life in selected areas in Shanxi and Jiangsu provinces. Results The birth prevalence of birth defects ( 232.4 per 10 000 births) and neural tube defects (NTDs) (138.7 per 10 000 births) in four counties of Shanxi province were significantly higher than that in Taiyuan city (75.3 and 28.2 per 10 000 births,respectively).There was no significant difference for all selected birth defects between Wuxi city and Xishan counties in low risk areas. There was a 6.1- fold of higher prevalence for NTDs in Taiyuan city compared with that in Wuxi areas (4.6 per 10 000 births).In four counties of Shanxi province,the prevalence rates of anencephaly,spina bifida,hydrocephaly,cleft palate alone and polydactyly were significantly higher than in Wuxi areas.The NTDs prevalence rate in four counties of Shanxi was 30.2 times higher than in Wuxi areas.When compared with previous surveillance data,the NTDs prevalence rate did not present obvious declining trend in high risk areas. The birth prevalence rate had a 31.8 % decrease when births were calculated after 28 gestational weeks and compared with those from 20 gestational weeks. Conclusion NTDs remained to be the most common birth defect seen in Shanxi province.The birth prevalence rate of NTDs in some areas of Shanxi province was among the highest that ever reported in the world in comparison with data from other countries and regions.The current prevalence rate in high risk areas in Shanxi province did not clearly show a declining trend.Programs on surveillance and prenatal diagnosis were proved to have made big impact on the rates of major external birth defects.
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