文章摘要
李凯,何祥波,张乐,李智文,叶荣伟,刘建蒙,翟瑞琴,段先进,任爱国.山西省两县妇女孕28周前终止妊娠对神经管缺陷总患病率的影响[J].中华流行病学杂志,2012,33(5):509-512
山西省两县妇女孕28周前终止妊娠对神经管缺陷总患病率的影响
Impact of pregnancy terminafions before 28 weeks of gestation on the overall prevalence of neural tube defects in two counties of Shanxi province
收稿日期:2011-11-29  出版日期:2014-11-03
DOI:
中文关键词: 神经管缺陷;终止妊娠;患病率;监测
英文关键词: Neural tube defects;Pregnancytermination;Prevalence;Surveillance
基金项目:国家自然科学基金(31071315)
作者单位E-mail
李凯 北京大学公共卫生学院流行病与卫生统计学系, 北京 100191
生育健康研究所卫生部生育健康重点实验室 
 
何祥波 北京大学公共卫生学院流行病与卫生统计学系, 北京 100191
生育健康研究所卫生部生育健康重点实验室 
 
张乐 生育健康研究所卫生部生育健康重点实验室  
李智文 生育健康研究所卫生部生育健康重点实验室  
叶荣伟 生育健康研究所卫生部生育健康重点实验室  
刘建蒙 生育健康研究所卫生部生育健康重点实验室  
翟瑞琴 山西省平定县妇幼保健院  
段先进 山西省太谷县妇幼保健院  
任爱国 生育健康研究所卫生部生育健康重点实验室 renag@bjmu.edu.cn 
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中文摘要:
      目的探讨妇女孕28周前终止妊娠对神经管缺陷(NTDs)总患病率的影响。方法2004--2010年山西省太谷和平定县进行以体表缺陷为主的出生缺陷监测,计算孕28周前、后(围产儿)和NTDs总患病率。分析其变化趋势并进行比较。同时计算孕28周前因产前诊断引产的NTDs病例数及构成。结果2004--2010年太谷和平定县共监测围产儿52 366名,其中NTDs患儿485例,总患病率为92。 6历;NTDs总患病率呈下降趋势。孕28周前NTDs患病率为60。9/万,围产几中NTDs患病率为31。7/万。因此,两县围产JL出生缺陷监测到的NTDs患病率比NTDs真实患病率低估66。O%。近年两县孕28周后监测到的NTDs病例数在NTDs总病例数中的构成比占40。O%左右。结论基于围产儿的出生缺陷监测,低估了人群中NTDs的真实患病率,无脑缺陷更严重。建议改进目前的出生缺陷监测方案,将任何孕周因产前诊断出生缺陷而引产的病例纳入监测范畴。
英文摘要:
      ObjectiveTo examine the impact of pregnancy termination before 28 weeks ofgestation on the overall prevalence of neural tube defects(NTDs).MethodsData collected during the period of 2004 and 2010 from a birth defects surveillance system in Pingding county and Taigu county of Shanxi province were used.Number of births≥28 weeks ofgestation and number of cases with major birth defects among the births were collected.Terminations of pregnancies before 28 weeks of gestation due to prenatal diagnosis also collected.The total prevalence of natura/tube defects,prevalence before 28 weeks of gestation.and prevatence of≥28 weeks gestation were calculated using the total number of pregnancies of≥28 weeks of gestation as denominator.The prevalence data were compared to examine the impact of preenalley termination on the total prevalence.The proportions of pregnancy terminations before 28 weeks of gestationd ue top renatal diagnosis of an NTD a gainst the total number of NrDcases were also calculated. ResultsDuring2004—2010.52 366 births we're recorded.and 485 NTD cases were ascertained.The over alipreva/caee of NTDs was 92.6 per 10030 births with prevalence of<28 weeks gestation due to pregnuney terminations as 60.9 per 10 000 births while the prevalence of≥28 week so fgestation was 31.7 per10030 births NTD prevalence of≥28 weeks gestation was 66.0%lower than the total NTD prevalence.In the 1ast two years.the proportion of NTDs ascertained≥28 weeks gestation accounted for about40.0%of the total NTD cases.Conclusion A birth-defect-surveillance program that covered only pregnancies≥28 weeks ofgestation resultedin a severe underestimation of the total birthprevalence of NTD sespecially for anencephaly.We would recommend that the current national birth defects surveillance system should include pregnancy terminations before 28 weeks of gestation and the talculmion oftotal NTD prevalence should also include these cases inta the numerator.SO as to better estimate true population NTD prevalence,upon which the related public health policyis based.
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