中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2012年
5期
509-512
,共4页
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
李凱%何祥波%張樂%李智文%葉榮偉%劉建矇%翟瑞琴%段先進%任愛國
리개%하상파%장악%리지문%협영위%류건몽%적서금%단선진%임애국
神经管缺陷%终止妊娠%患病率%监测
神經管缺陷%終止妊娠%患病率%鑑測
신경관결함%종지임신%환병솔%감측
Neural tube defects%Pregnancy termination%Prevalence%Surveillance
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52366名,其中NTDs患儿485例,总患病率为92.6/万；NTDs总患病率呈下降趋势.孕28周前NTDs患病率为60.9/万,围产儿中NTDs患病率为31.7/万,因此,两县围产儿出生缺陷监测到的NTDs患病率比NTDs真实患病率低估66.0％.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40.0％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.
目的 探討婦女孕28週前終止妊娠對神經管缺陷(NTDs)總患病率的影響.方法 2004-2010年山西省太穀和平定縣進行以體錶缺陷為主的齣生缺陷鑑測,計算孕28週前、後(圍產兒)和NTDs總患病率,分析其變化趨勢併進行比較.同時計算孕28週前因產前診斷引產的NTDs病例數及構成.結果 2004-2010年太穀和平定縣共鑑測圍產兒52366名,其中NTDs患兒485例,總患病率為92.6/萬；NTDs總患病率呈下降趨勢.孕28週前NTDs患病率為60.9/萬,圍產兒中NTDs患病率為31.7/萬,因此,兩縣圍產兒齣生缺陷鑑測到的NTDs患病率比NTDs真實患病率低估66.0％.近年兩縣孕28週後鑑測到的NTDs病例數在NTDs總病例數中的構成比佔40.0％左右.結論 基于圍產兒的齣生缺陷鑑測,低估瞭人群中NTDs的真實患病率,無腦缺陷更嚴重.建議改進目前的齣生缺陷鑑測方案,將任何孕週因產前診斷齣生缺陷而引產的病例納入鑑測範疇.
목적 탐토부녀잉28주전종지임신대신경관결함(NTDs)총환병솔적영향.방법 2004-2010년산서성태곡화평정현진행이체표결함위주적출생결함감측,계산잉28주전、후(위산인)화NTDs총환병솔,분석기변화추세병진행비교.동시계산잉28주전인산전진단인산적NTDs병례수급구성.결과 2004-2010년태곡화평정현공감측위산인52366명,기중NTDs환인485례,총환병솔위92.6/만；NTDs총환병솔정하강추세.잉28주전NTDs환병솔위60.9/만,위산인중NTDs환병솔위31.7/만,인차,량현위산인출생결함감측도적NTDs환병솔비NTDs진실환병솔저고66.0％.근년량현잉28주후감측도적NTDs병례수재NTDs총병례수중적구성비점40.0％좌우.결론 기우위산인적출생결함감측,저고료인군중NTDs적진실환병솔,무뇌결함경엄중.건의개진목전적출생결함감측방안,장임하잉주인산전진단출생결함이인산적병례납입감측범주.
Objective To examine the impact of pregnancy termination before 28 weeks of gestation on the overall prevalence of neural tube defects (NTDs).Methods Data collected during the period of 2004 and 2010 from a birth defects surveillance system in Pingding county and Talgu county of Shanxi province were used.Number of births ≥28 weeks of gestation 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 were also collected.The total prevalence of neural tube defects,prevalence before 28 weeks of gestation,and prevalenee 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 pregnancy termination on the total prevalence.The proportions of pregnancy terminations before 28 weeks of gestation due to prenatal diagnosis of an NTD against the total number of NTD cases were also calculated.Results During 2004-2010,52 366 births were recorded,and 485 NTD cases were ascertained.The overall prevalence of NTDs was 92.6 per 10 000 births,with prevalence of ＜28 weeks gestation due to pregnancy terminations as 60.9 per 10 000 births,while the prevalence of ≥28 weeks of gestation was 31.7 per 10 000 births.NTD prevalence of ≥28 weeks gestation was 66.0％ lower than the total NTD prevalence.In the last two years,the proportion of NTDs ascertained ≥28 weeks gestation accounted for about 40.0％ of the total NTD cases.Conclusion A birth-defect-surveillance program that covered only tregnancies ≥28 weeks of gestation resulted in a severe underestimation of the total birth prevalence of NTDs,especially for anencephaly.We would recommend that the current national birth defects surveillance system should include pregnancy terminations before 28 weeks of gestation and the calculation of total NTD prevalence should also include these cases into the numerator,so as to better estimate true population NTD prevalence,upon which the related public health policy is based.
