Stevenson R E, Allen W P, Pai G S, Best R, Seaver L H, Dean J, Thompson S
Greenwood Genetic Center, Greenwood, South Carolina 29646, USA.
Pediatrics. 2000 Oct;106(4):677-83. doi: 10.1542/peds.106.4.677.
To conduct surveillance for neural tube defects (NTDs) in a high-risk region of the United States and to prevent occurrence and recurrence of NTDs through the periconceptional use of folic acid supplements.
Active and passive methods were used for surveillance of NTD-affected pregnancies and births during a 6-year period (October 1992-September 1998). Individual genetic counseling was used to prevent NTD recurrences and a public awareness campaign was used to reduce NTD occurrences.
State of South Carolina.
All cases of spina bifida, anencephaly, and encephalocele identified among 278 122 live births and fetal deaths to South Carolina residents during 1992-1998 were included.
Changes in occurrence and recurrence rates during a 6-year period.
Over the 6 years of surveillance, the prevalence rates for NTDs decreased from 1.89 to.95 cases per 1000 live births and fetal deaths. The prevalence decrease is explained primarily by a decrease in cases of spina bifida. Isolated NTDs accounted for 297/360 (82%) NTDs and 63/360 (18%) had at least 1 other structural anomaly. Females predominated among isolated NTDs but the sex distribution was equal among NTD cases with other anomalies. Prevalence rates for whites (1.48 cases per 1000 live births and fetal deaths) were higher than rates for blacks (.87 cases per 1000 live births and fetal deaths). There were no NTD recurrences in 113 subsequent pregnancies to mothers of infants with isolated NTDs who took periconceptional folic acid. The rate of periconceptional folic acid use among women of childbearing years increased from 8% to 35% during the 6-year project period.
The prevalence of NTDs in a high-risk region has declined coincident with the increased periconceptional use of folic acid supplements among women of childbearing age.neural tube defects, high-risk region, birth defects, folic acid, spina bifida, anencephaly, encephalocele.
对美国一个高危地区的神经管缺陷（NTDs）进行监测，并通过孕前补充叶酸来预防NTDs的发生和复发。
采用主动和被动方法对1992年10月至1998年9月这6年期间受NTDs影响的妊娠和分娩情况进行监测。采用个体遗传咨询来预防NTDs复发，并开展公众宣传活动以减少NTDs的发生。
南卡罗来纳州。
纳入了1992 - 1998年期间南卡罗来纳州居民的278122例活产和死胎中确诊的所有脊柱裂、无脑儿和脑膨出病例。
6年期间发生率和复发率的变化。
在6年的监测期内，NTDs的患病率从每1000例活产和死胎1.89例降至0.95例。患病率下降主要是由于脊柱裂病例减少。孤立性NTDs占360例NTDs中的297例（82%），63例（18%）至少合并1种其他结构异常。在孤立性NTDs中女性占多数，但在合并其他异常的NTDs病例中性别分布均衡。白人的患病率（每1000例活产和死胎1.48例）高于黑人（每1000例活产和死胎0.87例）。在113例后续妊娠中，其婴儿为孤立性NTDs且母亲在孕前服用叶酸，未出现NTDs复发情况。在6年的项目期内，育龄妇女孕前叶酸的服用率从8%升至35%。
高危地区NTDs的患病率下降，与此同时育龄妇女孕前补充叶酸的比例增加。神经管缺陷、高危地区、出生缺陷、叶酸、脊柱裂、无脑儿、脑膨出
