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产前筛查与终止妊娠对围产期死亡率的影响。

The influence of prenatal screening and termination of pregnancy on perinatal mortality rates.

作者信息

van der Pal-de Bruin K M, Graafmans W, Biermans M C J, Richardus J H, Zijlstra A G, Reefhuis J, Mackenbach J P, Verloove-Vanhorick S P

机构信息

TNO Prevention and Health, PO BOX 2215, 2301 CE Leiden, The Netherlands.

出版信息

Prenat Diagn. 2002 Nov;22(11):966-72. doi: 10.1002/pd.442.

Abstract

OBJECTIVES

This study concerns the possible effect of practice of prenatal screening of congenital anomalies followed by termination of pregnancy on the perinatal mortality between European countries.

METHODS

Data of nine region-specific EUROCAT registries from five European countries were used to compare the pregnancy termination rate and perinatal mortality due to congenital anomalies between the registries. The impact of pregnancy terminations on the perinatal mortality rate was estimated using a calculated lethality for each congenital anomaly in the hypothetical case that no pregnancy terminations had been performed and was expressed in the 'natural' perinatal mortality rate.

RESULTS

There are large differences between the EUROCAT registries in the number of pregnancy terminations for congenital anomalies. The difference between the 'natural' and regular perinatal mortality rate vary between 3.7 and 14.1 per 10 000 live births and stillbirths. The difference is greater in regions where prenatal screening is more common than in regions where this is not common.

CONCLUSION

Differences in practice of prenatal screening and termination of pregnancy of congenital anomalies contribute to the variations in the overall perinatal mortality rate between European regions and countries.

摘要

目的

本研究关注先天性异常产前筛查并终止妊娠的做法对欧洲国家围产期死亡率的可能影响。

方法

使用来自五个欧洲国家的九个特定地区的欧洲先天性异常监测(EUROCAT)登记处的数据,比较各登记处因先天性异常导致的妊娠终止率和围产期死亡率。在假设未进行妊娠终止的情况下,通过计算每种先天性异常的致死率来估计妊娠终止对围产期死亡率的影响,并以“自然”围产期死亡率表示。

结果

欧洲先天性异常监测登记处在先天性异常妊娠终止数量方面存在很大差异。“自然”围产期死亡率与常规围产期死亡率之间的差异在每10000例活产和死产中为3.7至14.1。产前筛查较普遍的地区差异大于不普遍的地区。

结论

先天性异常产前筛查和妊娠终止做法的差异导致欧洲各地区和国家总体围产期死亡率存在差异。

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