Omran M, Stone D H, McLoone P
Public Health Research Unit, University of Glasgow.
Health Bull (Edinb). 1992 Sep;50(5):407-13.
The results of three studies spanning the period 1964 to 1989 were aggregated in an attempt to identify secular trends which might contribute to aetiological understanding of anencephaly and spina bifida (ASB). All data related to the prevalence of ASB in a geographically defined population in Glasgow, a known high risk area of neural tube defects. Multiple sources of ascertainment were employed to identify affected cases, whether live births, still births or induced abortions following prenatal diagnosis. The birth prevalence of ASB dropped by 82%, from 5.63 per 1,000 births in 1964-1968 to 1.04 per 1,000 births in 1979-1989, while the pregnancy prevalence (adjusted by including induced abortions) declined by 46%, from 5.63 per 1,000 births in 1964-1968 to 3.02 per 1,000 births in 1979-1989. Thus, prenatal screening contributed just under half of the observed decline in ASB birth prevalence. The pregnancy prevalence appeared to decline throughout the 1970's and early 1980's, and to increase again, temporarily, in the mid-1980s. These data could be interpreted as being broadly consistent with socio-economic hypotheses of ASB aetiology.
对1964年至1989年期间的三项研究结果进行了汇总，试图确定可能有助于从病因学角度理解无脑儿和脊柱裂（ASB）的长期趋势。所有数据均与格拉斯哥一个地理区域内ASB的患病率有关，格拉斯哥是一个已知的神经管缺陷高风险地区。采用多种确诊来源来识别受影响的病例，无论是活产、死产还是产前诊断后的人工流产。ASB的出生患病率下降了82%，从1964 - 1968年的每1000例出生5.63例降至1979 - 1989年的每1000例出生1.04例，而妊娠患病率（通过纳入人工流产进行调整）下降了46%，从1964 - 1968年的每1000例出生5.63例降至1979 - 1989年的每1000例出生3.02例。因此，产前筛查对观察到的ASB出生患病率下降的贡献略低于一半。妊娠患病率在整个20世纪70年代和80年代初似乎呈下降趋势，并在80年代中期暂时再次上升。这些数据可以解释为与ASB病因学的社会经济假说大致一致。
