Klusmann Anne, Heinrich Beate, Stöpler Heike, Gärtner Jutta, Mayatepek Ertan, Von Kries Rüdiger
Department of General Paediatrics, Children's Hospital, Heinrich Heine University, Düsseldorf, Germany.
Acta Paediatr. 2005 Nov;94(11):1538-42. doi: 10.1080/08035250500340396.
BACKGROUND/AIM: Neural tube defects (NTDs) are the most common birth defects, resulting in severe mortality and morbidity. In 1995, the supplementation of folic acid periconceptionally was officially recommended in Germany. The impact of the recommendations on the rate of NTDs was assessed.
An active surveillance system was established in the northern Rhine area. From 1996, all departments of obstetrics were asked to report cases of NTDs in all abortions, live births and stillbirths. Compliance with the recommendations was evaluated in a sample of mothers who delivered at the Department of Obstetrics of Düsseldorf University in 2001.
From 1996-2003, 520 NTDs were reported. Compared to the rate of NTDs in 1996 (10.5/10,000), the average incidence in the years 1997 to 2003 dropped (6.8/10,000). The intake of folic acid, as recommended, was low among the general population (21.1%).
Active surveillance data on the rate of NTDs are compatible with the maximum decrease of about 20% to be expected from data on the implementation of the recommendations. A much greater decrease in NTDs should be the challenge for the future.
背景/目的：神经管缺陷（NTDs）是最常见的出生缺陷，会导致严重的死亡率和发病率。1995年，德国正式建议在受孕前后补充叶酸。评估了这些建议对神经管缺陷发生率的影响。
在莱茵河地区北部建立了一个主动监测系统。从1996年起，要求所有产科部门报告所有流产、活产和死产中的神经管缺陷病例。对2001年在杜塞尔多夫大学产科分娩的母亲样本进行了建议依从性评估。
1996年至2003年期间，共报告了520例神经管缺陷。与1996年神经管缺陷发生率（10.5/10000）相比，1997年至2003年的平均发病率有所下降（6.8/10000）。一般人群中按建议摄入叶酸的比例较低（21.1%）。
神经管缺陷发生率的主动监测数据与建议实施数据预期的约20%的最大降幅相符。未来的挑战应该是更大幅度地降低神经管缺陷的发生率。
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