Dolk H
Département d'Epidémiologie et de Médecine préventive, Ecole de Santé publique, Université catholique de Louvain-en-Woluwe.
Bull Mem Acad R Med Belg. 1991;146(8-10):365-73.
One of the aims of epidemiologic surveillance is to assess the role of environmental factors acting during pregnancy (teratogens) in abnormal development of the nervous system. The data of Eurocat, a european system of congenital anomaly surveillance, was analysed and evaluated. Great geographical variation is observed in the prevalence of neural tube defects. Geographical variation in the prevalence of microcephaly, hydrocephaly and holoprosencephaly, may be related to problems of definition, validation and precision of diagnosis. A better definition of the unit of surveillance is required for anomalies where phenotypic heterogeneity is linked to aetiologic heterogeneity (such as neural tube defects) and for anomalies which range from minor to major forms (such as microcephaly). The strengths and deficiencies of the surveillance system for central nervous system anomalies are revealed by its performance in the evaluation of the Chernobyl accident.
流行病学监测的目标之一是评估孕期环境因素（致畸物）在神经系统异常发育中的作用。对欧洲先天性异常监测系统Eurocat的数据进行了分析和评估。神经管缺陷的患病率存在很大的地域差异。小头畸形、脑积水和前脑无裂畸形患病率的地域差异，可能与诊断的定义、验证和准确性问题有关。对于表型异质性与病因异质性相关的异常（如神经管缺陷）以及从轻度到重度形式的异常（如小头畸形），需要对监测单位进行更好的定义。中枢神经系统异常监测系统的优缺点在对切尔诺贝利事故的评估中得以体现。
