Khoshnood Babak, Greenlees Ruth, Loane Maria, Dolk Helen
INSERM, UMRS953, Hospital St. Vincent de Paul, Paris, France.
Birth Defects Res A Clin Mol Teratol. 2011 Mar;91 Suppl 1(Suppl 1):S16-22. doi: 10.1002/bdra.20776. Epub 2011 Mar 4.
The purpose of this article is to present the specific public health indicators recently developed by EUROCAT that aim to summarize important aspects of the public health impact of congenital anomalies in a few quantitative measures.
The six indicators are: (1) congenital anomaly perinatal mortality, (2) congenital anomaly prenatal diagnosis prevalence, (3) congenital anomaly termination of pregnancy, (4) Down syndrome livebirth prevalence, (5) congenital anomaly pediatric surgery, and (6) neural tube defects (NTD) total prevalence. Data presented for this report pertained to all cases (livebirths, fetal deaths, or stillbirths after 20 weeks of gestation and terminations of pregnancy for fetal anomaly [TOPFA]) of congenital anomaly from 27 full member registries of EUROCAT that could provide data for at least 3 years during the period 2004 to 2008. Prevalence of anomalies, prenatal diagnosis, TOPFA, pediatric surgery, and perinatal mortality were calculated per 1000 births.
The overall perinatal mortality was approximately 1.0 per 1000 births for EUROCAT registries with almost half due to fetal and the other half due to first week deaths. There were wide variations in perinatal mortality across the registries with the highest rates observed in Dublin and Malta, registries in countries where TOPFA are illegal, and in Ukraine. The overall perinatal mortality across EUROCAT registries slightly decreased between 2004 and 2008 due to a decrease in first week deaths. The prevalence of TOPFA was fairly stable at about 4 per 1000 births. There were variations in livebirth prevalence of cases typically requiring surgery across the registries; however, for most registries this prevalence was between 3 and 5 per 1000 births. Prevalence of NTD decreased by about 10% from 1.05 in 2004 to 0.94 per 1000 in 2008.
It is hoped that by publishing the data on EUROCAT indicators, the public health importance of congenital anomalies can be clearly summarized to policy makers, the need for accurate data from registries emphasized, the need for primary prevention and treatment services highlighted, and the impact of current services measured.
本文旨在介绍欧洲先天性异常监测网络（EUROCAT）最近制定的特定公共卫生指标，这些指标旨在通过一些定量措施总结先天性异常对公共卫生影响的重要方面。
这六个指标分别为：（1）先天性异常围产期死亡率；（2）先天性异常产前诊断患病率；（3）先天性异常妊娠终止率；（4）唐氏综合征活产患病率；（5）先天性异常小儿外科手术率；（6）神经管缺陷（NTD）总患病率。本报告所呈现的数据涉及EUROCAT的27个正式成员登记处的所有先天性异常病例（活产、死胎或妊娠20周后的死产以及因胎儿异常而终止妊娠[TOPFA]），这些登记处能够提供2004年至2008年期间至少3年的数据。异常患病率、产前诊断率、TOPFA、小儿外科手术率和围产期死亡率按每1000例出生计算。
EUROCAT登记处的总体围产期死亡率约为每1000例出生1.0例，其中近一半是由于胎儿死亡，另一半是由于第一周内死亡。各登记处的围产期死亡率差异很大，在都柏林和马耳他（TOPFA在这些国家非法）以及乌克兰的登记处观察到最高死亡率。由于第一周内死亡人数减少，2004年至2008年期间EUROCAT登记处的总体围产期死亡率略有下降。TOPFA的患病率相当稳定，约为每1000例出生4例。各登记处典型需要手术的病例活产患病率存在差异；然而，对于大多数登记处来说，这一患病率在每1000例出生3至5例之间。NTD的患病率从2004年的每1000例1.05例下降到2008年的每1000例0.94例，下降了约10%。
希望通过公布EUROCAT指标数据，能够向政策制定者清晰地总结先天性异常对公共卫生的重要性，强调登记处提供准确数据的必要性，突出初级预防和治疗服务的必要性，并衡量当前服务的影响。
