National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
World J Pediatr. 2011 Nov;7(4):302-10. doi: 10.1007/s12519-011-0326-0. Epub 2011 Oct 20.
Birth defects are a global public health problem because of their large contribution to infant mortalities and disabilities. It is estimated that 4%-6% of Chinese newborns are affected by birth defects every year. Surveillance is a basic approach to understanding the occurrence and associated factors of birth defects. The Ministry of Health of China initiated a national hospital-based birth defects monitoring system 20 years ago. Nearly every province in this country has established its own surveillance system in the past. The authors reviewed the result of the monitoring system at different administrative levels in China.
Available publications on the surveillance of birth defects and data from national and provincial birth defects surveillance systems were reviewed to evaluate the effectiveness of the surveillance systems.
According to the 2009 data, the national hospital-based birth defects surveillance system monitored over 1.3 million births, which accounted for more than 8% of births in China. In addition, 30 provincial hospital-based surveillance programs covered a birth population of more than 3.6 million (22% of births in China). Great achievements have been made in terms of case ascertainment, data quality control, and online reporting. But the surveillance systems in China still have some limitations. A short ascertainment period may miss some internal anomalies, inherited metabolic diseases, and malformed fetus aborted before the 28th gestational week. Discrepancies in antenatal or postnatal diagnosis of birth defects between surveillance institutes may affect the detection rate and introduce biases. Absence of baseline data and lack of integrated database systems limit the application of surveillance data to etiological studies and affect the process of decision-making.
The surveillance system for birth defects is prerequisite to propose, conduct and assess any interventions for the disease. To meet the need of study and prevention of birth defects, measures should be taken to improve the national and provincial birth defects surveillance systems in China.
出生缺陷是一个全球性的公共卫生问题，因为它们对婴儿死亡率和残疾率有很大的影响。据估计，中国每年有 4%-6%的新生儿受到出生缺陷的影响。监测是了解出生缺陷的发生和相关因素的基本方法。中国卫生部 20 年前启动了全国医院出生缺陷监测系统。过去，该国几乎每个省份都建立了自己的监测系统。作者回顾了中国不同行政级别监测系统的结果。
对出生缺陷监测的可用出版物和国家及省级出生缺陷监测系统的数据进行了审查，以评估监测系统的有效性。
根据 2009 年的数据，全国医院出生缺陷监测系统监测了超过 130 万例分娩，占中国分娩总数的 8%以上。此外，30 个省级医院出生缺陷监测项目覆盖了超过 360 万例分娩（占中国分娩总数的 22%）。在病例确定、数据质量控制和在线报告方面取得了巨大成就。但中国的监测系统仍存在一些局限性。较短的确定期可能会错过一些内部异常、遗传性代谢疾病和 28 孕周前流产的畸形胎儿。监测机构之间对出生缺陷的产前或产后诊断的差异可能会影响检测率并引入偏差。缺乏基线数据和综合数据库系统限制了监测数据在病因学研究中的应用，并影响了决策过程。
出生缺陷监测系统是提出、实施和评估任何疾病干预措施的前提。为满足研究和预防出生缺陷的需要，应采取措施改进中国的国家和省级出生缺陷监测系统。
