Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Semin Fetal Neonatal Med. 2014 Jun;19(3):153-60. doi: 10.1016/j.siny.2013.11.008. Epub 2013 Dec 14.
Birth defects are an urgent global health priority. They affect millions of births worldwide. But their prevalence and impact are largely under-ascertained, particularly in middle- and low-income countries. Fortunately, a large proportion of birth defects can be prevented. This review examines the global prevalence and primary prevention methods for major preventable birth defects: congenital rubella syndrome, folic acid-preventable spina bifida and anencephaly, fetal alcohol syndrome, Down syndrome, rhesus hemolytic disease of the fetus and the newborn; and those associated with maternal diabetes, and maternal exposure to valproic acid or iodine deficiency during pregnancy. Challenges to prevention efforts are reviewed. The aim of this review is to bring to the forefront the urgency of birth defects prevention, surveillance, and prenatal screening and counseling; and to help public health practitioners develop population-based birth defects surveillance and prevention programs, and policy-makers to develop and implement science-based public health policies.
出生缺陷是全球紧急的健康优先事项。它们影响着全球数以百万计的出生。但是，它们的普遍性和影响在很大程度上还没有被确定，特别是在中低收入国家。幸运的是，很大一部分出生缺陷是可以预防的。本综述检查了主要可预防出生缺陷的全球患病率和初级预防方法：先天性风疹综合征、叶酸可预防的脊柱裂和无脑畸形、胎儿酒精综合征、唐氏综合征、母婴血型不合溶血病以及与母亲糖尿病、孕期暴露于丙戊酸或碘缺乏相关的出生缺陷。本文还审查了预防工作面临的挑战。本综述的目的是强调预防、监测和产前筛查与咨询的紧迫性，并帮助公共卫生从业人员制定基于人群的出生缺陷监测和预防计划，以及帮助政策制定者制定和实施基于科学的公共卫生政策。
