Jaruratanasirikul Somchit, Kor-anantakul Ounjai, Limpitikul Wannee, Dissaneevate Pathikan, Khunnarakpong Nattasit, Sattapanyo Atchara
Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand,
Childs Nerv Syst. 2014 Jul;30(7):1269-75. doi: 10.1007/s00381-014-2410-y. Epub 2014 Apr 17.
Neural tube defects (NTDs) are a group of congenital malformation of the central nervous system that leads to permanent physical disability and requires lifelong treatment. In Thailand, there have been three published articles on NTDs, all hospital-based studies, which found prevalence of NTDs of 4.8-6.7 per 10,000 live births.
It was our purpose with this study to determine the prevalence and type of NTDs in southern Thailand through a population-based survey.
Data were obtained through the population-based surveillance during 2009-2012 in three provinces (Songkhla, Phatthalung, Trang) in southern Thailand. Entries in the birth defects registry included all live births, all stillbirths after 24-week gestational age, and termination of pregnancy following the prenatal diagnosis at any gestational age of all congenital anomalies.
During 2009-2012, 148,759 births were registered in the three provinces. Twenty-eight NTD cases were identified, giving an average of 1.88 per 10,000 births (95 % CI 1.20-2.51): 12 cases with anencephaly (42.8 %), 5 with occipital encephalocele (17.9 %), and 11 with myelomeningocele (39.3 %). The birth prevalence per 10,000 births of anencephaly, encephalocele, and myelomeningocele were 0.81, 0.33, and 0.74, respectively. Sixteen (57 %) were detected in live births, and 12 (43 %) were detected by prenatal diagnosis which later resulted in termination of pregnancy.
The prevalence of NTDs based on the population-based study in southern Thailand was low. About 40 % of NTD cases were detected prenatally and later terminated. Hence, examining only registry live births will result in an inaccurately low NTD prevalence rate.
神经管缺陷（NTDs）是一组中枢神经系统先天性畸形，会导致永久性身体残疾并需要终身治疗。在泰国，有三篇关于神经管缺陷的已发表文章，均为基于医院的研究，其发现神经管缺陷的患病率为每10000例活产中有4.8 - 6.7例。
本研究的目的是通过基于人群的调查确定泰国南部神经管缺陷的患病率和类型。
数据通过2009 - 2012年期间泰国南部三个省份（宋卡、博他仑、董里）基于人群的监测获得。出生缺陷登记处的记录包括所有活产、孕龄24周后的所有死产以及在任何孕龄对所有先天性异常进行产前诊断后终止妊娠的情况。
在2009 - 2012年期间，这三个省份登记了148759例出生。确定了28例神经管缺陷病例，平均每10000例出生中有1.88例（95%可信区间1.20 - 2.51）：无脑儿12例（42.8%），枕部脑膨出5例（17.9%），脊髓脊膜膨出11例（39.3%）。每10000例出生中无脑儿、脑膨出和脊髓脊膜膨出的出生患病率分别为0.81、0.33和0.74。16例（57%）在活产中被检测到，12例（43%）通过产前诊断被检测到，随后终止妊娠。
基于泰国南部人群研究的神经管缺陷患病率较低。约40%的神经管缺陷病例在产前被检测到并随后终止妊娠。因此，仅检查登记的活产会导致神经管缺陷患病率不准确地偏低。
