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中国北京三个地区神经管缺陷的患病率及产前诊断的影响

Prevalence of Neural Tube Defects and the Impact of Prenatal Diagnosis in Three Districts of Beijing, China.

作者信息

Jin Lei, Jin Lei, Yu Jingru, Xu Yanjun, Liu Hui, Ren Aiguo

机构信息

Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University.

出版信息

Paediatr Perinat Epidemiol. 2017 Jul;31(4):293-300. doi: 10.1111/ppe.12354. Epub 2017 May 2.

Abstract

BACKGROUND

The objectives of this study were to explore the prevalence of neural tube defects (NTDs) in three districts of Beijing, and to evaluate the impact of prenatal diagnosis on the prevalence.

METHODS

Data were collected between 2006 and 2012 from the Beijing Birth Defects Surveillance System. P and P represent the prevalence of NTDs diagnosed from 13 weeks and 28 weeks of gestation, respectively, to 7 days after delivery. Populations were classified as household (permanent) and non-household (non-permanent) because differences exist in access to health care, education, and income, among others.

RESULTS

The P of NTDs was 11.7 per 10 000 births in the three districts, which declined from 2006-12. In addition, the prevalence of NTDs in the non-household population was 1.7-fold higher than that among the household population. The P of anencephaly, spina bifida, and encephalocele were 5.3, 4.9, 1.6, respectively, per 10 000 births. The P of NTDs only represented 29.1% of P , and this proportion decreased over the 7-year period.

CONCLUSIONS

The prevalence of NTDs remains high in the three districts of Beijing, and the rate was higher in the non-household than household population. The prevalence of birth defects would be under estimated by almost 70 per cent if the report time was set on 28 weeks' gestation or later compared with report time on 13 weeks of gestation. It is better to set the report time earlier in birth defect surveillance in contemporary China.

摘要

背景

本研究旨在探讨北京三个区神经管缺陷(NTDs)的患病率,并评估产前诊断对患病率的影响。

方法

收集2006年至2012年期间北京出生缺陷监测系统的数据。P和P分别代表从妊娠13周和28周诊断出的NTDs患病率,直至分娩后7天。人群分为家庭(常住人口)和非家庭(非常住人口),因为在获得医疗保健、教育和收入等方面存在差异。

结果

三个区NTDs的P为每10000例出生11.7例,从2006年至2012年呈下降趋势。此外,非家庭人口中NTDs的患病率比家庭人口高1.7倍。无脑儿、脊柱裂和脑膨出的P分别为每10000例出生5.3例、4.9例和1.6例。NTDs的P仅占P的29.1%,且这一比例在7年期间有所下降。

结论

北京三个区NTDs的患病率仍然很高,非家庭人口的患病率高于家庭人口。如果将报告时间设定为妊娠28周或更晚,与妊娠13周的报告时间相比,出生缺陷的患病率将被低估近70%。在当代中国的出生缺陷监测中,最好将报告时间提前设定。

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