高危地区先天性神经管缺陷的筛查：流行病学视角
Screening for congenital neural tube defects in a high-risk area: an epidemiological perspective.
作者信息
Stone D H, Smalls M J, Rosenberg K, Womersley J
机构信息
Social Paediatric and Obstetric Research Unit, University of Glasgow, Glasgow.
出版信息
J Epidemiol Community Health. 1988 Sep;42(3):271-3. doi: 10.1136/jech.42.3.271.
Data from the Glasgow Register of Congenital Malformations were used to investigate the extent of the recent decline in the prevalence of anencephaly and spina bifida, and the contribution of antenatal screening to it. Over the period 1974-85 inclusive, 303 pregnancies with an anencephalic foetus were diagnosed, representing an "adjusted" prevalence of 1.9 per 1000 total births, of which 179 (59%) were terminated following antenatal screening. There were 364 pregnancies with a spina bifida foetus representing an "adjusted" prevalence of 2.3 per 1000 total births, of which 84 (23%) were terminated. Over the study period, the "adjusted" prevalence of anencephaly fell by 50% while the birth prevalence fell by 89%; the "adjusted" prevalence of spina bifida fell by 38% while the birth prevalence fell by 76%. It was concluded that although the birth prevalence of both defects (particularly anencephaly) would have declined substantially in the absence of screening, the West of Scotland programme should continue.
利用格拉斯哥先天性畸形登记处的数据，调查无脑儿和脊柱裂患病率近期下降的程度以及产前筛查对此的贡献。在1974年至1985年（含）期间，诊断出303例怀有无脑儿胎儿的妊娠，“调整后”患病率为每1000例总出生数中有1.9例，其中179例（59%）在产前筛查后终止妊娠。有364例怀有脊柱裂胎儿的妊娠，“调整后”患病率为每1000例总出生数中有2.3例，其中84例（23%）终止妊娠。在研究期间，无脑儿的“调整后”患病率下降了50%，而出生患病率下降了89%；脊柱裂的“调整后”患病率下降了38%，而出生患病率下降了76%。得出的结论是，尽管在没有筛查的情况下，这两种缺陷（尤其是无脑儿）的出生患病率会大幅下降，但苏格兰西部的筛查项目仍应继续开展。
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