State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A, Datun Road, Chaoyang District, Beijing, 100101, China.
Sinomaps Press, No. 3, Baizhifangxi Road, Xuanwu District, Beijing, 100054, China.
Int Health. 2021 Feb 24;13(2):161-169. doi: 10.1093/inthealth/ihaa035.
Neural tube defects (NTDs) are congenital birth defects of the central nervous system that affect 0.5-2 per 1000 pregnancies worldwide. Therefore effective interventions for birth defects, especially NTDs, are very important.
Yuanping City is a coal mining city in Shanxi Province, China, with a high incidence of NTDs. This study evaluates the effects of NTD interventions in this city after adjusting for covariates that characterize the native environment. The number of NTD cases and births for the 18 towns in Yuanping City from 2007 to 2014 were included in the study. A shared-component zero-inflated Poisson regression was applied to analyse the temporal-spatial variance among the incidence rates of NTDs in Yuanping City before and after the interventions.
The results showed that existing interventions to mitigate birth defects, such as folic acid supplementation, reduced the incidence of NTDs by 53.5% in coal mining areas in Yuanping City. However, the NTD risk in areas near coal mines, especially unrestored coal mines, was still high, even after the intervention.
The government should focus on health hazards related to mining and agricultural production and should provide education and resources to reduce environmental exposure. Reducing environmental risks should be regarded as an early intervention strategy to mitigate birth defects.
神经管缺陷（NTDs）是一种先天性中枢神经系统出生缺陷，全球每 1000 次妊娠中就有 0.5-2 次受到影响。因此，针对出生缺陷，特别是神经管缺陷的有效干预措施非常重要。
山西省原平市是一个煤矿城市，NTD 发病率较高。本研究在调整了反映当地环境特征的协变量后，评估了该市针对 NTD 所采取的干预措施的效果。研究纳入了 2007 年至 2014 年原平市 18 个镇的 NTD 病例数和出生人数。采用共享分量零膨胀泊松回归分析方法，分析了干预前后原平市 NTD 发病率的时空变化。
结果表明，现有的减轻出生缺陷干预措施，如叶酸补充，使原平市煤矿地区 NTD 的发病率降低了 53.5%。然而，即使在干预之后，煤矿附近地区，特别是未恢复的煤矿地区，NTD 风险仍然很高。
政府应关注与采矿和农业生产相关的健康危害，并提供教育和资源，以减少环境暴露。减少环境风险应被视为减轻出生缺陷的早期干预策略。
