Ministry of Health, General Directorate of Public Health, Ankara, Turkey.
Department of Pediatrics, Division of Social Pediatrics, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey.
BMC Pregnancy Childbirth. 2022 Apr 19;22(1):340. doi: 10.1186/s12884-022-04678-z.
The aim of this study is to determine the frequency of neural tube defects (NTDs) and to examine the epidemiological characteristics of NTD related deaths in Turkey.
This nationwide descriptive study was included NTD related infant deaths, termination of pregnancy for fetal anomaly (ToPFA) and stillbirth cases registered in Death Notification System between 2014 and 2019, and patients diagnosed with NTD in the 2018 birth cohort.
In the 2018 birth cohort, there were 3475 cases of NTD at birth (27.5 per 10,000). The fatality rates for live-born babies with NTD in this cohort were 13.5% at first year, and 15.6% at the end of March, 2022. NTDs were associated with 11.7% of ToPFA cases, 2.5% of stillbirths and 2.8% of infant deaths in 2014-2019. NTD related stillbirth rate was 1.74 per 10,000 births, while NTD related ToPFA rate and infant mortality rate were 0.61 and 2.70 per 10,000 live births respectively. NTD-related stillbirth and infant mortality rate were highest in the Eastern region (3.64 per 10,000 births; 4.65 per 10,000 live births respectively), while ToPFA rate was highest in the North and West regions (1.17 and 0.79 per 10,000 live births respectively) (p < 0.05). Prematurity and low birth weight were the variables with the highest NTD related rates for stillbirths (11.26 and 16.80 per 10,000 birth), ToPFA (9.25 and 12.74) per 10,000 live birth), and infant deaths (13.91 and 20.11 per 10,000 live birth) (p < 0.05).
NTDs are common and have an important place among the mortality causes in Turkey. Primary prevention through mandatory folic acid fortification should be considered both to reduce the frequency of NTD and related mortality rates.
本研究旨在确定神经管缺陷（NTD）的发生率，并研究土耳其 NTD 相关死亡的流行病学特征。
本全国性描述性研究纳入了 2014 年至 2019 年期间死亡通报系统中登记的 NTD 相关婴儿死亡、因胎儿异常而终止妊娠（ToPFA）和死产病例，以及 2018 年出生队列中诊断为 NTD 的患者。
在 2018 年的出生队列中，有 3475 例 NTD 活产（每 10000 例中有 27.5 例）。该队列中 NTD 活产婴儿的第一年病死率为 13.5%，2022 年 3 月底为 15.6%。2014-2019 年，NTD 与 11.7%的 ToPFA 病例、2.5%的死产和 2.8%的婴儿死亡有关。NTD 相关死产率为每 10000 例活产 1.74 例，而 NTD 相关 ToPFA 率和婴儿死亡率分别为每 10000 例活产 0.61 例和 2.70 例。NTD 相关死产和婴儿死亡率在东部地区最高（每 10000 例活产分别为 3.64 例和 4.65 例），而北部和西部地区的 ToPFA 率最高（每 10000 例活产分别为 1.17 例和 0.79 例）（p<0.05）。早产和低出生体重是与死产（每 10000 例活产分别为 11.26 例和 16.80 例）、ToPFA（每 10000 例活产分别为 9.25 例和 12.74 例）和婴儿死亡（每 10000 例活产分别为 13.91 例和 20.11 例）相关的 NTD 发生率最高的变量（p<0.05）。
NTD 在土耳其是常见的，在死亡原因中占有重要地位。通过强制叶酸强化来进行一级预防，既可以降低 NTD 的发生率，也可以降低相关的死亡率。
