National Disease Registration Service (NDRS), NHS England, Redditch, UK
National Disease Registration Service (NDRS), NHS England, Redditch, UK.
Arch Dis Child. 2024 Jan 22;109(2):106-112. doi: 10.1136/archdischild-2023-325856.
To determine the baseline trends in the total birth prevalence of neural tube defects (NTDs) in England (2000-2019) to enable the impact of folic acid fortification of non-wholemeal wheat flour to be monitored.
Population-based, observational study using congenital anomaly (CA) registration data for England curated by the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
Regions of England with active registration in the time period.
Babies that were liveborn or stillborn and pregnancies that resulted in a termination of pregnancy or a late miscarriage (20-23 weeks' gestation) with an NTD.
Total birth prevalence of anencephaly, spina bifida and all NTDs in England. Poisson regression analysis was used to evaluate time trends with regional register as a random effect. The progress of national registration across England was assessed.
There were 4541 NTD pregnancies out of 3 637 842 births in England; 1982 anencephaly and 2127 spina bifida. NTD prevalence was 12.5 (95% CI 12.1 to 12.9) per 10 000 total births. NTD prevalence per 10 000 total births was significantly higher in 2015-2019 (13.6, 95% CI 12.9 to 14.4) compared with 2010-2014 (12.1, 95% CI 11.7 to 12.5). An increasing trend in NTDs overall was detected (incidence rate ratio (IRR) 1.01, 1.00 to 1.02), although further analysis determined this effect was confined to 2015-2019 (compared against 2000-2004, IRR 1.14, 1.04 to 1.24). The birth prevalence of anencephaly reflected this pattern. The prevalence of spina bifida remained relatively stable over time.
Baseline NTD prevalence for England has been established. National and standardised CA registration is in place, facilitating the systematic and consistent monitoring of pre-fortification and post-fortification NTD trends and evaluating the impact of fortification on NTD prevalence.
确定英格兰神经管缺陷（NTD）总出生流行率的基线趋势，以便能够监测叶酸强化非全麦面粉的影响。
利用国家先天性异常和罕见疾病登记服务（NCARDRS）为英格兰编纂的先天性异常（CA）登记数据进行的基于人群的观察性研究。
在该时间段内有活跃登记的英格兰地区。
活产或死产婴儿，以及导致妊娠终止或晚期流产（20-23 周妊娠）的妊娠，且患有 NTD。
英格兰无脑畸形、脊柱裂和所有 NTD 的总出生流行率。使用泊松回归分析评估具有区域登记的时间趋势作为随机效应。评估英格兰全国登记的进展情况。
英格兰有 4541 例 NTD 妊娠，3637842 例活产或死产；1982 例无脑畸形和 2127 例脊柱裂。NTD 的患病率为每 10000 例总出生数 12.5（95%CI 12.1 至 12.9）。2015-2019 年（13.6，95%CI 12.9 至 14.4）NTD 患病率每 10000 例总出生数明显高于 2010-2014 年（12.1，95%CI 11.7 至 12.5）。总体上检测到 NTD 呈上升趋势（发病率比（IRR）1.01，1.00 至 1.02），尽管进一步分析确定这种影响仅限于 2015-2019 年（与 2000-2004 年相比，IRR 为 1.14，1.04 至 1.24）。无脑畸形的患病率反映了这一模式。脊柱裂的患病率随着时间的推移保持相对稳定。
已确定英格兰 NTD 的基线流行率。全国性和标准化的 CA 登记已经到位，便于系统和一致地监测强化前和强化后 NTD 趋势，并评估强化对 NTD 流行率的影响。
