Yu Min, Gan Lu, Ma Xi, Ping Zhi-Guang
Public Health Center,Hospital of Xi'an Jiaotong University,Xi'an 710049,China.
Primary Health Care Department,Shaanxi Provincial Maternity and Child Healthcare Hospital,Xi'an 710003,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2024 Aug;46(4):513-518. doi: 10.3881/j.issn.1000-503X.15932.
Objective To evaluate the changes in the incidence of neural tube defects (NTDs) in Shaanxi province from 2003 to 2022,investigate the diagnosis time and outcomes of defective infants,and predict the incidence of NTDs in Shaanxi province from 2023 to 2025,thereby providing a basis for improving the birth defects surveillance system. Methods Data were collected from all the perinatal infants from 28 weeks of gestation to 7 days after birth in all the hospitals with obstetrical department in Shaanxi province during 2003-2022.The changes in the incidence of NTDs from 2003 to 2022 were analyzed based on the birth defects surveillance system. Results A total of 1 106 483 perinatal infants in Shaanxi province from 2003 to 2022 were surveyed,among which NTDs occurred in 848 perinatal infants,with an incidence of 7.66/10 000.The incidence was the highest (48.02/10 000) in 2005 and the lowest (0.57/10 000) in 2022.The NTDs in Shaanxi province were mainly spina bifida (55.90%),which was followed by anencephaly (25.71%) and encephalocele (18.40%).The incidences of the three declined with fluctuations (<0.001).The results of the Joinpoint analysis showed that the incidence of NTDs decreased slowly with the annual percentage change of -4.04 from 2003 to 2014 and declined rapidly with the annual percentage change of -28.05 from 2014 to 2022.From 2003 to 2022,the average proportion of prenatal diagnosis of NTDs in Shaanxi province was 72.88%.Dead fetus (61.91%) was the main birth outcome,followed by live birth (26.77%),stillbirth (8.73%),and death within seven days after birth (2.59%).The incidence of NTDs in Shaanxi province from 2023 to 2025 were predicted by the GM (1,1) model as 0.49/10 000,0.41/10 000,and 0.35/10 000,respectively. Conclusion The incidence of NTDs in Shaanxi province declined significantly during 2003-2022,especially in a rapid manner after 2014.Dead fetus was the primary outcome of perinatal infants with NTDs,followed by live birth.
目的 评估2003年至2022年陕西省神经管缺陷（NTDs）发病率的变化，调查缺陷儿的诊断时间及结局，并预测2023年至2025年陕西省NTDs的发病率，从而为完善出生缺陷监测系统提供依据。方法 收集2003 - 2022年陕西省设有产科的所有医院中孕周28周及以上至出生后7天的所有围产儿数据。基于出生缺陷监测系统分析2003年至2022年NTDs发病率的变化。结果 2003年至2022年陕西省共调查1106483例围产儿，其中848例围产儿发生NTDs，发病率为7.66/万。发病率在2005年最高（48.02/万），2022年最低（0.57/万）。陕西省NTDs主要为脊柱裂（55.90%），其次是无脑儿（25.71%）和脑膨出（18.40%）。三者发病率均呈波动下降趋势（<0.001）。Joinpoint分析结果显示，2003年至2014年NTDs发病率以每年-4.04%的变化率缓慢下降，2014年至2022年以每年-28.05%的变化率快速下降。2003年至2022年，陕西省NTDs产前诊断平均比例为72.88%。死胎（61.91%）是主要出生结局，其次是活产（26.77%）、死产（8.73%）和出生后7天内死亡（2.59%）。采用GM（1,1）模型预测陕西省2023年至2025年NTDs发病率分别为0.49/万、0.41/万和0.35/万。结论 2003年至2022年陕西省NTDs发病率显著下降，尤其是2014年后下降迅速。死胎是NTDs围产儿的主要结局，其次是活产。
