Omran M, McLoone P, Stone D, Aitken D, Crossley J
Public Health Research Unit, University of Glasgow, UK.
Paediatr Perinat Epidemiol. 1993 Oct;7(4):461-8. doi: 10.1111/j.1365-3016.1993.tb00427.x.
The effectiveness of a prenatal screening programme in reducing the birth prevalence of anencephaly and spina bifida (ASB) is influenced by three principal factors: the proportion of affected pregnancies screened (uptake), the proportion of affected pregnancies detected on screening (sensitivity) and the proportion of affected pregnancies terminated when detected (compliance). The purpose of the study was two-fold: to develop an epidemiologically-based method for the retrospective monitoring of these three factors and to attempt to quantify their relative importance in relation to the outcome of screening. Data on births and terminations associated with ASB for the period 1976-1986 were obtained from the Glasgow Register of Congenital Anomalies and from the Department of Medical Genetics, Yorkhill Hospitals. Increasing proportions of affected pregnancies screened, detected and terminated were observed, to a greater degree for anencephaly than for spina bifida. The relationships between uptake, sensitivity, compliance and terminations are described in the form of a simple arithmetic expression. In policy terms, further efforts are required to increase all three in order to improve the effectiveness of screening for spina bifida.
一项产前筛查计划在降低无脑儿和脊柱裂（ASB）出生患病率方面的有效性受三个主要因素影响：接受筛查的受影响妊娠比例（筛查参与率）、筛查时检测出的受影响妊娠比例（灵敏度）以及检测出后终止妊娠的受影响妊娠比例（依从性）。该研究有两个目的：开发一种基于流行病学的方法来回顾性监测这三个因素，并试图量化它们相对于筛查结果的相对重要性。1976年至1986年期间与ASB相关的出生和终止妊娠数据来自格拉斯哥先天性异常登记处和约克希尔医院医学遗传学系。观察到接受筛查、检测出和终止妊娠的受影响妊娠比例不断增加，无脑儿的增加程度大于脊柱裂。筛查参与率、灵敏度、依从性和终止妊娠之间的关系以一个简单的算术表达式形式描述。从政策角度来看，需要进一步努力提高这三个方面，以提高脊柱裂筛查的有效性。
