Miller L A, Shaikh T, Stanton C, Montgomery A, Rickard R, Keefer S, Hoffman R
Colorado Department of Public Health and Environment, DCEED-EE-A3, Denver 80222-1530, USA.
Public Health Rep. 1995 Nov-Dec;110(6):690-7.
The authors performed surveillance for fetal alcohol syndrome with an existing birth defects registry. Fetal alcohol syndrome cases were identified from multiple sources using passive surveillance and from two selected medical sites using enhanced surveillance. Between May 1992 and March 1994, a total of 173 cases were identified, and the medical records of the cases were reviewed to determine whether the cases met a surveillance case definition for fetal alcohol syndrome. Of these cases, 37 (21 percent) met either definite (28) or probable (9) criteria for fetal alcohol syndrome, 76 met possible criteria (44 percent), and 60 (35 percent) were defined as not fetal alcohol syndrome. Enhanced surveillance had the highest sensitivity for definite or probable cases, 31 of 37 (84 percent), followed by hospital discharge data, 14 of 37 (38 percent). The authors also compared birth certificate information for 22 definite or probable cases in children born between 1989 and 1992 to birth certificate information for all Colorado births for that period. The proportion of mothers of children with fetal alcohol syndrome was statistically significantly greater (as determined by exact binomial 95 percent confidence limits) than the proportion of all mothers for the following characteristics: black race (0.23 versus 0.05), unmarried (0.55 versus 0.22), not employed during pregnancy (0.86 versus 0.43), and started prenatal care in the third trimester (0.18 versus 0.04). Surveillance for fetal alcohol syndrome can be accomplished with an existing registry system in combination with additional case finding and verification activities. Through followup investigation of reported cases, data can be gathered on the mothers of children with fetal alcohol syndrome. These data could be used to target fetal alcohol syndrome prevention programs.
作者利用现有的出生缺陷登记系统对胎儿酒精综合征进行监测。通过被动监测从多个来源识别胎儿酒精综合征病例，并通过强化监测从两个选定的医疗场所识别病例。在1992年5月至1994年3月期间，共识别出173例病例，并对这些病例的医疗记录进行审查，以确定这些病例是否符合胎儿酒精综合征的监测病例定义。在这些病例中，37例（21%）符合胎儿酒精综合征的确切（28例）或可能（9例）标准，76例符合可能标准（44%），60例（35%）被定义为非胎儿酒精综合征。强化监测对确诊或可能病例的敏感性最高，37例中的31例（84%），其次是医院出院数据，37例中的14例（38%）。作者还将1989年至1992年出生的儿童中22例确诊或可能病例的出生证明信息与该时期科罗拉多州所有出生的出生证明信息进行了比较。患有胎儿酒精综合征儿童的母亲在以下特征方面的比例在统计学上显著高于所有母亲的比例（通过精确二项式95%置信区间确定）：黑人种族（0.23对0.05）、未婚（0.55对0.22）、孕期未就业（0.86对0.43）以及在孕晚期开始产前护理（0.18对0.04）。利用现有的登记系统结合额外的病例发现和核实活动，可以实现对胎儿酒精综合征的监测。通过对报告病例的后续调查，可以收集患有胎儿酒精综合征儿童母亲的数据。这些数据可用于针对胎儿酒精综合征预防项目。
