Murphy M, Seagroatt V, Hey K, O'Donnell M, Godden M, Jones N, Botting B
Unit of Healthcare Epidemiology, Institute of Health Sciences, University of Oxford.
Arch Dis Child Fetal Neonatal Ed. 1996 Sep;75(2):F133-4. doi: 10.1136/fn.75.2.f133.
To describe accurately the total prevalence of neural tube defects (NTDs) in England and Wales over time, and to provide a benchmark up to 1994.
National data about NTDs reported as births or terminations are available from 1974-94, but reporting is incomplete. A local register of NTDs covering Oxfordshire/west Berkshire from 1965-94 was used to validate national data for the locality, using the method of capture and recapture, and hence to estimate incompleteness of reporting nationally.
National underreporting is consistent at about two thirds of the true number of cases reaching at least the second trimester. The local register is much more complete, but time trends locally and nationally are similar. In England and Wales total prevalence declined from about 34 per 10000 live and stillbirths in 1974 to a plateau of just under 8 per 10000 in the 1990s.
The decline in NTD prevalence is real and seems to have stopped. How this relates to changes in diet or the practice of vitamin supplementation is unknown, and the implications of the plateau are uncertain. OPCS figures of 500 NTDs annually in England and Wales represent about two thirds of the true number of cases.
准确描述英格兰和威尔士神经管缺陷（NTDs）的总体患病率随时间的变化情况，并提供截至1994年的基准数据。
1974年至1994年有关于NTDs作为出生或终止妊娠报告的国家数据，但报告并不完整。使用捕获再捕获法，利用1965年至1994年涵盖牛津郡/西伯克郡的NTDs地方登记册来验证该地区的国家数据，从而估计全国报告的不完整性。
全国漏报情况较为一致，至少妊娠中期的实际病例数约有三分之二未被报告。地方登记册要完整得多，但地方和全国的时间趋势相似。在英格兰和威尔士，总患病率从1974年每10000例活产和死产约34例下降到20世纪90年代略低于每100００例8例的稳定水平。
NTD患病率的下降是真实的，而且似乎已经停止。这与饮食变化或维生素补充剂的使用有何关系尚不清楚，稳定水平的影响也不确定。英格兰和威尔士每年500例NTDs的卫生和社会保障部数据约占实际病例数的三分之二。
