Forrester M B, Merz R D, Yoon P W
Hawaii Birth Defects Program, Honolulu 96813, USA.
Am J Epidemiol. 1998 Dec 15;148(12):1206-11. doi: 10.1093/oxfordjournals.aje.a009610.
This study examined the effect of prenatal diagnosis and elective termination on the prevalence of neural tube defects, oral clefts, abdominal wall defects, and chromosomal anomalies in Hawaii by using actively ascertained surveillance data collected between 1987 and 1996 by the Hawaii Birth Defects Program. Because the Program has nearly universal access to prenatal diagnostic information and to follow-up data on elective terminations, Hawaii is an ideal setting in which to study their effects on prevalence rates of birth defects. Except for oral clefts, a large proportion of the defects studied were prenatally diagnosed: anencephaly (87%), spina bifida (62%), encephalocele (83%), cleft palate (0%), cleft lip with or without cleft palate (14%), omphalocele (60%), gastroschisis (76%), Down syndrome (43%), trisomy 18 (61 %), and trisomy 13 (40%). The effect of elective terminations on the birth prevalence rates for most of these birth defects was significant. Including electively terminated cases in the calculations of birth prevalence rates increased the rates by more than 50% for five of the 10 birth defects studied.
本研究利用夏威夷出生缺陷项目于1987年至1996年间收集的主动监测数据，调查了产前诊断和选择性终止妊娠对夏威夷神经管缺陷、口腔腭裂、腹壁缺陷和染色体异常患病率的影响。由于该项目几乎能全面获取产前诊断信息和选择性终止妊娠的随访数据，夏威夷是研究它们对出生缺陷患病率影响的理想之地。除口腔腭裂外，所研究的大部分缺陷在产前都能被诊断出来：无脑儿（87%）、脊柱裂（62%）、脑膨出（83%）、腭裂（0%）、唇裂伴或不伴腭裂（14%）、脐膨出（60%）、腹裂（76%）、唐氏综合征（43%）、18三体综合征（61%）和13三体综合征（40%）。选择性终止妊娠对这些出生缺陷中大多数的出生患病率的影响是显著的。在所研究的10种出生缺陷中，有5种在计算出生患病率时将选择性终止妊娠的病例纳入后，患病率增加了50%以上。
