泽州县2003～2004年神经管畸形的流行状况

目的了解泽州县目前神经管畸形患病水平及流行特征,为今后制定本县出生缺陷的预防措施提供依据。方法以人群为基础,对泽州县26个乡镇所有在本地长期居住的妇女所分娩的孕20周及以上到生后7d的胎儿和新生儿进行监测。结果2003年1月至2004年12月,共监测到孕满20周及以上的出生7992名,发现NTDs病例128例,NTDs出生患病率为160.2/万,其中无脑儿为72.6/万(58/7992)、脊柱裂为81.3/万(65/7992)、脑膨出为6.3/万(57992)。NTDs占全部体表重大出生缺陷病例的71.5%(128/179)。NTDs的患病率与母亲年龄、文化程度及妊娠胎数显著相关。母亲年龄<20岁或≥30岁、文化程度为小学及以下、双胎或多胎的妊娠妇女中NTDs的出生患病率显著升高。结论我县NTDs出生患病率处于我国乃至世界最高的水平。文化程度低、怀孕年龄太小或较大以及多胎妊娠的妇女生育神经管畸形患儿的危险性较大。积极推动孕前保健各项措施,有望有效降低我县NTDs发生率。

To study epidemiology of neural tube defects in Zezhou County of Shanxi Province,China(2003-2004)

ObjectiveTo understand the birth prevalence and the epidemiological status of the neural tube defects(NTDs)in Zezhou county of Shanxi province,so as to provide the evidence for policy making.MethodsData came from a population-based birth defects surveillance system which was established in 2003 under the guidance of Peking University.The system captures information on all live births,still births from 20 weeks of gestation to 7 days of life,and pregnancy terminations at any gestational age resulting from prenatal diagnosis of a birth defect.ResultsA total of 7 992 births were registered from 26 townships in our county during 2003-2004.The birth prevalence of NTDs was 160.2 per 10 000 births,accounting for 71.5 % of all external birth defects cases.The prevalence of anencephaly,spina bifida and encephalocele were 72.6/10 000,81.3/10 000 and 6.3/10 000,respectively.The NTDs prevalence was significantly higher among women with age less than 20 or more than 30 years,with lower education,or with multiple pregnancies.ConclusionThe NTDs prevalence in our county is among the highest level worldwide.Women with too younger or older pregnant age,with lower education,or with multi-pregnancy may have the higher risk of having a child with neural tube defects.Promoting the pre-pregnancy care may be one of the important measures to reduce the prevalence of NTDs.