2000～2004年山西省神经管缺陷的动态监测

目的利用2000-01~2004-12期间山西省出生缺陷监测网收集的资料,描述围产儿无脑、脊柱裂和脑膨出3种神经管缺陷(NTDs)的流行病学特征及其动态变化趋势。方法采用以医院为基础的监测方法收集资料。调查对象为孕28周至产后7 d住院分娩的围产儿,包括活产、死胎和死产。结果共收集围产儿130 783例;神经管缺陷儿730例。围产儿NTDs总发生率为49.77/万,其中无脑、脊柱裂和脑膨出的发生率分别为19.19/万、28.67/万和7.95/万。总的NTDs和无脑畸形年度发生率呈下降趋势。男性NTDs发生率为42.60/万,女性为70.05/万,城市为26.03/万,农村为105.83/万,母龄别发生率在<20岁和>35岁组高于其他年龄组。NTDs围产儿早产占65.07%,低出生体重占56.85%,围产期病死率为81.57%。结论山西省围产儿总NTDs发生率及无脑发生率呈下降趋势;无脑及神经管缺陷(NTDS)发生率女性均高于男性;无脑、脊柱裂、脑膨出及神经管缺陷(NTDS)发生率农村高于城市;神经管缺陷儿出生素质差,围产期病死率高,预后不良。加强预防和产前诊断是降低神经管缺陷发生率的有效措施。

Dynamic monitoring of neural tube defects in Shanxi during 2000 to 2004

Objective To describe the epidemiological features and dynamic trends of neural tube defects(NTDs),including anencephaly,spina bifida and encephalocele.Methods From 2000 to 2004,data were collected with hospital-based cluster sampling method.During that period all live or still births with 28 weeks of gestation or more were assessed within 7 days after delivery.Results There were 730 cases with NTDs identified from 130 783 births,with an overall prevalence rate of 49.77 per 10 000 births.And the prevalence rate of anencephaly,spina bifida and encephalocele were 19.19 per 10 000,28.67 per 10 000and 7.95 per 10 000 respectively.Significant fell in overall prevalence rate of NTDs and anenephaly were the observed.The prevalence rates of NTDs were 42.60 per 10 000 and 105.83 per 10 000 in the urban and rural areas,respectively.The prevalence rate was higher in the groups with maternal age less than 20 years and more than 30 years than in other maternal ages.The prevalence rates of anenephaly,spina bifida and encephalocele were lowest from 25 to 29 years.Preterm babies and babies with low birth weight accounted for 65.07% and 56.85% of perinatal babies with NTDs respectively.With a perinatal mortality of 81.57%.Conclusion In Shanxi the occurrence of NTDs is higher in femal than in male births,higher in rural than in urban.Annual prevalence rate of NTDs in Shanxi presents a decling trend.Babies with NTDs are in poor birth quality,higher perinatal mortality and poor prognosis.Effective preventive measures and prenatal diagnosis should be strengthened to reduce the occurrence of neural tube defects.