2003至2022年陕西省神经管缺陷发生率下降速率及缺陷儿转归OA北大核心CSTPCDMEDLINE
Declining Rate of Neural Tube Defects and Outcomes of Defective Infants in Shaanxi Province from 2003 to 2022
目的 总结2003至2022年陕西省神经管缺陷(NTDs)发生率的流行趋势和下降速率,掌握NTDs诊断时间及缺陷儿转归情况,预测2023至2025年陕西省NTDs发生率,为进一步完善出生缺陷监测系统提供新的科学依据.方法 对2003至2022年陕西省各级开设产科的医疗保健机构孕28周至出生后7 d所有围产儿进行出生缺陷监测并收集资料,基于出生缺陷监测系统分析2003至2022年NTDs发生率的分布趋势.结果 陕西省2003至2022年共监测围产儿1 106 483例,NTDs病例共848例,发生率为7.66/万,其中2005年发生率(48.02/万)最高,2022年发生率(0.57/万)最低.NTDs以脊柱裂为主,占55.90%,其次为无脑儿(25.71%)和脑膨出(18.40%),三者发生率均在波动中呈显著下降趋势(P<0.001).根据Joinpoint分析结果显示,2003至2014年NTDs发生率下降速度较慢,年度变化百分比为-4.04,2014至2022年NTDs发生率下降速度较快,年度变化百分比为-28.05.2003至2022年,陕西省NTDs产前诊断的平均比例为72.88%,出生结局以死胎(61.91%)为主,其次为活产(26.77%)、死产(8.73%)、出生7 d内死亡(2.59%).经GM(1,1)模型预测,陕西省2023、2024和2025年NTDs率分别为0.49/万、0.41/万和0.35/万.结论 2003至2022年陕西省NTDs发生率显著下降,尤其以2014年后下降速率加快.NTDs患儿出生结局以死胎为主,其次为活产.
Objective To evaluate the changes in the incidence of neural tube defects(NTDs)in Shaanxi province from 2003 to 2022,investigate the diagnosis time and outcomes of defective infants,and pre-dict the incidence of NTDs in Shaanxi province from 2023 to 2025,thereby providing a basis for improving the birth defects surveillance system.Methods Data were collected from all the perinatal infants from 28 weeks of gestation to 7 days after birth in all the hospitals with obstetrical department in Shaanxi province during 2003-2022.The changes in the incidence of NTDs from 2003 to 2022 were analyzed based on the birth defects surveil-lance system.Results A total of 1 106 483 perinatal infants in Shaanxi province from 2003 to 2022 were surveyed,among which NTDs occurred in 848 perinatal infants,with an incidence of 7.66/10 000.The incidence was the highest(48.02/10 000)in 2005 and the lowest(0.57/10 000)in 2022.The NTDs in Shaanxi province were mainly spina bifida(55.90%),which was followed by anencephaly(25.71%)and encephalocele(18.40%).The incidences of the three declined with fluctuations(P<0.001).The results of the Joinpoint analysis showed that the incidence of NTDs decreased slowly with the annual percentage change of-4.04 from 2003 to 2014 and declined rapidly with the annual percentage change of-28.05 from 2014 to 2022.From 2003 to 2022,the aver-age proportion of prenatal diagnosis of NTDs in Shaanxi province was 72.88%.Dead fetus(61.91%)was the main birth outcome,followed by live birth(26.77%),stillbirth(8.73%),and death within seven days after birth(2.59%).The incidence of NTDs in Shaanxi province from 2023 to 2025 were predicted by the GM(1,1)model as 0.49/10 000,0.41/10 000,and 0.35/10 000,respectively.Conclusions The incidence of NTDs in Shaanxi province declined significantly during 2003-2022,especially in a rapid manner after 2014.Dead fetus was the primary outcome of perinatal infants with NTDs,followed by live birth.
于敏;甘露;马西;平智广
西安交通大学医院公共卫生中心,西安 710049陕西省妇幼保健院基层保健科,西安 710003郑州大学公共卫生学院卫生统计教研室,郑州 450001
预防医学
出生缺陷神经管缺陷产前诊断出生结局
birth defectsneural tube defectsprenatal diagnosisbirth outcome
《中国医学科学院学报》 2024 (004)
513-518 / 6
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