309例神经管缺陷围产儿相关因素研究

目的:描述1998~2003年期间辽宁省围产儿神经管缺陷(NTDs)的特征及变化趋势。方法:以医院为基础的监测方法。结果:辽宁省累计NTDs发生率9.99/万,其中男性6.95/万,女性13.15/万,城市5.96/万,农村17.35/万。无脑畸形发生率6年下降73.19%。母龄别发生率为25~29岁组发生率最低;孕妇末次月经在8、9月时出生的男性NTDs高发。NTDs围产儿早产占51.78%,低出生体重占46.92%,围产期病死率为75.08%。结论:辽宁省围产儿NTDs发生率女性高于男性,农村高于城市。男性NTDs发生有季节性流行趋势。NTDs儿围产期病死率高,预后差。加强药物预防、科普宣教和产前诊断是降低其发生率的有效措施。

Study of risk factors in 309 perinatal neural tube defects

The database from Liaoning Province Birth Defects Monitoring Network was used to describe the features and secular trends of neural tube defects (NTDs) prevalence during 1998 to 2003. Methods: Data were collected with hospital-based cluster sampling method. Results: There were 309 cases with NTDs identified from 309 247, with an overall prevalence rate of 9. 99 per 10 000 births. The prevalence rates of NTDs were 6. 95 per 10 000 and 13. 15 per 10 000 in male and female births, respectively, 5. 96 per 10 000 and 17. 35 per 10 000 in the urban and rural areas, respectively. 73. 2 percent falls in prevalence rate of anencephaly during six years. The prevalence was the lowest in the group with maternal age of 25~29 years. The prevalence rate of male NTDs was higher in August and September, estimated by last menstrual period (LMP). Preterm babies and babies with low birth weight accountde for 51.8% and 46. 9% of perinatal babies with NTDs, with a perinatal mortality of 75. 1%. Conclusion: In Liaoning, the occurrence of NTDs was higher in female births than that in male births, higher in the rural than that in the urban. Male babies with NTDs has a seasonal prevalence. Babies with NTDs were in poor birth quality, higher perinatal mortality and poor prognosis. Effective measures of primary prevention and prenatal diagnosis could reduce the occurrences of neural tube defects.