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目的:了解神经管缺陷变化趋势,评价一二级预防出生缺陷干预效果。方法:利用1996～2011年辽宁省出生缺陷监测网收集到的资料,调查对象为孕28周～产后7天住院分娩的围产儿及孕28周前出生缺陷儿。结果:共收集围产儿1 292 669例,围产期神经管缺陷儿983例,2011年孕28周前神经管缺陷140例;围产儿总神经管缺陷发生率为7.60/万,呈逐年下降趋势。1996～2009年农村神经管缺陷发生率高于城镇,是城镇的2.23倍;2010～2011年城乡神经管缺陷发生率无明显差异。2011年无脑畸形、脊柱裂和脑膨出3种畸形经超声产前诊断并终止妊娠的平均孕周分别为19.8、25.9和21.5周;2011年186例神经管缺陷,140例在孕28周前诊断并终止妊娠(占75.27%),早期新生儿中的神经管缺陷11例,仅占5.91%。结论:辽宁省超声产前诊断水平显著提高,达到发达国家水平;增补小剂量叶酸以及孕中期超声筛查等一二级干预措施是降低神经管缺陷发生率、提高城市人口素质的有效途径。
Objective: To understand the trend of neural tube defects and evaluate the effect of primary and secondary prevention of birth defects. Methods: The data collected from the Birth Defects Monitoring Network of Liaoning Province from 1996 to 2011 were collected from 28 weeks of gestation to 7 days of postnatal hospitalization and birth defects before 28 weeks of gestation. Results: A total of 1 292 669 perinatal infants, 983 children with perinatal neural tube defects and 140 cases of neural tube defects 28 weeks before 2011 were collected. The incidence of perinatal total neural tube defects was 7.60 / million, showing a declining trend year by year . From 1996 to 2009, the incidence of neural tube defects in rural areas was higher than that of urban areas, which was 2.23 times that of urban areas. There was no significant difference in the incidence of neural tube defects in urban and rural areas between 2010 and 2011. 2011 anomalies, spina bifida and encephalocele three kinds of abnormalities by ultrasound prenatal diagnosis and termination of pregnancy average gestational age were 19.8,25.9 and 21.5 weeks; 186 cases of neural tube defects in 2011, 140 cases of 28 weeks pregnant Pre-diagnosis and termination of pregnancy (75.27%), early neonatal neural tube defects in 11 cases, accounting for only 5.91%. Conclusion: The prenatal diagnosis of ultrasonography in Liaoning Province was significantly improved to reach the level of developed countries. Supplementing small doses of folic acid and second and third trimester ultrasound screening is an effective way to reduce the incidence of neural tube defects and improve the quality of urban population.