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  

Declining Rate of Neural Tube Defects and Outcomes of Defective Infants in Shaanxi Province from 2003 to 2022

作　　者：于敏[1] 甘露 马西 平智广[3] YU Min;GAN Lu;MA Xi;PING Zhiguang(Public Health Center,Hospital of Xi’an Jiaotong University,Xi’an 710049,China;Primary Health Care Department,Shaanxi Provincial Maternity and Child Healthcare Hospital,Xi’an 710003,China;Department of Health Statistics,College of Public Health,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]西安交通大学医院公共卫生中心,西安710049 [2]陕西省妇幼保健院基层保健科,西安710003 [3]郑州大学公共卫生学院卫生统计教研室,郑州450001

出　　处：《中国医学科学院学报》2024年第4期513-518,共6页Acta Academiae Medicinae Sinicae

摘　　要：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1106483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 predict 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 surveillance system.Results A total of 1106483 perinatal infants in Shaanxi province from 2003 to 2022 were surveyed,among which NTDs occurred in 848 perinatal infants,with an incidence of 7.66/10000.The incidence was the highest(48.02/10000)in 2005 and the lowest(0.57/10000)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 average 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 0.49/10000,0.41/10000,and 0.35/10000,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.

关 键 词：出生缺陷 神经管缺陷 产前诊断 出生结局 

分 类 号：R1[医药卫生—公共卫生与预防医学]