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目的分析北方农村30年间神经管畸形发生率的变动趋势,评价叶酸制剂预防效果。方法在神经管畸形高发区对同一家医院进行30年监测,分三个阶段统计分娩和中期引产的出生缺陷和神经管畸形病例并进行比较。结果 30年间出生缺陷和神经管畸形发生率呈现明显下降趋势。出生缺陷发生率从1978～1985年的34.9‰下降到2008～2010年的11.6‰,神经管畸形从17.4‰下降到2.8‰,下降6倍。2008～2010年引产的出生缺陷发生率和神经管畸形发生率明显增高。结论妇女增补小剂量叶酸既有效地预防神经管畸形的发生,也受到一些限制。B型超声波用于产前诊断,减少了神经管畸形出生率,助生了防治研究新课题。
Objective To analyze the change trend of incidence of neural tube defects in rural areas in northern China for 30 years and evaluate the preventive effect of folic acid preparations. Methods The same hospital was monitored for 30 years in a high risk area of neural tube defects. Birth defects and neural tube defects were observed and compared in three stages in terms of birth defects and neural tube defects. Results 30-year birth defects and the incidence of neural tube defects showed a significant downward trend. The incidence of birth defects dropped from 34.9 ‰ in 1978 ~ 1985 to 11.6 ‰ in 2008 ~ 2010, and the incidence of neural tube defects decreased from 17.4 ‰ to 2.8 ‰, down 6-fold. The incidence of birth defects and the incidence of neural tube defects were significantly increased in 2008-2010. Conclusions Women’s supplement of small dose of folate not only effectively prevented the occurrence of neural tube defects, but also limited them. B-type ultrasound for prenatal diagnosis, reducing the birth rate of neural tube defects, giving birth to a new topic of prevention and treatment.