目的了解１９８８～１９９２年我国神经管缺陷（ＮＴＤ）发生率的变化趋势。方法采用以医院为基础的监测方法收集资料，调查对象为孕２８周至生后７天的围产儿，对１９８８～１９９２年全国３０省市、自治区出生缺陷监测网监测的３２４６４０８例围产儿，７７７８例ＮＴＤ病例进行回顾性分析。结果ＮＴＤ发生率由１９８８年２５３／万下降到１９９２年的１８０／万，５年下降了２８９％，年下降率８２％，农村ＮＴＤ下降幅度为３０５％，城市为２６７％；无脑畸形、脑膨出发生率分别下降了３４２％、４８５％；北方ＮＴＤ下降幅度为３０５％，南方为２７８％。结论我国ＮＴＤ发生率呈下降趋势，农村下降幅度大于城市；无脑畸形、脑膨出发生率下降较快；北方省份下降幅度较南方大 Objective To understand the trend of the incidence of neural tube defects (NTD) in China from 1988 to 1992. Methods A hospital-based monitoring method was used to collect data about 2846408 perinatal babies and 7778 cases of perinatal children monitored during the period from 28 weeks pregnant to 7 days after birth. From 1988 to 1992, NTD cases were retrospectively analyzed. Results The incidence of NTD dropped from 253 / 000 in 1988 to 180,000 in 1992, decreased by 289% in 5 years and decreased by 82% annually. The NTD in rural areas decreased by 305% The city was 26.7%. The incidence of anencephaly and encephalocele was decreased by 342% and 485% respectively. The NTD decline in the north was 305% and that in the south was 278%. Conclusions The incidence of NTD in our country shows a declining trend, and the decline rate in rural areas is larger than that in urban areas. The incidence of anencephaly and encephalocele is declining rapidly. The declining rate of northern provinces is larger than that of southern China