目的了解2008年-2012年余姚市神经管缺陷变化趋势,评价一二级预防出生缺陷干预效果。方法对余姚市2008年至2012年在各级医疗保健机构(包括本地户口在外地医疗机构)孕产妇分娩的围产儿及<28w的治疗性引产儿进行监测。结果余姚市5年间本地户口出生数24 139例,发现神经管缺陷29例,神经管缺陷总发生率为12.01/万,呈逐年下降趋势;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19.3、26.2、20.6w。21例在孕28w前诊断并终止妊娠(占72.41),早期新生儿中的神经管缺陷2例,仅占6.90%。结论对准备怀孕的育龄妇女开展增补小剂量叶酸是降低神经管缺陷发生率的有效措施;孕中期超声产前诊断水平的提高,是降低神经管缺陷儿出生,提高人口素质的关键措施。 Objective To understand the change trend of neural tube defects in Yuyao City from 2008 to 2012 and evaluate the effect of primary and secondary prevention of birth defects. Methods From 2008 to 2012, Yuyao was monitored by perinatal delivery and <28 weeks of therapeutic induced labor in pregnant women at all levels of health care institutions (including local accounts in local medical institutions) from 2008 to 2012. Results In Yuyao City during the five years, there were 24 139 cases of local registered permanent residence, 29 cases of neural tube defects were found, and the total incidence of neural tube defects was 12.01 / million, showing a declining trend year by year. There were 3 kinds of deformities such as anencephaly, spina bifida and encephalocele The average gestational weeks for prenatal diagnosis and termination of pregnancy were 19.3, 26.2 and 20.6 w, respectively. Twenty-one cases were diagnosed and terminated before 28 weeks of gestation (72.41%), and 2 cases of early neural tube defects in newborns accounted for only 6.90%. Conclusion It is an effective measure to reduce the incidence of neural tube defects in women of childbearing age who are pregnant. It is the key measure to reduce the birth of neural tube defects and improve the population quality.