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目的评价“削峰工程”一级干预措施对神经管缺陷(NTDs)的预防效果。方法随机抽取1998-2012年山西省52个县区出生缺陷监测的数据,监测人群包括活产、死胎死产和因为NTDs引产的妇女。以2002年为间隔点,分析“削峰工程”一级干预措施实施前后NTDs发生率的变化。结果 1998-2012年52个县区共监测围产儿2 710 314例,所有孕周引产和分娩的NTDs16 054例,15年来NTDs发生率总体呈下降趋势,1998-2001年处于平缓期,2002年开始显著下降,时间序列分析有显著的长期效果。乡村、城镇分别下降了112.922/万、40.546/万,无脑儿、脑膨出、脊柱裂分别下降了49.83/万、26.35/万、7.32/万。结论 “削峰工程”一级干预措施对我省NTDs防控作用显著,农村效果优于城镇,对致死性出生缺陷无脑儿干预效果最好。
Objectives To evaluate the preventive effect of Level 1 interventions on neural tube defects (NTDs). Methods Data of monitoring birth defects in 52 counties of Shanxi Province from 1998 to 2012 were randomly selected to monitor the population including live births, stillbirths and women who had induced NTDs. At the interval of 2002, we analyzed the changes of the incidence of NTDs before and after the implementation of the first-level interventions of “cutting peak engineering”. Results A total of 2 710 314 perinatal infants were monitored in 52 counties in 1998-2012. NTDs16 054 were induced during pregnancy and induced labor. The incidence of NTDs tended to decrease from 1998 to 2001, and remained flat during 1998-2001. Significant decline, time series analysis have significant long-term effects. Rural areas and urban areas dropped by 112.922 / million and 40.546 / million, respectively. Brainless, encephalocele and spina bifida decreased by 49.83 / million, 26.35 / million and 7.32 / million respectively. Conclusions The first-level interventions of “cutting peak engineering” have a significant effect on the prevention and control of NTDs in our province, and the effect in rural areas is better than that in urban areas. The intervention effect of no brain injury to fatal birth defects is the best.