【目的】 了解2002-2010年山东省神经管缺陷(neural tube defects,NTDs) 发生率的变化趋势,为进一步开展预防工作提供依据。 【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 d的围产儿,对2002-2010年全省17市出生缺陷监测网监测的642 282 例围产儿,242 例NTDs 病例进行回顾性分析。 【结果】 NTDs 发生率由2002年6.8/万下降到2010年的2.1/万,9 年下降了69.1%,年下降率13.7%,农村 NTDs 下降幅度为75%,城市为61.1% ;脊柱裂、脑膨出发生率分别下降了70.8% 、80.0%。 【结论】 山东NTDs 发生率呈下降趋势,农村下降幅度大于城市;脊柱裂、脑膨出发生率下降较快,进一步加强预防和产前诊断是降低发生率的有效措施。

【Objective】 To study the variation trend in incidence of neural tube defects (NTDs) during 2002 to 2010 in Shandong Province. 【Methods】 Data were collected by hospital-based monitoring,with women of gestation of 28 weeks to seven days after birth as study subjects.And 642 282 perinates were monitored in the Provincial Birth Defect Monitoring Network in 17 regions all over the province,and 242 cases of NTDs during 2002 to 2010 were recorded and analyzed. 【Results】 Incidence of NTDs was 2.1 per 10 000 in 2010,69.1% reduction from 6.8 per 10 000 in 2002,and yearly average reduction of 13.7%.Incidence of NTDs decreased by 61.1% and 75% in rural and urban areas,respectively,and incidence of spina bifida and encephalocele fell by 70.8% and 80.0%,respectively. 【Conclusions】 Incidence of NTDs showed a falling trend in Shandong province,more decrease in rural areas than in urban areas,and incidences of spina bifida and encephalocele fell faster.Babies with NTDs were in poor birth quality,higher perinatal mortality and poor prognosis.Effective preventive measures and prenatal diagnosis should be strengthened to reduce the occurrences of neural tube defects.