The Changing Epidemiology of Neural Tube Defects

摘要: • Objective. —To describe the recent trends and epidemiologic characteristics of neural tube defects in United States. Research Design. —Ongoing surveillance data. Setting. —Two birth defect systems: nationwide Birth Defects Monitoring Program Metropolitan Atlanta (Ga) Congenital for 1970 through 1989 1968 1989, respectively. Participants. —Between using discharge diagnoses approximately 1 million live-born stillborn infants per year, identified 15503 cases spina bifida anencephaly. Between clinical records until age year 38000 800 Interventions. —None. Measurements/Main Results. —Nationwide, rates have declined from 1.3 1000 births to 0.6 1989. In Atlanta, 2.0 Several changes were observed: (1) proportion has increased; (2) compared with other unrelated (3) race ratio whites races isolated Atlanta; (4) rate females also decreased. Conclusions. —The declining can be partially explained by increased widespread prenatal diagnostic techniques, strongly suggesting role environmental factors defects. particular, use multivitamins folic acid prevent occurrence needs further evaluation. Nevertheless, changing over time points etiologic heterogeneity these conditions. ( AJDC . 1992;146:857-861)