Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
Birth Defects Res. 2019 Nov 1;111(18):1420-1435. doi: 10.1002/bdr2.1589. Epub 2019 Oct 3.
Using the National Birth Defects Prevention Network (NBDPN) annual data report, U.S. national prevalence estimates for major birth defects are developed based on birth cohort 2010-2014.
Data from 39 U.S. population-based birth defects surveillance programs (16 active case-finding, 10 passive case-finding with case confirmation, and 13 passive without case confirmation) were used to calculate pooled prevalence estimates for major defects by case-finding approach. Fourteen active case-finding programs including at least live birth and stillbirth pregnancy outcomes monitoring approximately one million births annually were used to develop national prevalence estimates, adjusted for maternal race/ethnicity (for all conditions examined) and maternal age (trisomies and gastroschisis). These calculations used a similar methodology to the previous estimates to examine changes over time.
The adjusted national birth prevalence estimates per 10,000 live births ranged from 0.62 for interrupted aortic arch to 16.87 for clubfoot, and 19.93 for the 12 critical congenital heart defects combined. While the birth prevalence of most birth defects studied remained relatively stable over 15 years, an increasing prevalence was observed for gastroschisis and Down syndrome. Additionally, the prevalence for atrioventricular septal defect, tetralogy of Fallot, omphalocele, and trisomy 18 increased in this period compared to the previous periods. Active case-finding programs generally had higher prevalence rates for most defects examined, most notably for anencephaly, anophthalmia/microphthalmia, trisomy 13, and trisomy 18.
National estimates of birth defects prevalence provide data for monitoring trends and understanding the impact of these conditions. Increasing prevalence rates observed for selected conditions warrant further examination.
利用国家出生缺陷预防网络(NBDPN)年度数据报告,根据 2010-2014 年出生队列,制定了美国主要出生缺陷的国家流行率估计值。
使用来自 39 个美国基于人群的出生缺陷监测项目(16 个主动病例发现、10 个被动病例发现且有病例确认、13 个被动病例发现但无病例确认)的数据,通过病例发现方法计算主要缺陷的汇总流行率估计值。14 个主动病例发现项目(包括至少活产和死胎妊娠结局监测),每年监测大约 100 万例出生,用于制定国家流行率估计值,调整了母体种族/民族(所有检查条件)和母体年龄(三体和腹裂)。这些计算使用与以前估计值相似的方法来研究随时间的变化。
每 10000 例活产的调整后全国出生流行率估计值从主动脉弓中断的 0.62 到马蹄内翻足的 16.87,以及 12 种严重先天性心脏缺陷的 19.93。虽然研究的大多数出生缺陷的出生流行率在 15 年中相对稳定,但腹裂和唐氏综合征的流行率有所增加。此外,在这段时间内,房室间隔缺损、法洛四联症、脐膨出和 18 三体的患病率与前几个时期相比有所增加。主动病例发现项目通常对大多数检查的缺陷具有更高的流行率,尤其是无脑畸形、无眼/小眼畸形、13 三体和 18 三体。
出生缺陷流行率的全国估计值为监测趋势和了解这些情况的影响提供了数据。对于某些选定条件观察到的流行率增加,需要进一步研究。