Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation.
Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation.
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DOI：
10.1002/bdra.23587
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发表时间：
2016-11
期刊：
影响因子：
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通讯作者：
National Birth Defects Prevention Network
中科院分区：
文献类型：
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作者：
Cragan JD;Isenburg JL;Parker SE;Alverson CJ;Meyer RE;Stallings EB;Kirby RS;Lupo PJ;Liu JS;Seagroves A;Ethen MK;Cho SJ;Evans M;Liberman RF;Fornoff J;Browne ML;Rutkowski RE;Nance AE;Anderka M;Fox DJ;Steele A;Copeland G;Romitti PA;Mai CT;National Birth Defects Prevention Network
先天性小头畸形与母亲寨卡病毒感染有关。然而，确定诊断患有小头畸形的婴儿可能具有挑战性。 30 个出生缺陷监测项目提供了 2009 年至 2013 年出生的被诊断患有小头畸形的婴儿的数据。每 10,000 名活产婴儿中小头畸形的汇总患病率是根据孕产妇/婴儿特征进行总体估计的。通过病例发现方法检查了患病率的变化。九个项目提供了有关头围和可能导致小头畸形的状况的数据。小头畸形的汇总患病率为每 10,000 名活产儿 8.7 例。使用主动（6.7）和被动（6.6）方法的方案中的中位患病率（每 10,000 个活产）相似；对于除西班牙裔以外的所有种族/民族类别，使用被动方法的项目中，患病率估计值的十分位数范围更大。患病率（每 10,000 名活产婴儿）在非西班牙裔白人中最低（6.5），在非西班牙裔黑人和西班牙裔中最高（分别为 11.2 和 11.9）；估计值按产妇年龄呈 U 形分布，其中 20 岁以下 (11.5) 和 40 岁以上 (13.2) 的母亲患病率最高。就胎龄和出生体重而言，妊娠<32周和<1500克的婴儿患病率最高。案例定义各不相同； 41.8% 的病例 HC ≥ 性别和孕龄的第 10 个百分位。方法、孕产妇/婴儿特征的人口分布以及小头畸形病例定义的差异可能有助于在各个出生缺陷监测项目中观察到广泛的患病率估计。在寨卡病毒感染的情况下解决这些因素可以提高流行率估计的质量。
Congenital microcephaly has been linked to maternal Zika virus infection. However, ascertaining infants diagnosed with microcephaly can be challenging. Thirty birth defects surveillance programs provided data on infants diagnosed with microcephaly born 2009 to 2013. The pooled prevalence of microcephaly per 10,000 live births was estimated overall and by maternal/infant characteristics. Variation in prevalence was examined across case finding methods. Nine programs provided data on head circumference and conditions potentially contributing to microcephaly. The pooled prevalence of microcephaly was 8.7 per 10,000 live births. Median prevalence (per 10,000 live births) was similar among programs using active (6.7) and passive (6.6) methods; the interdecile range of prevalence estimates was wider among programs using passive methods for all race/ethnicity categories except Hispanic. Prevalence (per 10,000 live births) was lowest among non-Hispanic Whites (6.5) and highest among non-Hispanic Blacks and Hispanics (11.2 and 11.9, respectively); estimates followed a U-shaped distribution by maternal age with the highest prevalence among mothers <20 years (11.5) and ≥40 years (13.2). For gestational age and birth weight, the highest prevalence was among infants <32 weeks gestation and infants <1500 gm. Case definitions varied; 41.8% of cases had an HC ≥ the 10th percentile for sex and gestational age. Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. Addressing these factors in the setting of Zika virus infection can improve the quality of prevalence estimates.