Trends in the postfortification prevalence of spina bifida and anencephaly in the United States
Trends in the postfortification prevalence of spina bifida and anencephaly in the United States
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DOI：
10.1002/bdra.20468
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发表时间：
2008-07-01
影响因子：
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通讯作者：
Mulinare, Joe
中科院分区：
文献类型：
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作者：
Boulet, Sheree L.;Yang, Quanhe;Mulinare, Joe
背景技术背景：在强制性叶酸强化后，美国NTD的患病率显著下降;然而，目前尚不清楚近年来NTD的患病率是否相对于强化后的时期继续下降。方法：从21个出生缺陷监测系统的人口为基础的数据被用来检查1999-2000年，2001-2002年和2003-2004年期间脊柱裂和无脑畸形的出生患病率的趋势。患病率数据按非西班牙裔白色、非西班牙裔黑人和西班牙裔人种或种族分层。流行率的计算方法是，用后来时期（2001-2002年和2003-2004年）的出生率除以1999-2000年期间的出生率。结果：1999-2004年共报告脊柱裂3,311例，无脑畸形2,116例。西班牙裔婴儿的NTD患病率最高的所有年份。从1999-2000年到2003 - 2004年，所有婴儿的脊柱裂和无脑畸形合并出生患病率下降了10%。脊柱裂（3%）的下降并不显著;然而，无脑儿（20%）的下降具有统计学意义。结论：虽然自从开始在食品供应中添加叶酸以来，美国脊柱裂和无脑畸形的发病率有所下降，但这些数据表明，2001-2004年期间，无脑畸形的发病率继续下降，种族和族裔及其他差异仍然存在。
BACKGROUND: The prevalence of NTDs in the US declined significantly after mandatory folic acid fortification; however, it is not known if the prevalence of NTDs has continued to decrease in recent years relative to the period immediately following the fortification mandate. METHODS: Population-based data from 21 birth defects surveillance systems were used to examine trends in the birth prevalence of spina bifida and anencephaly during 1999-2000, 2001-2002, and 2003-2004. Prevalence data were stratified by non-Hispanic White, non-Hispanic Black, and Hispanic race or ethnicity. Prevalence ratios were calculated by dividing the birth prevalences during the later time periods (2001-2002 and 2003-2004) by the birth prevalences during 1999-2000. RESULTS: During 1999-2004, 3,311 cases of spina bifida and 2,116 cases of anencephaly were reported. Hispanic infants had the highest prevalences of NTDs for all years. For all infants, the combined birth prevalences of spina bifida and anencephaly decreased 10% from the 1999-2000 period to the 20032004 period. The decline in spina bifida (3%) was not significant; however the decline in anencephaly (20%) was statistically significant. CONCLUSIONS: While the prevalences of spina bifida and anencephaly in the United States have declined since folic acid fortification in the food supply began, these data suggest that reductions in the prevalence of anencephaly continued during 2001-2004 and that racial and ethnic and other disparities remain.