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BMJ：看欧洲神经管缺陷的长期发病率如何

2015-11-25 MedSci MedSci原创

神经管缺陷无脑儿脊柱裂
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本研究旨在探究欧洲神经管缺陷（NTD）发生的长期趋势以及神经管缺陷婴儿的出生率。目前，许多欧洲国家已经推荐孕妇怀孕期间应服用叶酸补充剂，但是强制补充叶酸的政策却并没有制定。

本研究旨在探究欧洲神经管缺陷（NTD）发生的长期趋势以及神经管缺陷婴儿的出生率。目前，许多欧洲国家已经推荐孕妇怀孕期间应服用叶酸补充剂，但是强制补充叶酸的政策却并没有制定。

该观察性研究以人群为基础，纳入了11353例伴染色体异常的NTD病例，包括4162例无脑畸形病例和5776例脊柱裂病例。这些病例均来自1991-2011年的28个EUROCAT注册数据，覆盖了19个国家的近1250万名新生儿。主要结局指标为NTD的总发病率和婴儿活产率，以及无脑儿和脊柱裂的发生率。使用随机效应泊松回归模型来解释注册与样本函数模拟非线性时间趋势的异质性。

总体来看，研究期间NTD总的发病率为9.1/10000胎。这期间NTD的患病率稍有波动，但是并没有明显的下降趋势，2011年NTD的患病率与1991年相似。泊松模型分析显示，考虑了异质性后，1995-1999年NTD的患病率增加了4%，而1999-2003年则每年下降3%，这之后NTD的患病率稳定无大的波动。无脑儿和脊柱裂的发病趋势相似，但是随着时间的推移其发病率并未出现显著下降。NTD的活产率则普遍下降，尤其是无脑儿的活产率下降幅度更大。注册问题及其他的数据问题作为解释所观察到的NTD发病率趋势的部分原因并不能被排除。

总而言之，尽管许多欧洲国家已经推荐孕妇怀孕期间应服用叶酸补充剂，但是在没有强制性的补充叶酸的政策下，NTD的患病率却未有下降。

原始出处：

Babak Khoshnood, Maria Loane, et al. Long term trends in prevalence of neural tube defects in Europe: population based study. BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5949.


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    2016-01-13 ms5906905816781247

    #神经管缺陷#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1635663, encodeId=0b1f163566322, content=<a href='/topic/show?id=23c6e44371b' target=_blank style='color:#2F92EE;'>#神经管缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74437, encryptionId=23c6e44371b, topicName=神经管缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a56c22510318, createdName=ms5906905816781247, createdTime=Wed Jan 13 16:30:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823256, encodeId=46c0182325616, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Dec 22 22:30:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847777, encodeId=8c8b184e7771b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Sep 28 17:30:00 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64484, encodeId=33bb64484a4, content=叶酸补充还是有必要的, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/14/d0501100fdfe783cab0715811e01c133.jpg, createdBy=51ed1602754, createdName=mengli1984, createdTime=Tue Feb 16 20:34:00 CST 2016, time=2016-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338954, encodeId=34ef1338954db, content=<a href='/topic/show?id=447663054f5' target=_blank style='color:#2F92EE;'>#欧洲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63054, encryptionId=447663054f5, topicName=欧洲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Fri Nov 27 04:30:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2015-12-22 lifestar

    #发病率#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1635663, encodeId=0b1f163566322, content=<a href='/topic/show?id=23c6e44371b' target=_blank style='color:#2F92EE;'>#神经管缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74437, encryptionId=23c6e44371b, topicName=神经管缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a56c22510318, createdName=ms5906905816781247, createdTime=Wed Jan 13 16:30:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823256, encodeId=46c0182325616, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Dec 22 22:30:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847777, encodeId=8c8b184e7771b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Sep 28 17:30:00 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64484, encodeId=33bb64484a4, content=叶酸补充还是有必要的, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/14/d0501100fdfe783cab0715811e01c133.jpg, createdBy=51ed1602754, createdName=mengli1984, createdTime=Tue Feb 16 20:34:00 CST 2016, time=2016-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338954, encodeId=34ef1338954db, content=<a href='/topic/show?id=447663054f5' target=_blank style='color:#2F92EE;'>#欧洲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63054, encryptionId=447663054f5, topicName=欧洲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Fri Nov 27 04:30:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2016-09-28 gaoxiaoe

    #BMJ#

    0

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    2016-02-16 mengli1984

    叶酸补充还是有必要的

    0

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    2015-11-27 仁医06

    #欧洲#

    0

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