欧洲关于产前检查并终止妊娠对出生缺陷监测发生率影响的资料分析

Impact of Prenatal Detection and Termination of Pregnancy on Prevalence of Birth Defects in Europe

目的：通过对欧洲数据评估产前检查并终止妊娠对出生缺陷监测发生率的影响，以期为中国开展出生缺陷干预研究提供参考依据。方法：利用欧洲出生缺陷登记中心1980～2002年监测数据，以SPSS10．0进行描述性分析，Epi000进行趋势x^2检验。结果：1980～2002年欧洲出生缺陷发生率平均为215．81／万，产前检查并终止妊娠病例在总病例中的构成比平均为13．70％，从3．97％（1980～1984年）上升到18．49％（2000-2002年）。不同缺陷类型产前检查并终止妊娠病例构成比均明显增加，趋势x^2检验均有显著统计学意义（P〈0．01），其中，染色体异常和神经系统缺陷的升幅最大，分别从11．18％和17．07％（1980～1984年）上升到55．62％和51．19％（2000～2002年）；而眼畸形、腭裂和先天性心脏病的上升速度较慢，分别从1．16％、2．16％和1．72％上升到7．36％、7．83％和10．82％。结论：产前检查并终止妊娠的病例占出生缺陷总数的1／5，染色体异常和神经系统缺陷超过50％。在出生缺陷监测项目应该考虑产前检查并终止妊娠对监测发生率的影响。

Objective ： To understand the impact of prenatal detecttion and termination of pregnancy （TOP） on the prevalence of birth defects in Europe. Methods ： Data of birth defects in 1980 - 2002 from 36 registered members in European Congenital Anomalies and Twins were analyzed by SPSS10.0 and chi square for trend by EPI 2000. Besults： The average incidence of birth defects was 215.81 per 10,000 births during twenty years in Europe. The mean proportion of TOP accounted for 13.70%, which increased from 3.97% （ 1980 - 1984） to 18.49% （2000 - 2002）. The proportion of TOP for different type of birth defects was rising, and chi square for trend was significant （P 〈 0.01 ）. The increasing of TOP for different birth defects was various, highest for chromosomal anomalies and neural defect, and their proportion rose from 11.18% and 17.07% （ 1980 - 1984） to 55.62% and 51.19% （2000 - 2002）, respectively. While proportion of TOP for eye abnormality, cleft palate and congenital heart defects rose from 1.16%, 2.16% and 1.72% to 7.36%, 7.83% and 10. 82% with lower speed, respectively. Conclusion： It shows almost 1/5 cases of TOP, and over 50% birth defects are chromosomal anomalies and neural defect in Europe. The impact of TOP on the prevalence of birth defects couldnt be neglected in birth defects monitoring program in China.