Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. An...Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. Analyses were conducted of occurrence of 16 specific categories of birth defects and developmental disabilities. Children were categorized as conceived before and after the start of participants’ Vietnam War service. Children conceived before the start of Vietnam War service were treated as being conceived when their fathers had unquantifiable dioxin values. Children conceived after the start of Vietnam War service for participants with missing dioxin values were excluded from primary analyses, but were used to assess the impact of their exclusion on conclusions. Correlation between values for specific categories for multiple children fathered by the same participant was accounted for. The dose-response relationship was treated as a step function increasing for dioxin values larger than adaptively identified individual thresholds changing with the specific category. Results: For 15 of 16 specific categories, the probability of occurrence increased substantially for a sufficiently high dioxin level above identified thresholds. Exclusion of children due to missing dioxin likely did not affect these results. Conclusions: Results supported the conclusion of substantial adverse effects on a wide variety of specific categories of birth defects and developmental disabilities due to sufficiently high exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War. Results may hold more generally, but might also have been affected by a variety of limitations.展开更多
Objective To investigate the association between birth defects and dietary nutrient intake in a high risk area of China. Methods A dietary survey was performed and serum folic acid was measured in women whose pregnanc...Objective To investigate the association between birth defects and dietary nutrient intake in a high risk area of China. Methods A dietary survey was performed and serum folic acid was measured in women whose pregnancy was affected by neural tube defects (NTDs) or unaffected by any birth defects (BDs) in Zhongyang and Jiaokou Counties in Shanxi Province of China. ResuIts The local average consumption of foods including dark green vegetables, fruits, fat and meat, and nutrient intake (e.g. energy, protein, retinol, riboflavin, vitamin E, and selenium) were lower than the national average level. In women of childbearing age, these regions, the intake of nutrients was much lower than the recommended nutrient intake (9%-77%). The case-control dietary nutrition study of women whose pregnancy was affected by BDs (including NTDs and congenital heart defects) demonstrated that, in early pregnancy, adequate nutrition (i.e. eating meat, fresh vegetables, fruit more than once a week) was a protective factor, while eating germinated potatoes was a risk factor. The geometrical mean (pS- p95) of serum folic acid in women with NTD birth defects was 9.6 nmol/L (3.6, 23.03), which was significantly lower than that in normal women (14.03 nmol/L). Conclusion Women of childbearing age in the two counties of Shanxi Province, China, have a marked insufficient intake of some nutrients, especially folic acid, zinc, vitamins A and B12. This nutrient deficiency may be an important risk factor for the high prevalence of birth defects in these regions. Therefore, adequate dietary nutrition in early pregnancy can prevent BDs.展开更多
Objective To describe the temporal trends and spatial patterns of birth defects occurring in Wuxi, a developed region of China. Methods Wavelet analysis was used to decompose the temporal trends of birth defect preval...Objective To describe the temporal trends and spatial patterns of birth defects occurring in Wuxi, a developed region of China. Methods Wavelet analysis was used to decompose the temporal trends of birth defect prevalence based on the birth defect rates over the past 16 years. Birth defect cases with detailed personal and family information were geo-coded and the relative risk in each village was calculated. General G statistic was used to test the spatial property with different scales. Results Wavelet analysis showed an increasing temporal trend of birth defects in this region. Clustering analysis revealed that changes continued in the spatial patterns with different scales. Conclusion Wuxi is confronted with severe challenges to reduce birth defect prevalence. The risk factors are stable and show no change with spatial scale but an increasing temporal trend. Interventions should be focused on villages with a higher prevalence of birth defects.展开更多
Objective To explore the "3+1" monitoring mode for birth defects and quality control measures based on the population, and to obtain the related information data for birth defects.Methods With the community populat...Objective To explore the "3+1" monitoring mode for birth defects and quality control measures based on the population, and to obtain the related information data for birth defects.Methods With the community population as the basis, adopting the unified monitoring scheme dominant by the leadership and administration of government, with districts (counties) as the monitoring sites, the "3+1 " monitoring mode for birth defects was based on a complete monitoring team with the combination of villages/residents' committees, townships (towns), counties (districts) and the municipality. Demonstration research was carried out in the pilot districts/counties in Chongqing City.Results Birth defects population monitoring system based on population and family planning management and service network was established, and during 2005 and 2006.application research was carried out for the monitoring methods among birth defects population in the pilot districts (counties), obtaining the relevant information in regional birth defects, with a monitoring coverage of over 99%. Conclusion Fully utilizing the birth management functions of Population and Famlty Planning System and the advantages of service networks, long term, dynamic birth defects monitoring system based on community population was established, with the integration of birth defects monitoring and regular reproductive health services, obtaining overall birth defects occurrence information in details, providing scientific basis for the government to formulate scientific, practical, economic and effective birth defects intervention policy, so as to improve the quality of the population.展开更多
Objective To provide evidence for more accurate diagnosis of birth defects based on the pathoauatomy of congenital malformations. Methods Data used in this study were obtained fi'om Luliang City Hospital and three co...Objective To provide evidence for more accurate diagnosis of birth defects based on the pathoauatomy of congenital malformations. Methods Data used in this study were obtained fi'om Luliang City Hospital and three county hospitals of Shanxi province between February 2004 and March 2006. Autopsy and pathological examination of 160 dead fetuses and stillbirths were performed. Photos of dead fetuses and stillbirths were taken, tissues were cut into sections for pathological examination under microscope, all pathological information was recorded, and percentage of birth defects was calculated. Results The proportion of dead fetuses and stillbirths with or without congenital malformations was 84.4% (135/160) and 15.6% (25/160), respectively. There were 16 categories of major external and internal birth defects in 135 cases of such defects. Congenital heart defects, anencephaly and spina bifida had a higher prevalence rate in the study period. The prevalence rate of non-malformation death and birth defects 〈 28 gestational weeks and internal anomalies ≥ 28 gestational weeks was 14.61% (61/4175) and 17.25% (72/4175), respectively. A total of 413 in situ anomalies were found in 135 cases of autopsy. Spina bifida, anencephaly, congenital heart defects, aplasia or accessory lobe of lung, renal agenesis and dysplasis and congenital hydrocephaly were more closely associated with severe malformations than with mitis malformations. The cases of dead fetuses and stillbirths with multiple malformations (/〉 2 in situ anomalies) had a higher proportion (74.1%), whereas those with isolated malformations had a lower proportion (25.93%). Conclusion The occurrence of congenital malformations in different embryonic developmental stages affects multiple organs. Postmortem examination of internal and multiple malformations of fetal deaths and stillbirths can provide more accurate diagnostic information for birth defects.展开更多
Information was obtained from the same questionnaire (23 risk factors listed) of cases and controls. We used a multivariate logistic model, which described variables significantly increased risk of birth defects....Information was obtained from the same questionnaire (23 risk factors listed) of cases and controls. We used a multivariate logistic model, which described variables significantly increased risk of birth defects. The risk factors included maternal educational levels, medicine taken during pregnancy and antenatal care. It was suggested to strengthen antenatal care was the main preventive measure against birth defects.展开更多
Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases...Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases of singleton deliver by infertile patients under 35 years old who received IVF/ICSI-ET in our center were analyzed.According to different fertilization methods,they were divided into IVF group(2967 cases)and ICSI group(1262 cases).The general situation of birth,birth defects and the location of defects were compared between the two groups.Results:a total of 38 cases of neonatal birth defects were found,the incidence of birth defects was 0.89%,including 30 cases(1.01%)in IVF group and 8 cases(0.64%)in ICSI group.There was no significant difference in the incidence of birth defects between the two groups(P>0.05).There was also no significant difference in birth weight,gestational age and gender ratio between the two groups(P>0.05).Conclusion:Different fertilization methods in assisted reproductive technology do not increase the incidence of neonatal birth defects.展开更多
The purpose of this article is to provide an overview of adaptive regression modeling and demonstrate its use in conducting nonlinear analyses of interrupted time series (ITS) data. Adaptive regression modeling is bas...The purpose of this article is to provide an overview of adaptive regression modeling and demonstrate its use in conducting nonlinear analyses of interrupted time series (ITS) data. Adaptive regression modeling is based on heuristic search over alternative models for data controlled by likelihood-cross validation (LCV) scores with larger scores indicating better models. Extended linear mixed models are used for correlated data like ITS data. Power transforms of predictor variables are used to account for nonlinearity. The use of adaptive regression modeling for assessing ITS effects is demonstrated using data on annual proportions of major birth defects in children fathered by male Air Force veterans of the Vietnam War over a 59-year period. The interruption for this ITS is conception after versus before the start of a participant’s first tour in the Vietnam War. Whether the ITS effect is related to dioxin exposure is also addressed. Dioxin is a highly toxic contaminant of the herbicide Agent Orange used in the Vietnam War. The core findings of the reported analyses are that a substantial adverse ITS interruption effect is identified and that this adverse effect can reasonably be attributed to participants having a high dioxin exposure level. Moreover, these results indicate that adaptive regression modeling can identify nonlinear ITS effects in general situations that can lead to consequential insights into nonlinear relationships over time, possibly varying with other available predictors.展开更多
The paper expounds the community maternity service system against birth defects, from the viewpoint of individualized service in family planning. We have utilized modern information technology to develop health manage...The paper expounds the community maternity service system against birth defects, from the viewpoint of individualized service in family planning. We have utilized modern information technology to develop health management information (HMI) network with individualized maternity, and to establish the community service system for intervention of birth dejects. The service system applied the concept of modern health management information to implementing informational management for screening, treatment, following up, outcome monitoring, so as to provide a base for promotion of health, diagnosis, treatment as well as scientific research, with the prenatal screening of Down's syndrome as a model. The introduction to informational network during the processes of service has been carried out with regards to its composition, function and application, while introducing the effects of computerized case record individualized in prevention, management and research of Down's syndrome.展开更多
Objective::To investigate the roles of transcription factors (TFs) in the etiology of complex human birth defects, including neural tube defects (NTDs), congenital heart diseases (CHDs), and hypospadias.Methods::We ex...Objective::To investigate the roles of transcription factors (TFs) in the etiology of complex human birth defects, including neural tube defects (NTDs), congenital heart diseases (CHDs), and hypospadias.Methods::We examined the overlap of genetically associated genes among NTDs, CHDs, and hypospadias. We then compared the expression profiles of these diseases based on all the detected genes and disease-associated TFs. The differentially expressed TFs that we obtained were further subjected to functional enrichment analysis to elucidate their role in the development of these birth defects.Results::TF genes were significantly enriched in complex birth defects ( P= 5.95 × 10^(-24)). NTDs, CHDs, and hypospadias showed distinct gene expression profiles compared with the controls. Although TFs could not efficiently separate CHDs from normal subjects, distinct gene expression profiles of TFs could distinguish NTDs and hypospadias from controls. Differentially expressed TFs can be used to characterize NTDs, hypospadias, and controls. The enriched TFs in biological processes (BPs) reflected the different morphological processes of NTDs, CHDs, and hypospadias. Conclusions::This study indicates that abnormal expression patterns of specific TFs may disrupt the normal requirements for developmental equilibrium through the related BPs. The investigation of genetically associated genes and gene expression profiles for the three different complex birth defects provides new insights into how the dysregulation of TFs influences their developmental process.展开更多
Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify...Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART (IVF and for ICSI) compared with those spontaneously conceived and also compared birth defects between subgroups of lVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk (RR) estimated for these studies ranged from 0.44 to 5.51, a signifieantly increased risk of birth defects was observed (RR=l.36, 95%CI=1.25-1.47) in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects (RR=0.90, 95%CI=0.80 1.02), but ICSI had a higher risk in subgroups of clinical research (RR=O. 76, 95%CI=0.65-0.89) and crude RR value (RR=O. 78, 95%CI=0.67 0.91). Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or 1CS1 using a summative analysis, however, 1CS1 had a significant higher risk in birth defect risk comparing with 1VF when using subgroup analyses of sample size and RR value.展开更多
Beijing will host the Second International Conference on Birth Defects and Disabilities in the Developing World from September 11 to 14, with estimated 1,200 participants from dozens of countries, an official with the...Beijing will host the Second International Conference on Birth Defects and Disabilities in the Developing World from September 11 to 14, with estimated 1,200 participants from dozens of countries, an official with the organizing committee said here Thursday.展开更多
A case-control study was conducted in 36 hospitals of the urban and suburban areas of shanghai about the relationships between birth defects and drug use and chemical exposures during pregnancy in the period of july 1...A case-control study was conducted in 36 hospitals of the urban and suburban areas of shanghai about the relationships between birth defects and drug use and chemical exposures during pregnancy in the period of july 1987-December 1990.The case group was composed if 1,609 subjects,and the control group 3,218 cases.On stall'stical analysl's,it was.found that a correlation ed'sted between birth defects and the intake Of APC and diazepam,and the exposure to pesticides,organic solvents.benzene,synthetic resin and physical.factors(noises)on foe part of foe mother.and the exposure to harmful chemicals and physical factors and the smoking of 20 or more cigarettes a day on the part Of the father.It is also found that foe familial heredilary history of the parents and multigravavidity,malnutrition,common colds,hepatitis and diarrhea during pregnancy may also be relaied to the birth defects.展开更多
NERVIDUCT malformation caught the attention of the Chinese government in 1983 when professor Yan Renying, now director of the China Maternal and Infant Health Care Center, conducted an epidemiological survey of new-bo...NERVIDUCT malformation caught the attention of the Chinese government in 1983 when professor Yan Renying, now director of the China Maternal and Infant Health Care Center, conducted an epidemiological survey of new-borns in Shunyi County, Beijing, and discovered that one-third of infant mortality in the area was caused展开更多
Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiagnosed, lifelong developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around ...Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiagnosed, lifelong developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around seven years of age. The most severe outcome in cases of FASD is mortality. The purpose of this scoping review is to 1) use a systematic review to provide an estimated mortality proportion for children with FASD, and 2) update a study published in 2014 by reviewing published reports of mortality in individuals diagnosed with FASD. Method: A search of PubMed, CINAHL, and Google Scholar for reports published between 2013 and 2023 on mortality in individuals with FASD. Results: Three population-based studies have reported on all-cause mortality rates, finding a combined mortality rate of 10.9%, a 2.63 fold (95% CI: 2.61 to 2.65) increase in mortality risk over the general population. Since 2016, this review identified only eight new cases meeting the study inclusion criteria. The reported causes of death were five cases of pneumonia, and one case each of failure to thrive and dehydration, intestinal dilatation and asphyxiation caused by overeating due to pica, and acute gastric volvulus. Discussion: While current research suggests a diagnosis of FASD is associated with a 2.6-fold increase in mortality risk, this is likely an underestimation, as most cases of FASD-related mortality go unreported. Globally, about 1 new case is reported every 15 months. However, in the United States alone, between 1752 to 4400 FASD related deaths occur annually. Our review suggests that FASD is rarely identified as a causal or contributing factor in deaths of children and adolescents, resulting in a substantial undercount of FASD-related deaths. Increased attention to the role of FASD in infant and child mortality case reviews, child death review committee reports, and mortality reviews is needed.展开更多
This study is to assess the prevalence rates spatial pattern of neural tube defects with geographic information system and spatial filtering technique. A total of 80 infants who diagnosed from neural tube defects in t...This study is to assess the prevalence rates spatial pattern of neural tube defects with geographic information system and spatial filtering technique. A total of 80 infants who diagnosed from neural tube defects in the area being studied between 1998 and 2001 were analyzed. Firstly, the geographic information system (GIS) software ArcGIS was used to map the crude prevalence rates. Secondly, the data were smoothed by the method of spatial filtering. We evaluated that the effect of changes in spatial filtering radius size was assessed by creating maps based on various filtering radius sizes. The 3 miles or larger filtering radius gives better section variability than the 2 and 2.5 miles or smaller ones. The maps produced by the spatial filtering technique indicate that prevalence rates in the villages in the southeastern region are to produce higher prevalence than that in the other regions. The smoothed maps based on Heshun County display a more adequate data representation than the raw prevalence rate map.展开更多
Abstract Objective To develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world. Methods The region of interest in this stud...Abstract Objective To develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world. Methods The region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes. Results The algorithm was easy to apply, with the accuracy of the results being 69.5%+7.02% at the 95% confidence level. Conclusion The proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.展开更多
A child born with untreatable birth defect encounters constant challenges in lifetime. Spina bifida is such type of defect mainly affecting neural tube. As a result, a child with spina bifida faces abnormal physical a...A child born with untreatable birth defect encounters constant challenges in lifetime. Spina bifida is such type of defect mainly affecting neural tube. As a result, a child with spina bifida faces abnormal physical appearance to neurological dysfunctions. The incident rate of such birth defect is relatively common compared to other birth defects, therefore, an awareness among people is necessary to avoid such vulnerability. Therefore, this article provides a general outline of symptoms, types, risk factors, pathophysiology, preventive and therapeutic strategies of spina bifida which will help the general people for better understanding of the disease and be able to take precautions to combat such defect.展开更多
Objective To determine the prevalence and determinants of folic acid(FA)supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.Methods This was a cross-sectional study based on t...Objective To determine the prevalence and determinants of folic acid(FA)supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.Methods This was a cross-sectional study based on the Shanghai PreConception Cohort(SPCC)study.Data on FA supplementation and socio-demographic features were collected using questionnaires.Couples visiting clinics for pre-pregnancy examination and pregnant women at<14 gestational weeks were recruited in Shanghai,China,between March 2016 and September 2018.Results Among the pregnancy planners,42.4%(4,710/11,099)women and 17.1%(1,377/8,045)men used FA supplements,while 93.4%(14,585/15,615)of the pregnant women used FA supplements.FA supplement use was higher in female pregnancy planners who were older(RR:1.13,95%CI:1.08–1.18),had higher education(RR:1.71,95%CI:1.53–1.92),and were residing in urban districts(RR:1.06,95%CI:1.01–1.11)of FA supplementation;female pregnancy planners with alcohol consumption(RR:0.95,95%CI:0.90–0.99)had lower odds of FA supplementation.In early pregnancy,women with higher educational level(RR:1.04,95%CI:1.03–1.06),who underwent pre-pregnancy examination(RR:1.02,95%CI:1.01–1.03)had higher odds of using an FA supplement;older aged(RR:0.99,95%CI:0.98–0.99),and multigravida(RR:0.97,95%CI:0.96–0.98)had lower odds of FA supplementation.Conclusion Although the majority of pregnant women took FA supplements,more than half of the women planning for pregnancy did not.Urgent strategies are needed to improve pre-conception FA supplementation.展开更多
文摘Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. Analyses were conducted of occurrence of 16 specific categories of birth defects and developmental disabilities. Children were categorized as conceived before and after the start of participants’ Vietnam War service. Children conceived before the start of Vietnam War service were treated as being conceived when their fathers had unquantifiable dioxin values. Children conceived after the start of Vietnam War service for participants with missing dioxin values were excluded from primary analyses, but were used to assess the impact of their exclusion on conclusions. Correlation between values for specific categories for multiple children fathered by the same participant was accounted for. The dose-response relationship was treated as a step function increasing for dioxin values larger than adaptively identified individual thresholds changing with the specific category. Results: For 15 of 16 specific categories, the probability of occurrence increased substantially for a sufficiently high dioxin level above identified thresholds. Exclusion of children due to missing dioxin likely did not affect these results. Conclusions: Results supported the conclusion of substantial adverse effects on a wide variety of specific categories of birth defects and developmental disabilities due to sufficiently high exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War. Results may hold more generally, but might also have been affected by a variety of limitations.
基金National "973"Project on Population and Health (No. 2001CB5103)National Healthy Baby Promotion Program (No. FP2000NO13)+1 种基金Education Ministry Key Program (No. 02185)National Yangzi Scholar Program, 211 and 985 Projects of Peking University (No. 20020903)
文摘Objective To investigate the association between birth defects and dietary nutrient intake in a high risk area of China. Methods A dietary survey was performed and serum folic acid was measured in women whose pregnancy was affected by neural tube defects (NTDs) or unaffected by any birth defects (BDs) in Zhongyang and Jiaokou Counties in Shanxi Province of China. ResuIts The local average consumption of foods including dark green vegetables, fruits, fat and meat, and nutrient intake (e.g. energy, protein, retinol, riboflavin, vitamin E, and selenium) were lower than the national average level. In women of childbearing age, these regions, the intake of nutrients was much lower than the recommended nutrient intake (9%-77%). The case-control dietary nutrition study of women whose pregnancy was affected by BDs (including NTDs and congenital heart defects) demonstrated that, in early pregnancy, adequate nutrition (i.e. eating meat, fresh vegetables, fruit more than once a week) was a protective factor, while eating germinated potatoes was a risk factor. The geometrical mean (pS- p95) of serum folic acid in women with NTD birth defects was 9.6 nmol/L (3.6, 23.03), which was significantly lower than that in normal women (14.03 nmol/L). Conclusion Women of childbearing age in the two counties of Shanxi Province, China, have a marked insufficient intake of some nutrients, especially folic acid, zinc, vitamins A and B12. This nutrient deficiency may be an important risk factor for the high prevalence of birth defects in these regions. Therefore, adequate dietary nutrition in early pregnancy can prevent BDs.
基金the National "973" Project on Population and Health (No. 2007CB5119001)the National Yang Zi Scholar Program,211 and 985 Projects of Peking University (No. 20020903)
文摘Objective To describe the temporal trends and spatial patterns of birth defects occurring in Wuxi, a developed region of China. Methods Wavelet analysis was used to decompose the temporal trends of birth defect prevalence based on the birth defect rates over the past 16 years. Birth defect cases with detailed personal and family information were geo-coded and the relative risk in each village was calculated. General G statistic was used to test the spatial property with different scales. Results Wavelet analysis showed an increasing temporal trend of birth defects in this region. Clustering analysis revealed that changes continued in the spatial patterns with different scales. Conclusion Wuxi is confronted with severe challenges to reduce birth defect prevalence. The risk factors are stable and show no change with spatial scale but an increasing temporal trend. Interventions should be focused on villages with a higher prevalence of birth defects.
基金The research has been C1 Project of the Three Major Programs in the Family Planning/High Quality Reproductive Health Services by the National Population and Family Planning Commission(2005C1-46)one of the key projects funded for social development by the Science & Technology Commission of Chongqing Municipality (8306-CSTC, 2004AC5018)
文摘Objective To explore the "3+1" monitoring mode for birth defects and quality control measures based on the population, and to obtain the related information data for birth defects.Methods With the community population as the basis, adopting the unified monitoring scheme dominant by the leadership and administration of government, with districts (counties) as the monitoring sites, the "3+1 " monitoring mode for birth defects was based on a complete monitoring team with the combination of villages/residents' committees, townships (towns), counties (districts) and the municipality. Demonstration research was carried out in the pilot districts/counties in Chongqing City.Results Birth defects population monitoring system based on population and family planning management and service network was established, and during 2005 and 2006.application research was carried out for the monitoring methods among birth defects population in the pilot districts (counties), obtaining the relevant information in regional birth defects, with a monitoring coverage of over 99%. Conclusion Fully utilizing the birth management functions of Population and Famlty Planning System and the advantages of service networks, long term, dynamic birth defects monitoring system based on community population was established, with the integration of birth defects monitoring and regular reproductive health services, obtaining overall birth defects occurrence information in details, providing scientific basis for the government to formulate scientific, practical, economic and effective birth defects intervention policy, so as to improve the quality of the population.
基金funded by National"973"project on Population and Health(No.2007CB511901)China Postdoctoral Science Fundation Funded Project(No.200801016)+2 种基金National Health Baby Promotion Program(No.FP2000NO13)Education Ministry Key Program(No.02185)National Yang Zi Scholar Program,211 and 985 projects of Peking University(No.20020903)
文摘Objective To provide evidence for more accurate diagnosis of birth defects based on the pathoauatomy of congenital malformations. Methods Data used in this study were obtained fi'om Luliang City Hospital and three county hospitals of Shanxi province between February 2004 and March 2006. Autopsy and pathological examination of 160 dead fetuses and stillbirths were performed. Photos of dead fetuses and stillbirths were taken, tissues were cut into sections for pathological examination under microscope, all pathological information was recorded, and percentage of birth defects was calculated. Results The proportion of dead fetuses and stillbirths with or without congenital malformations was 84.4% (135/160) and 15.6% (25/160), respectively. There were 16 categories of major external and internal birth defects in 135 cases of such defects. Congenital heart defects, anencephaly and spina bifida had a higher prevalence rate in the study period. The prevalence rate of non-malformation death and birth defects 〈 28 gestational weeks and internal anomalies ≥ 28 gestational weeks was 14.61% (61/4175) and 17.25% (72/4175), respectively. A total of 413 in situ anomalies were found in 135 cases of autopsy. Spina bifida, anencephaly, congenital heart defects, aplasia or accessory lobe of lung, renal agenesis and dysplasis and congenital hydrocephaly were more closely associated with severe malformations than with mitis malformations. The cases of dead fetuses and stillbirths with multiple malformations (/〉 2 in situ anomalies) had a higher proportion (74.1%), whereas those with isolated malformations had a lower proportion (25.93%). Conclusion The occurrence of congenital malformations in different embryonic developmental stages affects multiple organs. Postmortem examination of internal and multiple malformations of fetal deaths and stillbirths can provide more accurate diagnostic information for birth defects.
文摘Information was obtained from the same questionnaire (23 risk factors listed) of cases and controls. We used a multivariate logistic model, which described variables significantly increased risk of birth defects. The risk factors included maternal educational levels, medicine taken during pregnancy and antenatal care. It was suggested to strengthen antenatal care was the main preventive measure against birth defects.
基金Major Science and Technology Project of Hainan Province(No.ZDKJ2017007)Key Research and Development Project of Hainan Provincial Science and Technology Department(No.ZDYF2019158)Scientific Research Project of Health and Family Planning Industry in Hainan Province(No.19A200124)。
文摘Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases of singleton deliver by infertile patients under 35 years old who received IVF/ICSI-ET in our center were analyzed.According to different fertilization methods,they were divided into IVF group(2967 cases)and ICSI group(1262 cases).The general situation of birth,birth defects and the location of defects were compared between the two groups.Results:a total of 38 cases of neonatal birth defects were found,the incidence of birth defects was 0.89%,including 30 cases(1.01%)in IVF group and 8 cases(0.64%)in ICSI group.There was no significant difference in the incidence of birth defects between the two groups(P>0.05).There was also no significant difference in birth weight,gestational age and gender ratio between the two groups(P>0.05).Conclusion:Different fertilization methods in assisted reproductive technology do not increase the incidence of neonatal birth defects.
文摘The purpose of this article is to provide an overview of adaptive regression modeling and demonstrate its use in conducting nonlinear analyses of interrupted time series (ITS) data. Adaptive regression modeling is based on heuristic search over alternative models for data controlled by likelihood-cross validation (LCV) scores with larger scores indicating better models. Extended linear mixed models are used for correlated data like ITS data. Power transforms of predictor variables are used to account for nonlinearity. The use of adaptive regression modeling for assessing ITS effects is demonstrated using data on annual proportions of major birth defects in children fathered by male Air Force veterans of the Vietnam War over a 59-year period. The interruption for this ITS is conception after versus before the start of a participant’s first tour in the Vietnam War. Whether the ITS effect is related to dioxin exposure is also addressed. Dioxin is a highly toxic contaminant of the herbicide Agent Orange used in the Vietnam War. The core findings of the reported analyses are that a substantial adverse ITS interruption effect is identified and that this adverse effect can reasonably be attributed to participants having a high dioxin exposure level. Moreover, these results indicate that adaptive regression modeling can identify nonlinear ITS effects in general situations that can lead to consequential insights into nonlinear relationships over time, possibly varying with other available predictors.
文摘The paper expounds the community maternity service system against birth defects, from the viewpoint of individualized service in family planning. We have utilized modern information technology to develop health management information (HMI) network with individualized maternity, and to establish the community service system for intervention of birth dejects. The service system applied the concept of modern health management information to implementing informational management for screening, treatment, following up, outcome monitoring, so as to provide a base for promotion of health, diagnosis, treatment as well as scientific research, with the prenatal screening of Down's syndrome as a model. The introduction to informational network during the processes of service has been carried out with regards to its composition, function and application, while introducing the effects of computerized case record individualized in prevention, management and research of Down's syndrome.
基金This work was supported by grants from the National Natural Science Foundation of China(81870459,81970572.Dr.Yun-Ping Lei was supported by NIH grant HD100535,HD098131,and HD083809).
文摘Objective::To investigate the roles of transcription factors (TFs) in the etiology of complex human birth defects, including neural tube defects (NTDs), congenital heart diseases (CHDs), and hypospadias.Methods::We examined the overlap of genetically associated genes among NTDs, CHDs, and hypospadias. We then compared the expression profiles of these diseases based on all the detected genes and disease-associated TFs. The differentially expressed TFs that we obtained were further subjected to functional enrichment analysis to elucidate their role in the development of these birth defects.Results::TF genes were significantly enriched in complex birth defects ( P= 5.95 × 10^(-24)). NTDs, CHDs, and hypospadias showed distinct gene expression profiles compared with the controls. Although TFs could not efficiently separate CHDs from normal subjects, distinct gene expression profiles of TFs could distinguish NTDs and hypospadias from controls. Differentially expressed TFs can be used to characterize NTDs, hypospadias, and controls. The enriched TFs in biological processes (BPs) reflected the different morphological processes of NTDs, CHDs, and hypospadias. Conclusions::This study indicates that abnormal expression patterns of specific TFs may disrupt the normal requirements for developmental equilibrium through the related BPs. The investigation of genetically associated genes and gene expression profiles for the three different complex birth defects provides new insights into how the dysregulation of TFs influences their developmental process.
文摘Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART (IVF and for ICSI) compared with those spontaneously conceived and also compared birth defects between subgroups of lVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk (RR) estimated for these studies ranged from 0.44 to 5.51, a signifieantly increased risk of birth defects was observed (RR=l.36, 95%CI=1.25-1.47) in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects (RR=0.90, 95%CI=0.80 1.02), but ICSI had a higher risk in subgroups of clinical research (RR=O. 76, 95%CI=0.65-0.89) and crude RR value (RR=O. 78, 95%CI=0.67 0.91). Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or 1CS1 using a summative analysis, however, 1CS1 had a significant higher risk in birth defect risk comparing with 1VF when using subgroup analyses of sample size and RR value.
文摘Beijing will host the Second International Conference on Birth Defects and Disabilities in the Developing World from September 11 to 14, with estimated 1,200 participants from dozens of countries, an official with the organizing committee said here Thursday.
文摘A case-control study was conducted in 36 hospitals of the urban and suburban areas of shanghai about the relationships between birth defects and drug use and chemical exposures during pregnancy in the period of july 1987-December 1990.The case group was composed if 1,609 subjects,and the control group 3,218 cases.On stall'stical analysl's,it was.found that a correlation ed'sted between birth defects and the intake Of APC and diazepam,and the exposure to pesticides,organic solvents.benzene,synthetic resin and physical.factors(noises)on foe part of foe mother.and the exposure to harmful chemicals and physical factors and the smoking of 20 or more cigarettes a day on the part Of the father.It is also found that foe familial heredilary history of the parents and multigravavidity,malnutrition,common colds,hepatitis and diarrhea during pregnancy may also be relaied to the birth defects.
文摘NERVIDUCT malformation caught the attention of the Chinese government in 1983 when professor Yan Renying, now director of the China Maternal and Infant Health Care Center, conducted an epidemiological survey of new-borns in Shunyi County, Beijing, and discovered that one-third of infant mortality in the area was caused
文摘Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiagnosed, lifelong developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around seven years of age. The most severe outcome in cases of FASD is mortality. The purpose of this scoping review is to 1) use a systematic review to provide an estimated mortality proportion for children with FASD, and 2) update a study published in 2014 by reviewing published reports of mortality in individuals diagnosed with FASD. Method: A search of PubMed, CINAHL, and Google Scholar for reports published between 2013 and 2023 on mortality in individuals with FASD. Results: Three population-based studies have reported on all-cause mortality rates, finding a combined mortality rate of 10.9%, a 2.63 fold (95% CI: 2.61 to 2.65) increase in mortality risk over the general population. Since 2016, this review identified only eight new cases meeting the study inclusion criteria. The reported causes of death were five cases of pneumonia, and one case each of failure to thrive and dehydration, intestinal dilatation and asphyxiation caused by overeating due to pica, and acute gastric volvulus. Discussion: While current research suggests a diagnosis of FASD is associated with a 2.6-fold increase in mortality risk, this is likely an underestimation, as most cases of FASD-related mortality go unreported. Globally, about 1 new case is reported every 15 months. However, in the United States alone, between 1752 to 4400 FASD related deaths occur annually. Our review suggests that FASD is rarely identified as a causal or contributing factor in deaths of children and adolescents, resulting in a substantial undercount of FASD-related deaths. Increased attention to the role of FASD in infant and child mortality case reviews, child death review committee reports, and mortality reviews is needed.
基金Supported by the National Basic Reserch Program of China (973 Program) (2001CB5103)the National Natural Science Foundation of China (40471111 and 70571076).
文摘This study is to assess the prevalence rates spatial pattern of neural tube defects with geographic information system and spatial filtering technique. A total of 80 infants who diagnosed from neural tube defects in the area being studied between 1998 and 2001 were analyzed. Firstly, the geographic information system (GIS) software ArcGIS was used to map the crude prevalence rates. Secondly, the data were smoothed by the method of spatial filtering. We evaluated that the effect of changes in spatial filtering radius size was assessed by creating maps based on various filtering radius sizes. The 3 miles or larger filtering radius gives better section variability than the 2 and 2.5 miles or smaller ones. The maps produced by the spatial filtering technique indicate that prevalence rates in the villages in the southeastern region are to produce higher prevalence than that in the other regions. The smoothed maps based on Heshun County display a more adequate data representation than the raw prevalence rate map.
基金supported by National Natural Science Foundation of China(No.41101431)the fourth installment special funding of China Postdoctoral Science Foundation(No.201104003)+1 种基金China Postdoctoral Science Foundation(No.20100470004)the State Key Funds of Social Science Project(Research on Disability Prevention Measurement in China,No.09&ZD072)
文摘Abstract Objective To develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world. Methods The region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes. Results The algorithm was easy to apply, with the accuracy of the results being 69.5%+7.02% at the 95% confidence level. Conclusion The proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.
文摘A child born with untreatable birth defect encounters constant challenges in lifetime. Spina bifida is such type of defect mainly affecting neural tube. As a result, a child with spina bifida faces abnormal physical appearance to neurological dysfunctions. The incident rate of such birth defect is relatively common compared to other birth defects, therefore, an awareness among people is necessary to avoid such vulnerability. Therefore, this article provides a general outline of symptoms, types, risk factors, pathophysiology, preventive and therapeutic strategies of spina bifida which will help the general people for better understanding of the disease and be able to take precautions to combat such defect.
基金Supported by a grant from the National Key Research and Development Program[2016YFC1000506]the Shanghai Public Health Three-year Action Plan[2015-82]+1 种基金the National Natural Science Foundation[81370198,81570283]CAMS Innovation Fund for Medical Sciences[2019-I2M-5-001].
文摘Objective To determine the prevalence and determinants of folic acid(FA)supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.Methods This was a cross-sectional study based on the Shanghai PreConception Cohort(SPCC)study.Data on FA supplementation and socio-demographic features were collected using questionnaires.Couples visiting clinics for pre-pregnancy examination and pregnant women at<14 gestational weeks were recruited in Shanghai,China,between March 2016 and September 2018.Results Among the pregnancy planners,42.4%(4,710/11,099)women and 17.1%(1,377/8,045)men used FA supplements,while 93.4%(14,585/15,615)of the pregnant women used FA supplements.FA supplement use was higher in female pregnancy planners who were older(RR:1.13,95%CI:1.08–1.18),had higher education(RR:1.71,95%CI:1.53–1.92),and were residing in urban districts(RR:1.06,95%CI:1.01–1.11)of FA supplementation;female pregnancy planners with alcohol consumption(RR:0.95,95%CI:0.90–0.99)had lower odds of FA supplementation.In early pregnancy,women with higher educational level(RR:1.04,95%CI:1.03–1.06),who underwent pre-pregnancy examination(RR:1.02,95%CI:1.01–1.03)had higher odds of using an FA supplement;older aged(RR:0.99,95%CI:0.98–0.99),and multigravida(RR:0.97,95%CI:0.96–0.98)had lower odds of FA supplementation.Conclusion Although the majority of pregnant women took FA supplements,more than half of the women planning for pregnancy did not.Urgent strategies are needed to improve pre-conception FA supplementation.