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[Occurrence of structural birth defect in high-prevalent areas of China]
Ting Zhang1, Fang Wang, Liang-Ming Lin
1Capital Institute of Pediatrics, Beijing, China.
Insights
Birth defect occurrence rates significantly increase with age, with current monitoring missing many cases. Expanding surveillance beyond 7 days post-birth is crucial for accurate birth defect tracking.
Area of Science:
- Public Health
- Pediatrics
- Genetics
Background:
- Birth defects represent a significant global health concern.
- Accurate monitoring systems are essential for understanding prevalence and distribution.
Purpose of the Study:
- To compare birth defect occurrence levels.
- To describe the distribution of primary birth defects across different monitored age ranges.
- To provide data for the China birth-defect monitoring system.
Main Methods:
- A retrospective study was conducted in two counties in Shanxi province, China.
- Data included birth defects in fetuses after 20 weeks' gestational age from 2002-2004.
- Included extrinsic and visceral anomalies.
Main Results:
- Birth defect rates increased with age: 17.6/1000 (20-27 weeks), 34.0/1000 (7 days), 43.6/1000 (1 year), 53.7/1000 (3 years).
- Monitoring from 20 weeks' gestation to 3 years post-birth revealed 2.1 to 3.3 times higher rates than the routine 28 weeks' gestation to 7 days range.
- Neural tube defects were often diagnosed prenatally or within 7 days, while visceral defects increased with age, with some identified up to 1 year post-birth.
Conclusions:
- The current Chinese monitoring program (28 weeks' gestation to 7 days) likely detects only about one-third of structural birth defects.
- Findings highlight the need to expand monitoring ranges to capture a more comprehensive picture of birth defect prevalence.
- Results offer valuable data for improving birth defect surveillance and related research.
Objective:
This research was to compare the occurrence levels of birth defect, to describe the distribution of primary birth defects in different range of monitored ages and to provide data to China birth-defect monitoring system.
Methods:
A retrospective study on birth defect was conducted in two counties, Shanxi province, China, which covered birth defects among fetuses after 20 weeks' gestational age from 2002 through 2004. Data collected on birth defect cases mainly included extrinsic and visceral anomaly.
Results:
The occurrence rates of the monitored structural birth defects significantly increased with the increase of age. The occurrence rates were 17.6, 34.0, 43.6, and 53.7 per 1000 births, for different statistical range, from 20-week to 27-week gestational age, 7 days, 1 year and 3 years after birth, respectively. The range from 28-week gestational age to 7 days after birth was usually regarded as the routinely monitored range. If the occurrence rate was calculated from the 20-week gestational age, it appeared a 2.1-time increase. However, if the range was changed to 1 or 3 years after birth, the occurrence rate increased to 2.7 or 3.3 times high, respectively. The distribution of time when birth-defect was identified was significantly different by categories with majority of neural tube defect cases diagnosed at antepartum or 7 days after birth. Visceral defects were mainly found at 7 days after birth but increased with age, even some were diagnosed at 1 year after birth.
Conclusion:
The routine Chinese monitoring program might detect approximately 1/3 of those structural birth defects with the base of current technique and monitoring range from 28-week gestational age to 7 days after birth. The result of our findings should be of help to other related studies.
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