Trends in the postfortification prevalence of spina bifida and anencephaly in the United States

被引:200
作者
Boulet, Sheree L.
Yang, Quanhe
Mai, Cara
Kirby, Russell S.
Collins, Julianne S.
Robbins, James M.
Meyer, Robert
Canfield, Mark A.
Mulinare, Joe
机构
[1] CDC, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA
[2] Univ Birmingham, Dept Mat & Child Hlth, Sch Publ Hlth, Birmingham, AL USA
[3] Greenwood Genet Ctr, JC Self Res Inst Human Genet, Greenwood, SC 29646 USA
[4] Univ Arkansas Med Sci, Dept Pediat, Little Rock, AR 72205 USA
[5] N Carolina Ctr Hlth Stat, Raleigh, NC USA
[6] State Hlth Serv, Texas Dept, Birth Defects Epidemiol & Surveillance Branch, Austin, TX USA
关键词
spina bifida; anencephaly; neural tube defects; folic acid; fortification;
D O I
10.1002/bdra.20468
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
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.
引用
收藏
页码:527 / 532
页数:6
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