title: High prevalence of NTDs in Shanxi Province: a combined epidemiological approach.
abstract: BACKGROUND
  Shanxi Province has historically reported a high prevalence of NTDs. In order to establish baseline rates for NTDs and discuss the risk factors associated with sociodemographic, maternal characteristics, and geographic factors, we performed the present study using an approach combining population and hospital-based methodologies.
  
  
  METHODS
  We used chi(2) and Fisher's exact tests to evaluate variation in the prevalence by selected covariates and computed crude ORs and 95% CIs. Adjusted odds ratios (AORs) were performed using logistic regression with all the covariates included in the model.
  
  
  RESULTS
  The overall NTD prevalence during the 3 year study period was 199.38 per 10,000 births, with a higher NTD prevalence clustered in 46 villages within this geographic area. However, no statistical significance was found between NTD prevalence and the elevation of the villages or their distance from coal plants. AORs revealed women aged 20 and above had a lower risk of NTDs compared to those younger than 20 (AOR range 0.4-0.5). A higher risk of NTDs was observed among female infants (AOR 1.50; 95% CI: 1.04-2.17), women with four or more previous births (AOR 2.80; 95% CI: 1.20-6.52), and a previous history of birth defects (AOR 3.23; 95% CI: 1.46-7.12).
  
  
  CONCLUSIONS
  This study has documented a high prevalence of NTDs in Shanxi. Similar variations to other reports were found in the risk of NTDs by maternal demographic characteristics and a clustering of NTDs in certain villages that require further exploration.
authors.affiliation: Capital Institute of Pediatrics, Beijing 100020, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Gu
authors.forename: Liangming
authors.initials: L
authors.lastname: Lin
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Zheng
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.forename: Xinming
authors.initials: X
authors.lastname: Song
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Wang
authors.forename: Xinhu
authors.initials: X
authors.lastname: Li
authors.forename: Peizhen
authors.initials: P
authors.lastname: Li
authors.forename: Gong
authors.initials: G
authors.lastname: Chen
authors.forename: Jilei
authors.initials: J
authors.lastname: Wu
authors.forename: Lihua
authors.initials: L
authors.lastname: Wu
authors.forename: Jufen
authors.initials: J
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors