title: Changes in the Incidence of Congenital Anomalies in Henan Province, China, from 1997 to 2011.
abstract: OBJECTIVE
  To investigate changes in incidence and characteristics of congenital anomalies in infants in Henan Province of China over a period of 15 years.
  
  
  METHODS
  Population-based surveillance in Henan Province was conducted from 1997 to 2011 in 75 hospitals (40 urban districts and 35 rural counties, comprising about 20% of the total births). Basic population information was obtained from the healthcare network. All live births, intrauterine deaths after 28 weeks, and stillbirths were included. Congenital anomalies were diagnosed and reported to Henan Provincial Maternal and Pediatric Healthcare Hospital.
  
  
  RESULTS
  Of 1,815,920 births from 1997 to 2011, 15,660 cases of congenital anomalies were identified, resulting in an average incidence of 86.2 cases per 10,000 births. The incidence of congenital anomalies showed a significant downward trend (p < 0.0001) in rural areas and the whole province (p < 0.0001), but an increase in urban areas (p = 0.003). The incidence was much higher in rural than in urban areas in 1997, but this discrepancy decreased rapidly and no difference was seen between rural and urban areas in 2003. The incidence in females was higher than in males in 1997-1999 but decreased to a similar level as that in males in 2000. Maternal age exceeding 35 years was associated with a higher incidence of congenital anomalies. Among the 23 types of congenital anomalies recorded, neural tube defects were the most common; the incidence declined from 39.3 cases per 10,000 births in 1997 to 6.1 cases per 10,000 births in 2011.
  
  
  CONCLUSIONS
  The incidence of congenital anomalies has decreased in Henan Province over the past 15 years due to significant reductions in rural areas and among girls. This decrease was partly related to a reduction in neural tube defects that was likely the result of a folic acid intervention in the province.
authors.affiliation: Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xia
authors.affiliation: Department of Women and Children's Healthcare, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Lihuan
authors.initials: L
authors.lastname: Sun
authors.affiliation: Reproduction Center, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Xingling
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Women and Children's Healthcare, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Meiling
authors.initials: M
authors.lastname: Yao
authors.affiliation: Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Falin
authors.initials: F
authors.lastname: Xu
authors.affiliation: Perinatal Center, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Guomei
authors.initials: G
authors.lastname: Cheng
authors.affiliation: Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Perinatal Center, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Center for Brain Repair and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Changlian
authors.initials: C
authors.lastname: Zhu
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008423:Maternal Age; D009436:Neural Tube Defects / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D014505:Urban Population; D055815:Young Adult