title: Prevalence and trend of neural tube defects in five counties in Shanxi province of Northern China, 2000 to 2014.
abstract: BACKGROUND
  The prevalence of neural tube defects (NTDs) in northern China is among the highest in the world. A massive folic acid supplementation program as a specific countermeasure was introduced in 2009. Examining trends in NTD prevalence may provide evidence for future intervention.
  
  
  METHODS
  Data for 2000 to 2014 in five counties in northern China were obtained through a population-based birth defects surveillance system. All live births, stillbirths of over 20 gestational weeks, and pregnancy terminations because of NTDs at any gestational age were recorded. The prevalence of NTDs by gestational weeks (< 28 vs. ≥ 28), by calendar year, and by subtype was presented.
  
  
  RESULTS
  From 2000 to 2014, a total of 234,225 births and 2027 cases of NTDs were recorded. The prevalence of total NTDs was extremely high during 2000 to 2004, but it began to decrease continuously thereafter, from a peak of 120.0/10,000 in 2004 to a low of 31.5/10,000 in 2014. A significant decrease (60%) was observed from 78.8/10,000 in 2009 to 31.5/10,000 in 2014, 5 years after the folic acid supplementation program was introduced. All three major subtypes, namely anencephaly, spina bifida, and encephalocele, showed a decline over this period. Although the perinatal (≥ 28 gestational weeks) prevalence of NTDs decreased progressively, the pre-perinatal (< 28 gestational weeks) prevalence of NTDs remained high until 2011 and then decreased.
  
  
  CONCLUSIONS
  The prevalence of NTDs remains high despite a substantial and continuous decrease over the past 15 years. To further reduce NTD risk in the population, fortification staples with folic acid should be considered.
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Jufen
authors.initials: J
authors.lastname: Liu
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Le
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Zhiwen
authors.initials: Z
authors.lastname: Li
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Jin
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Rongwei
authors.initials: R
authors.lastname: Ye
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Jianmeng
authors.initials: J
authors.lastname: Liu
authors.affiliation: Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
authors.forename: Aiguo
authors.initials: A
authors.lastname: Ren
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology
chemical_list: D005492:Folic Acid
keywords: folic acid; neural tube defect; perinatal; prevalence; prevention