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Open Access Research article

Geographic and urban–rural disparities in the total prevalence of neural tube defects and their subtypes during 2006–2008 in China: a study using the hospital-based birth defects surveillance system

Xiaohong Li12, Jun Zhu1*, Yanping Wang3*, Dezhi Mu4, Li Dai1, Guangxuan Zhou1, Qi Li1, He Wang5, Mingrong Li3 and Juan Liang3

Author Affiliations

1 National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, No 17, section 3, Ren Min Nan Lu, Chengdu, Sichuan, China

2 West China School of Public Health, Sichuan University, No 17, section 3, Ren Min Nan Lu, Chengdu, Sichuan, China

3 National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, No 17, section 3, Ren Min Nan Lu, Chengdu, Sichuan, China

4 Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, No 17, section 3, Ren Min Nan Lu, Chengdu, Sichuan, China

5 Prenatal Diagnosis Department, West China Second University Hospital, Sichuan University, No 17, section 3, Ren Min Nan Lu, Chengdu, Sichuan, China

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BMC Public Health 2013, 13:161  doi:10.1186/1471-2458-13-161

Published: 22 February 2013

Abstract

Background

Previous reports on the prevalence of neural tube defects (NTDs) in China did not include cases of NTDs that were less than 28 weeks of gestational age (GA) and hence did not accurately reflect the total prevalence of NTDs or the geographic and urban–rural disparities in their prevalence. This article includes cases of NTDs that were less than 28 weeks of GA.

Methods

Data used in this study were collected from 2006 to 2008 using a nationwide hospital-based registry, the Chinese Birth Defects Monitoring Network. The total prevalence ratio (PR) of NTDs and their subtypes, the ratios of PR (PRR), and 95% confidence intervals (CI) were used to analyse geographic disparities at both the regional (north, south) and provincial levels and to analyse disparities between rural and urban areas.

Results

Overall, the total PR of NTDs was 14.0 per 10,000 births. The PRR of NTDs of rural women between the north and south region was 2.26 (95% CI: 2.04-2.52), which was much higher than that of urban women (PRR: 1.56, 95% CI: 1.41-1.72). The three subtypes of NTDs had different geographic distribution at the level of province. The urban–rural PRR of NTDs was 2.14 (95% CI: 1.94-2.34) in the north but only 1.47 (95% CI: 1.31-1.66) in the south.

Conclusions

There is a high total prevalence of NTDs, which remains one of the major public health concerns in China. Eliminating the geographic and urban–rural disparities in the disease burden is a priority for future intervention.

Keywords:
Neural tube defects; Prevalence ratio; Geographic disparity; Urban–rural disparity