Vis enkel innførsel

dc.contributor.authorKhoshnood, Babaken_US
dc.contributor.authorLoane, Mariaen_US
dc.contributor.authorDe Walle, Hermienen_US
dc.contributor.authorKlungsøyr, Karien_US
dc.date.accessioned2016-04-01T08:59:42Z
dc.date.available2016-04-01T08:59:42Z
dc.date.issued2015-11-24
dc.PublishedBMJ (Clinical Research Edition) 2015, 351eng
dc.identifier.issn0959-8138
dc.identifier.urihttps://hdl.handle.net/1956/11807
dc.description.abstractStudy question. What are the long term trends in the total (live births, fetal deaths, and terminations of pregnancy for fetal anomaly) and live birth prevalence of neural tube defects (NTD) in Europe, where many countries have issued recommendations for folic acid supplementation but a policy for mandatory folic acid fortification of food does not exist? Methods. This was a population based, observational study using data on 11 353 cases of NTD not associated with chromosomal anomalies, including 4162 cases of anencephaly and 5776 cases of spina bifida from 28 EUROCAT (European Surveillance of Congenital Anomalies) registries covering approximately 12.5 million births in 19 countries between 1991 and 2011. The main outcome measures were total and live birth prevalence of NTD, as well as anencephaly and spina bifida, with time trends analysed using random effects Poisson regression models to account for heterogeneities across registries and splines to model non-linear time trends. Summary answer and limitations. Overall, the pooled total prevalence of NTD during the study period was 9.1 per 10 000 births. Prevalence of NTD fluctuated slightly but without an obvious downward trend, with the final estimate of the pooled total prevalence of NTD in 2011 similar to that in 1991. Estimates from Poisson models that took registry heterogeneities into account showed an annual increase of 4% (prevalence ratio 1.04, 95% confidence interval 1.01 to 1.07) in 1995-99 and a decrease of 3% per year in 1999-2003 (0.97, 0.95 to 0.99), with stable rates thereafter. The trend patterns for anencephaly and spina bifida were similar, but neither anomaly decreased substantially over time. The live birth prevalence of NTD generally decreased, especially for anencephaly. Registration problems or other data artefacts cannot be excluded as a partial explanation of the observed trends (or lack thereof) in the prevalence of NTD. What this study adds. In the absence of mandatory fortification, the prevalence of NTD has not decreased in Europe despite longstanding recommendations aimed at promoting peri-conceptional folic acid supplementation and existence of voluntary folic acid fortification.en_US
dc.language.isoengeng
dc.publisherThe BMJ (British Medical Journal Publishing Group)eng
dc.relation.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658393/pdf/bmj.h5949.pdf
dc.rightsAttribution CC BY-NC 4.0eng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0eng
dc.titleLong term trends in prevalence of neural tube defects in Europe: population based studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2016-01-22T12:46:26Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2015 British Medical Journal Publishing Group
dc.identifier.doihttps://doi.org/10.1136/bmj.h5949
dc.identifier.cristin1320284
dc.subject.nsiVDP::Medisinske Fag: 700en_US


Tilhørende fil(er)

Thumbnail

Denne innførselen finnes i følgende samling(er)

Vis enkel innførsel

Attribution CC BY-NC 4.0
Med mindre annet er angitt, så er denne innførselen lisensiert som Attribution CC BY-NC 4.0