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Trends of neural tube defects in urban China and effects of socio-demographic factors, 2013–2022: a descriptive analysis

Cheng, Xiao; Meng, Chao; Galea, Gabriel L; Nie, Lirong; Wang, Duoduo; Xia, Shuangbo; Wei, Yuan; ... Li, Zhiwen; + view all (2025) Trends of neural tube defects in urban China and effects of socio-demographic factors, 2013–2022: a descriptive analysis. BMJ Public Health , 3 (2) , Article e001489. 10.1136/bmjph-2024-001489. Green open access

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Abstract

Background: Periconceptional folic acid supplementation has progressively reduced the prevalence of neural tube defects (NTDs) in rural Northern China, which had a high baseline. Long-term epidemiological trends have not been comprehensively assessed in urban China with a lower baseline. // Methods: Data from a hospital-based birth-defect surveillance system in Haidian District between 2013 and 2022 were used. The prevalence of NTDs by different characteristics was analysed. χ2, Pearson’s tests and Joinpoint regression analyses were used to compare the prevalence of NTDs by year and explore trends. // Results: 363 732 births and 258 NTDs were recorded in Beijing’s Haidian District from 2013 to 2022. NTD prevalence did not change significantly: it decreased in the first 4 years, then increased and subsequently hovered around 8.14/10 000. Stalling of NTD prevention is superimposed on changing maternal socio-demographics, including increasing education and self-reported regular use of folic acid in NTD-affected pregnancies. Maternal age of NTD-affected pregnancies also increased markedly from 2013 to 2022. To test which factors might alter NTD risk, we compared NTD-affected pregnancies with those affected by non-NTD congenital malformations. Compared with non-NTD malformations, advanced maternal age and multiple birth are independent risk factors for NTDs (adjusted OR: 1.776 and 2.513, respectively). Multiparity and regular folic acid use are protective factors (adjusted OR: 0.040 and 0.556). // Conclusions: The accessibility of maternal folic acid in urban China needs to be evaluated, and it is necessary to investigate biological differences which may render some NTDs folic acid resistant. Meanwhile, the implementation of mandatory fortification of foods with folic acid is imperative.

Type: Article
Title: Trends of neural tube defects in urban China and effects of socio-demographic factors, 2013–2022: a descriptive analysis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjph-2024-001489
Publisher version: https://doi.org/10.1136/bmjph-2024-001489
Language: English
Additional information: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, https://creativecommons.org/licenses/by/4.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10211540
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