A POPULATION-BASED BIRTH DEFECTS SURVEILLANCE SYSTEM AND ITS UTILIZATION

LI S^a, MOORE CA^b, HONG SX^a, WANG TM^a, LI Z^a

a The Third Hospital, Peking University, Beijing, China

b Centers for Disease Control and Prevention, Atlanta, GA USA

Objective: To describe a unique birth defects surveillance system in the People’s Republic of China.

Methods: The system was instituted in 1992 as a component of an evaluation of the effectiveness of a community intervention program using periconceptional folic acid supplementation to prevent neural tube defects and currently surveys a birth cohort of approximately 150,000 infants after 20 weeks of gestational age per year,in 32 counties of 4 provinces in China. Information is collected in the form of detailed written descriptions by local health care providers and photographs of affected infants. The system allows for detection of birth defects at the local level with later definitive classification and coding by 3 pediatricians from BMU and one pediatrician from CDC; however, information is limited to those structural anomalies which are visible on physical examination.

Results: This birth defects surveillance system provides an extensive database of infants with major and minor external structural anomalies. From 1993 to 1996, more than 10000 birth defects with 30000 photos and 5000 of major birth defects was reported from 1000000 total birth. The most frequently reported birth defects are neural tube defects, oral-facial clefts, and limb anomalies.

Conclusions: This system can be utilized for etiologic studies, descriptive epidemiology, and identification of unusual trends. This is a unique birth defects surveillance system in the People’s Republic of China with multiple advantages.

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