Neural tube defects in Beijing-Tianjin area of China. Urban-rural distribution and some other epidemiological characteristics.

Records in the obstetric wards and nurseries of 18 hospitals were reviewed and studied epidemiologically, covering about 210,000 deliveries and 1000 cases of neural tube defects (NTD). All live and still births occurred in the period 1970-84. Following the NTD classification used by Koch (1984), our case series consisted of anencephalus 50.3%, spina bifida 44.2%, and NTD with other system defects 5.5%. Overall NTD prevalence rate at birth was 4 per thousand, obviously higher than those in most other countries. Marked urban-rural differences in NTD prevalence rate at birth were observed. The rate in rural areas after correction for selection bias was still as high as 7.25 per thousand. As compared with cities and suburbs, the relative risk of NTD born to mothers in rural regions was 2.4. The male-to-female ratios were much less than 1 for various kinds of NTD. Looking at the effect of maternal age and birth order simultaneously in 12 different settings, it can be seen that prevalence of NTD was moderately higher among second and third births to women aged less than or equal to 24 and those greater than or equal to 35 years of age.