Congenital hydrocephalus (CH) was a major birth defect of the central nervous system besides neural tube defects (NTDs). Few studies have focused on both the prevalence and trend of isolated and complicated CH in China. Data were drawn from a population-based birth defects surveillance program in five rural counties in northern China from 2005 to 2015. All livebirths and pregnancy terminations at any gestational age affected with CH were recorded. The prevalence and trend of isolated and complicated CH were examined. During the 11-year period, a total of 176,223 births and 357 CH cases were recorded, resulting in a prevalence rate of 20.3 CH cases per 10,000 births. Of the CH cases, 146 were isolated CH, resulting in a prevalence rate of 8.3 per 10,000 births. The pre-perinatal prevalence (<28 gestational weeks) was higher than the perinatal prevalence for both isolated and total CH. The prevalence rates of total and isolated CH showed a similar downward trend during the 11-year period. This downward trend was statistically significant after 2009 (p < 0.05), when a massive folic acid supplementation program was introduced. Although it decreased over time, the prevalence of CH remains high in this population which has a high prevalence of neural tube defects.

After understanding the patients' decision-making process regarding amputation, healthcare providers should be encouraged to empathize with such patients. Further, providers should respect the patients' and families' decision and provide them with necessary care. Future research should explore professional perspective and family members' care process for amputees to understand the decision-making process of patients who require amputation.

BackgroundFolic acid supplementation is universally recommended for women of child-bearing age to prevent fetal neural tube defects (NTDs). Concerns have arisen over the potential risk for childhood allergy and asthma due to folic acid supplementation. We examined whether periconceptional supplementation with low-dose folic acid only was associated with an increased risk for allergy symptoms or asthma in offspring at 4–6 years of age.MethodsOut of 247 831 participating women enrolled in 1993–1996, 9090 were randomly selected and their children were followed up in 2000–2001. Information on mothers' demographic characteristics, folic acid supplementation and allergic diseases among children was collected. We used logistic regression to evaluate the association between folic acid intake and risk for allergic disease while adjusting for potential confounding factors.ResultsThe rate of allergy symptoms was 1.54% among children whose mothers had taken folic acid compared with 2.04% among those whose mothers had not taken folic acid, and the rate of asthma was 0.92% and 0.88%, respectively. Maternal folic acid supplementation was not associated with risk for allergy symptoms or asthma, with odds ratios (95% CI) of 0.80 (0.58–1.11) and 1.04 (0.67–1.61), respectively. No differences in the occurrence of allergy symptoms or asthma were observed when data were analysed by timing of supplementation or compliance with folic acid supplementation.ConclusionsSupplementation with low-dose folic acid only during the periconceptional period did not increase risk for allergy symptoms or asthma in children at 4–6 years of age in a population without staple fortification with folic acid.