Population and policy challenges in East Asia

Objective: To evaluate the change of birth defects rate after the abolition of mandatory premarital health examination in 2003 in China, to get more accurate results and to provide evidence-based medical clues for maternal and child health care and public health care. Data and Method: By searching papers with “Birth defects monitoring” as the keywords, 15 papers are available in this meta analysis, involving 1439007 perinatal infants and 16093 birth defects infants. The birth defects number and perinatal infants number of 2002 and 2003 were amalgamated to calculate the merged birth defects rate, regarding as control group to compare with the merged birth defect rate from 2005 to 2008 that was the exposed group in this study. Result: By meta analysis, D+L pooled RR is 1.32(95%CI=1.13~1.53) , which indicated that the merged birth defects rate of 2005-2008 after the abolition of mandatory premarital medical examination was 1.32 times as that of the merged birth defect rate of 2002 and 2003. Conclusion: This result indicated that the birth defect rate of China increased after the policy of abolition the mandatory premarital medical examination. It is more necessary to advocate the free premarital examination to enhance medical examination rate.