WHO. Factor sheets: congenital disorders; 2023. https://www.who.int/news-room/fact-sheets/detail/birth-defects. Accessed 7 July 2023.

WHO. Congenital disorders—overview; 2023. https://www.who.int/health-topics/congenital-anomalies#tab=tab_1. Accessed 8 July 2023.

GBD 2019 Under-5 Mortality Collaborators. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet. 2021;398:870–905.

Ministry of Health of the People's Republic of China. National stocktaking report on birth defect prevention (2012). Beijing: Ministry of Health; 2012.

Carmona RH. The global challenges of birth defects and disabilities. Lancet. 2005;366:1142–4.

Article  PubMed  Google Scholar 

He C, Liu L, Chu Y, Perin J, Dai L, Li X, et al. National and subnational all-cause and cause-specific child mortality in China, 1996–2015: a systematic analysis with implications for the sustainable development goals. Lancet Glob Health. 2017;5:e186–97.

Article  PubMed  Google Scholar 

WHO. Congenital disorders—impact; 2023. https://www.who.int/health-topics/congenital-anomalies#tab=tab_3. Accessed 28 June 2023.

Frick AP. Advanced maternal age and adverse pregnancy outcomes. Best Pract Res Clin Obstet Gynaecol. 2021;70:92–100.

Article  PubMed  Google Scholar 

WHO. Congenital disorders—causes; 2023. https://www.who.int/health-topics/congenital-anomalies#tab=tab_2. Accessed 8 July 2023.

Groisman B, Bermejo-Sánchez E, Romitti PA, Botto LD, Feldkamp ML, Walani SR, et al. Join world birth defects day. Pediatr Res. 2019;86:3–4.

Article  PubMed  Google Scholar 

GBD 2017 Congenital Heart Disease Collaborators. Global, regional, and national burden of congenital heart disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Child Adolesc Health. 2020;4:185–200.

WHO. Sixty-third World Health Assembly Provisional agenda item 11.7: Birth defects, 2010. https://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_10-en.pdf. Accessed 8 July 2023.

Li Z, Di J. Prevention and control of birth defects in china: achievements and challenges. China CDC Wkly. 2021;3:771–2.

Article  PubMed  PubMed Central  Google Scholar 

The Central Committee of the Communist Party of China. Outline of the 14th Five-Year Plan (2021–2025) for National Economic and Social Development and Vision 2035 of the People's Republic of China, 2021. https://www.gov.cn/xinwen/2021-03/13/content_5592681.htm. Accessed 8 July 2023.

The Central Committee of the Communist Party of China, State Council of the People's Republic of China. The Healthy China 2030 Initiative, 2016. https://www.gov.cn/zhengce/2016-10/25/content_5124174.htm. Accessed 8 July 2023.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

Article  PubMed  PubMed Central  Google Scholar 

Bhide P, Kar A. A national estimate of the birth prevalence of congenital anomalies in India: systematic review and meta-analysis. BMC Pediatr. 2018;18:175.

Article  PubMed  PubMed Central  Google Scholar 

Zhao L, Chen L, Yang T, Wang T, Zhang S, Chen L, et al. Birth prevalence of congenital heart disease in China, 1980–2019: a systematic review and meta-analysis of 617 studies. Eur J Epidemiol. 2020;35:631–42.

Article  PubMed  PubMed Central  Google Scholar 

Wang M, Yuan Y, Wang Z, Liu D, Wang Z, Sun F, et al. Prevalence of orofacial clefts among live births in china: a systematic review and meta-analysis. Birth Defects Res. 2017;109:1011–9.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ministry of Health of the People’s Republic of China. China maternal and child health surveillance work manual (2013 Edition) Finalized, 2013. https://www.mchscn.cn/National-22/450.html. Accessed 20 June 2023.

Dai L, Zhu J, Liang J, Wang YP, Wang H, Mao M. Birth defects surveillance in China. World J Pediatr. 2011;7:302–10.

Article  PubMed  Google Scholar 

The Joanna Briggs Institute. Critical appraisal tools for use in JBI systematic reviews: checklist for prevalence studies, 2020. https://jbi.global/sites/default/files/2020-08/Checklist_for_Prevalence_Studies.pdf. Accessed 5 March 2023.

Cénat JM, Blais-Rochette C, Morse C, Vandette MP, Noorishad PG, Kogan C, et al. Prevalence and risk factors associated with attention-deficit/hyperactivity disorder among US black individuals: a systematic review and meta-analysis. JAMA Psychiat. 2021;78:21–8.

Article  Google Scholar 

DerSimonian R, Laird N. Meta-analysis in clinical trials revisited. Contemp Clin Trials. 2015;45:139–45.

Article  PubMed  PubMed Central  Google Scholar 

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

Article  PubMed  PubMed Central  Google Scholar 

The Cochrane Collaboration. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]: 9.6.4 Meta-regression, 2011. http://handbook-5-1.cochrane.org/. Accessed 28 September 2023.

Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lin L, Chu H. Quantifying publication bias in meta-analysis. Biometrics. 2018;74:785–94.

Article  MathSciNet  PubMed  Google Scholar 

Knapp G, Hartung J. Improved tests for a random effects meta-regression with a single covariate. Stat Med. 2003;22:2693–710.

Article  PubMed  Google Scholar 

The European Surveillance of Congenital Anomalies (EUROCAT). Prevalence charts and tables of congenital anomalies, 2022. https://eu-rd-platform.jrc.ec.europa.eu/eurocat/eurocat-data/prevalence_en. Accessed 26 June 2023.

Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ, et al. National population-based estimates for major birth defects, 2010–2014. Birth Defects Res. 2019;111:1420–35.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hanaoka T, Tamura N, Ito K, Sasaki S, Araki A, Ikeno T, et al. Prevalence and risk of birth defects observed in a prospective cohort study: the Hokkaido Study on Environment and Children’s Health. J Epidemiol. 2018;28:125–32.

Article  PubMed  PubMed Central  Google Scholar 

Boyd PA, Haeusler M, Barisic I, Loane M, Garne E, Dolk H. Paper 1: the EUROCAT network–organization and processes. Birth Defects Res A Clin Mol Teratol. 2011;91(Suppl 1):S2-15.

CAS  PubMed  Google Scholar 

National Bureau of Statistics. Statistical Bulletin of the National Economic and Social Development of China in 2022, 2023. http://www.stats.gov.cn/sj/zxfb/202302/t20230228_1919011.html. Accessed 28 June 2023.

Institute for Health Metrics and Evaluation (IHME). GBD Result Tool, 2019. https://vizhub.healthdata.org/gbd-results/. Accessed 28 June 2023.

Qiao J, Wang Y, Li X, Jiang F, Zhang Y, Ma J, et al. A Lancet Commission on 70 years of women’s reproductive, maternal, newborn, child, and adolescent health in China. Lancet. 2021;397:2497–536.

Article  CAS  PubMed  Google Scholar 

Zhao Y, Zhang H, Peng M, Zhou Y, Cheng X, Yang S, et al. The burden of congenital birth defects between 1990 and 2019 in China: an observational study. Front Pediatr. 2023;11:1170755.

Article  PubMed  PubMed Central  Google Scholar 

The National Health Commission of the People’s Republic of China. National Comprehensive Prevention and Control Plan for Birth Defects 2018. http://www.nhc.gov.cn/fys/s3589/201812/9644ce7d265342779099d54b6962a4e0.shtml. Accessed 25 June 25 2023.

Wenli X, Changfei D, Wenyan L, Ke W, Jing T, Yuyang G, et al. National perinatal prevalence of selected major birth defects—China, 2010–2018. China CDC Weekly. 2020;2:711–7.

Google Scholar 

Yang W, Zeng L, Cheng Y, Chen Z, Wang X, Li X, et al. The effects of periconceptional risk factor exposure and micronutrient supplementation on birth defects in Shaanxi Province in Western China. PLoS ONE. 2012;7:e53429.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, et al. Quality of primary health care in China: challenges and recommendations. Lancet. 2020;395:1802–12.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Liu Y, Chen S, Zühlke L, Black GC, Choy MK, Li N, et al. Global birth prevalence of congenital heart defects 1970–2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019;48:455–63.

Article  PubMed  PubMed Central  Google Scholar 

Zhang Y, Wang J, Zhao J, Huang G, Liu K, Pan W, et al. Current status and challenges in prenatal and neonatal screening, diagnosis, and management of congenital heart disease in China. Lancet Child Adolesc Health. 2023;7:479–89.

Article  PubMed  Google Scholar 

Zhao QM, Liu F, Wu L, Ma XJ, Niu C, Huang GY. Prevalence of Congenital heart disease at live birth in china. J Pediatr. 2019;204:53–8.

Article  PubMed  Google Scholar 

Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet. 2009;374:1773–85.

Article  PubMed  Google Scholar 

Al Amin ASM, Carter KR. Polydactyly. In: StatPearls [Internet]; 2023. https://www.ncbi.nlm.nih.gov/books/NBK562295/. Accessed 2 October 2023.

Department of Maternal and Child Health, National Health Commission of People’s Republic of China. Report on the development of maternal and child health in China (2019), 2019. http://www.nhc.gov.cn/fys/jdt/201905/bbd8e2134a7e47958c5c9ef032e1dfa2.shtml. Accessed 3 October 2023.

Liu J, Zhang L, Li Z, Jin L, Zhang Y, Ye R, et al. Prevalence and trend of neural tube defects in five counties in Shanxi province of Northern China, 2000 to 2014. Birth Defects Res A Clin Mol Teratol. 2016;106:267–74.

Article  CAS  PubMed  Google Scholar 

Zhang TN, Gong TT, Chen YL, Wu QJ, Zhang Y, Jiang CZ, et al. Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006–2015: a population-based study. Oncotarget. 2017;8:17092–104.

Article  PubMed  PubMed Central  Google Scholar 

National Health Commission of the People’s Republic of China. Notice of the National Health Commission on the Project of Supplementing Folic Acid to Prevent Neural Tube Defects; 2009. http://www.nhc.gov.cn/wjw/gfxwj/201304/02c3c3d51117464aa054c08de04b0468.shtml. Accessed 3 October 2023.

Liu J, Wang L, Zhang Y, Zhang L, Jin L, Li Z, et al. Selected Structural birth defects—Shanxi Province, China, 2000–2019. China CDC Wkly. 2020;2:718–22.

Article  PubMed  PubMed Central  Google Scholar 

Song Q, Wei J, Wang J, Zhang L, Liu X, Zhang Y, et al. Rate of correct use of folic acid supplementation among pregnant women—Beijing Municipality, China, 2017–2019. China CDC Wkly. 2021;3:783–7.

Article