Demographic factors and associated anomalies in fetuses with neural tube defects (original) (raw)
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IRJNS Journal, 2019
Background and Aim: The risk factors of the Neural Tube Defects (NTD) have been previously described but there are ethnic and geographical variations. Data from the Iranian population is still scarce. The objective of the current study was to investigate the NTDs risk factors in a large sample of Iranian patients admitted to a single center. Methods and Materials/Patients: This case-control study was performed within five years from 2012 to 2017 in Namazi Hospital of Shiraz, a tertiary referral center for neonatal anomalies in the south of Iran. One hundred newborns with NTDs were included in the study as the case group and 200 healthy newborns as the control group. We recorded the baseline characteristics including the maternal variables (age, weight, height, previous pregnancy and gravidity, gestational age), newborn information (birth weight, clinical diagnosis, clinical findings in the examination, and clinical findings in radiologic test) and medical history of the perinatal period. Results: The baseline characteristics of the mothers were matched in both groups. NTDs were associated with lower folic acid intake during pregnancy (66% vs. 78%; P=0.030; OR 95% CI=1.82) and before pregnancy (P=0.002; OR95% CI=2.36). The prevalence of NTD was significantly higher in patients who lived in hot climates (P=0.001). Conclusion: Taking adequate folic acid supplements before and during pregnancy can reduce the risk of NTDs in the Iranian population. Hot climate zones were associated with an increased risk of NTDs in Iran.
Maternal factors and associated anomalies in NTD fetuses from Tunisia
Central European Journal of Medicine, 2013
Aim of the study: To determine the impact of maternal age, consanguinity, season of conception and variation in the amount of amniotic fluid for the appearance of anomalies associated with neural tube defects (NTDs). Materials and methods: 150 NTD fetuses, a result from autopsies (macroscopic autopsy; microscopic study of biopsy fragments; macro and microscopic brain examination), have been examined during a period of three years (01.2006, 01.2009), in the Clinic of Fetopathology, at the Center of Maternity and Neonatology-Tunisia. Results: Anomalies associated with NTDs occur three times more often in pregnancies with an abnormal amount of amniotic fluid. Also, their likelihood of cardiovascular and reproductive system anomalies is increased four times. Nearly 80% of the NTD fetuses conceived during the autumn-winter period have acrania. Women older than 35, are twice more likely to have underweight children and children with defects of the digestive system and hand. They are also three times more likely to have fetuses with endocrine system abnormalities. Anomalies incompatible with life occur twice as often in consanguineous unions. Conclusion: The mother's age, consanguinity, season of conception, and variation in the amount of amniotic fluid have considerable impact on the emergence of associated anomalies in fetuses with NTDs.
Epidemiology of neural tube defect subtypes in Tunisia, 1991–2011
Pathology - Research and Practice, 2014
Background: Neural tube defects are common major congenital anomalies that result from very early disruption in the development of the brain and spinal cord. Aim of the study: We conducted an epidemiological study to determine the impact of some feto-maternal characteristics in the occurrence of NTD subtypes. Methods: Characteristics and outcomes of births with NTD and pregnancy characteristics of mothers over a period of twenty years (1991-2011) were recorded in the medical chart. Results: From 1991 through 2011, 769 stillborns with NTD were delivered, yielding a prevalence of 2.02/10,000. The increase in NTD prevalences over these years was statistically significant (P = 0.000). In addition, differences between prevalences of NTD subtypes over season (P = 0.003) and between genders (P < 0.001) were significant. The highest frequency was noticed in winter with 3, 7 per 10,000 births among females. The difference in fetal term between subtypes was significant (P = 0.017). The probability to have a malformed fetus with a weight less than 1500 g was three times higher in myelomeningocele than in craniorachischisis, two times higher in anencephaly and encephalocele, but two times lower than rachischisis. Mothers with one gestation were two fold higher in anencephaly than in encephalocele. Nulliparous mothers' cases were significantly more likely to have NTD than uni-or multiparous mothers. O+ mother's blood type presented a significant risk factor and was significantly less common in myelomeningocele than in rachischisis, but three times higher than in craniorachischisis. Consanguinity was present in cases with rachischisis and was two times higher than in cases with anencephaly, and three times higher than in cases with encephalocele. In this study, the results have been interpreted with caution due to analyses not being adjusted. Conclusion: One of the main findings of the study is that there are many differences between NTD subtypes, which suggests that there may be etiologic differences between subtypes. This suggests that, although epidemiologic studies frequently do not distinguish between NTD subtypes in analyses, they should be analyzed separately when possible.
Science Journal of Public Health
Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A fouryear and eight months (January 1 st , 2007 to August 31 st , 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ 2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and welldocumented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.
Iranian Journal of Neurosurgery, 2020
Background and Aim: The risk factors of the Neural Tube Defects (NTD) have been previously described but there are ethnic and geographical variations. Data from the Iranian population is still scarce. The objective of the current study was to investigate the NTDs risk factors in a large sample of Iranian patients admitted to a single center. Methods and Materials/Patients: This case-control study was performed within five years from 2012 to 2017 in Namazi Hospital of Shiraz, a tertiary referral center for neonatal anomalies in the south of Iran. One hundred newborns with NTDs were included in the study as the case group and 200 healthy newborns as the control group. We recorded the baseline characteristics including the maternal variables (age, weight, height, previous pregnancy and gravidity, gestational age), newborn information (birth weight, clinical diagnosis, clinical findings in the examination, and clinical findings in radiologic test) and medical history of the perinatal p...
Risk factors for neural tube defects in Riyadh City, Saudi Arabia: Case-control study
Both genetic and non-genetic environmental factors are involved in the etiology of neural tube defects (NTD) which affect 0.5-2/1000 pregnancies worldwide. This study aimed to explore the risk factors for the development of NTD in Saudi population, and highlight identifiable and preventable causes. Similar studies are scarce in similar populations of the Arabian Peninsula and North Africa. This is an unmatched concurrent case-control study including NTD cases born at King Khalid University Hospital, Riyadh during a 4-year period (2002-2006). The case-control study included 25 cases and 125 controls (case: control ratio of 1:5). Years of formal education, employment, household environment (including availability of air conditioning) and rate of parental consanguinity did not differ between mothers of cases and controls. Significantly higher proportion of mothers of cases had history of stillbirth compared to control mothers (16% vs 4.1%, P=0.02). Also family history of hydrocephalus ...
Electronic physician, 2017
Background: Neural tubes defects (NTDs) are known to be the second most prevalent congenital disorder worldwide whose risk factors have not been explicitly addressed yet. Aim: To determine the risk factors affecting NTDs among infants who referred to obstetrical centers in Kurdistan, a western province of Iran. Methods: This prospective case-control study was conducted in the form of prospective case-control. Sample population included all women (27,153 cases) who referred to obstetrical centers in Kurdistan for either delivery or abortion during 2013 and 2014. Inclusion criterion was the presence of a known NTD in infants, and exclusion criterion was the reluctance of patients to participate in the study. Accordingly, 46 cases participated in the study as the case group, and 138 cases (three times higher than case group) were selected to be the control group. Case and control groups were matched in terms of the number of pregnancies and place of birth. The variables investigated in the present study were as follows: age, occupation, BMI, abortion history, family relation with husband, fetus' sex, number of twins, history of previous children with NTD, receiving prenatal surveillance, consumption of folic acid and multivitamins, smoking, alcohol drinking, passive smoking, and suffering from such diseases as epilepsy and diabetes. Data were analyzed using various statistical tests, including chi-square, Fishers' exact test, multiple logistic regression analysis using SPSS version 20. In the study group, inclusion criteria included all women who had an infant with tube defects that their total number was 46 individuals. In the control group inclusion criteria included mothers with healthy infants who were similar to the study group in terms of birth place and frequency of pregnancy. Results: The results of the present study demonstrated that prenatal surveillance (p<0.002), multivitamin consumption (p<0.001), history of having a child with NTD (p<0.001), alcohol drinking (p<0.014), and passive smoking were related to NTDs (p<0.001). Conclusion: Before fertilization and during pregnancy, mothers should be examined in terms of exposure to harmful agents, diet, and nutritional status in order to identify possible risk factors and find opportunities to prevent NTDs in infants.
Incidence of neural tube defects and their risk factors within a cohort of Moroccan newborn infants
BMC Pediatrics
Background Neural tube defects (NTDs) are a group of birth defects that result from a partial or complete failure of the neural tube to close during embryogenesis. Their prevalence varies between 0.5 to 2 per 1000 births in countries without folic acid supplementation. The aim of our study is to assess the NTDs incidence and describe the risk factors within Moroccan newborn infants. Method This is a descriptive study over a period of 5 and a half years including all births at “Les Orangers” Maternity and Reproductive Health Hospital of Rabat with notification of NTD cases, whether isolated or combined with other anomalies. Data were reported on pre-established sheets and on the teratovigilance registry. Statistical analysis was performed with SPSS version 18 statistical software. Results During the study period, 43,923 births were recorded including 44 cases of neural tube defects, an incidence rate of 1 per 1000 births, with a female predominance; sex ratio = 0.8. These defects inc...
Prevalence of Neural Tube Defects: Moroccan Study 2008-2011
Open Journal of Pediatrics, 2015
Background: Neural tube defects have a considerable importance because they can be prevented by supplementing Folic acid & Vitamin B12 during periconceptional period and fortification of staple foods. In Morocco, the Ministry of Health launched a national program for fortification of flour with folic acid. Our goal should be to evaluate the prevalence of neural tube defects after fortification. Description: This is a retrospective descriptive at the National Reference Centre for Nutrition and Neonatology of the Children's Hospital of Rabat over 4 years. Data were identified from the registry of congenital malformations held at the perinatology unit. Results: During the 4 years, 674 congenital malformations were identified. The neural tube defects NTDs account for 11.9%. Their annual prevalence decreased significantly from 21.78 in 2008 to 12.1 per 10,000 total births in 2011. The most common form was anencephaly (60%). Neural tube defects were isolated in 85% of cases and associated with other malformations in 15% of cases. 49.4% of infants with neural tube defects were female and 50.6% were male. Perinatal mortality in newborns with neural tube defects was 63.8% versus 25.2% in malformed newborns without neural tube defects. Conclusions: The neural tube defects seem to be common in our context. Permanent epidemiological surveillance is needed to determine the true prevalence at the national as well as its temporal trends level.
Epidemiology, prenatal management, and prevention of neural tube defects
Saudi medical journal, 2014
This review article discusses the epidemiology, risk factors, prenatal screening, diagnosis, prevention potentials, and epidemiologic impact of neural tube defects (NTDs). The average incidence of NTDs is 1/1000 births, with a marked geographic variation. In the developed countries, the incidence of NTDs has fallen over recent decades. However, it still remains high in the less-developed countries in Latin America, Africa, the Middle East, Asia, and the Far East (>1 to 11/1000 births). Recognized NTDs risks include maternal diabetes, obesity, lower socioeconomic status, hyperthermia, and exposure to certain teratogens during the periconceptional period. Periconceptional folic acid supplementation decreased the prevalence of NTDs by 50-70%, and an obligatory folic acid fortification of food was adopted in several countries to reach women with unplanned pregnancies and those facing social deprivation. Prevention of NTDs can be accelerated if more, especially low income countries, a...