Prevalence of open neural tube defects and risk factors related to isolated anencephaly and spina bifida in live births from the “Dr. Juan I. Menchaca” Civil Hospital of Guadalajara (Jalisco, Mexico) (original) (raw)
Related papers
Decline of neural tube defects cases after a folic acid campaign in Nuevo Le�n, M�xico
Teratology, 2002
Background: Nuevo León is a state in northeastern Mexico, near the border of Texas. Mean mortality rate from 1996-98 due to anencephaly cases was 0.6/1,000. In 1999 a surveillance program for the registry and prevention of neural tube defects (NTD) cases was initiated. Methods: Cases were obtained from hospitals and OB-GYN clinics by immediate notification, death certificates, or fetal death registries. Only isolated cases of NTD were included. In August 1999 a folic acid campaign was initiated with the free distribution of the vitamin to low-income women with a recommendation to take a 5.0-mg pill once a week. Number of cases and rates from 1999 to 2001 were compared (2 test). Results: After 2 years there has been a significant reduction in the number of cases and rates. In 1999 there were 95 NTD cases and in the years 2000 and 2001 there were only 59 and 55 respectively (P Ͻ 0.
Extremely high prevalence of neural tube defects in a 4-county area in Shanxi Province, China
Birth Defects Research Part A: Clinical and Molecular Teratology, 2006
In the past, northern China's Shanxi Province has reported the highest incidence of neural tube defects (NTDs) in the world. However, little is known about the epidemiology of NTDs in this area in recent years. METHODS: Data were collected from a population-based birth defects surveillance system in 4 counties that captures information on all live births, stillbirths of at least 20 weeks' gestation, and pregnancy terminations at any gestational age resulting from prenatal diagnosis of a birth defect. We also surveyed mothers of NTD case patients to determine their use of folic acid before and during early pregnancy. RESULTS: During 2003, 160 NTD cases were identified among 11,534 births (NTD birth prevalence ϭ 138.7/10,000 births). The rates of anencephaly, spina bifida and encephalocele were 65.9, 58.1, and 14.7 per 10,000, respectively, and a female predominance was observed among anencephaly cases (male-to-female relative risk [RR], 0.49; 95% confidence interval [CI], 0.30 -0.79), but not among spina bifida (RR, 0.90; 95% CI, 0.55-1.45) and encephalocele (RR, 1.03; 95% CI, 0.40 -2.69) cases. The percentages of pregnancy termination following prenatal diagnosis of anencephaly, spina bifida, and encephalocele were 50%, 41.8%, and 35.3%, respectively. NTD birth prevalence tended to be higher among mothers aged Ͻ20 or Ն30 years (P ϭ .06) and was markedly associated with lower levels of maternal education (P Ͻ .001). Among 143 NTD mothers, only 6 (4.2%) used folic acid supplements during the periconceptional period. CONCLUSIONS: The NTD birth prevalence rate in the study area is among the highest worldwide. Folic acid deficiency may be one important risk factor. Birth Defects Research (Part A) 76: 237-240, 2006.
Decline in Prevalence of Neural Tube Defects in a High-Risk Region of the United States
Pediatrics, 2000
Objectives. To conduct surveillance for neural tube defects (NTDs) in a high-risk region of the United States and to prevent occurrence and recurrence of NTDs through the periconceptional use of folic acid supplements. Design. Active and passive methods were used for surveillance of NTD-affected pregnancies and births during a 6-year period (October 1992-September 1998). Individual genetic counseling was used to prevent NTD recurrences and a public awareness campaign was used to reduce NTD occurrences. Setting. State of South Carolina. Patients. All cases of spina bifida, anencephaly, and encephalocele identified among 278 122 live births and fetal deaths to South Carolina residents during 1992-1998 were included. Main Outcome Measure. Changes in occurrence and recurrence rates during a 6-year period. Results. Over the 6 years of surveillance, the prevalence rates for NTDs decreased from 1.89 to .95 cases per 1000 live births and fetal deaths. The prevalence decrease is explained primarily by a decrease in cases of spina bifida. Isolated NTDs accounted for 297/360 (82%) NTDs and 63/360 (18%) had at least 1 other structural anomaly. Females predominated among isolated NTDs but the sex distribution was equal among NTD cases with other anomalies. Prevalence rates for whites (1.48 cases per 1000 live births and fetal deaths) were higher than rates for blacks (.87 cases per 1000 live births and fetal deaths). There were no NTD recurrences in 113 subsequent pregnancies to mothers of infants with isolated NTDs who took periconceptional folic acid. The rate of periconceptional folic acid use among women of childbearing years increased from 8% to 35% during the 6-year project period. Conclusion. The prevalence of NTDs in a high-risk region has declined coincident with the increased periconceptional use of folic acid supplements among women of childbearing age. Pediatrics 2000;106:677-683; neural tube defects, high-risk region, birth defects, folic acid, spina bifida, anencephaly, encephalocele.
Long Term Maintenance of Neural Tube Defects Prevention in a High Prevalence State
The Journal of Pediatrics, 2011
Objective-To assess the efficacy of folic acid (FA) supplementation and fortification in preventing neural tube defects (NTDs) in a high prevalence region of the US. Study design-Active and passive surveillance methods were used to identify all fetuses/infants affected by an NTD in South Carolina. Prevalence rates were compared with FA intake to determine the effects of increased intake on NTD occurrence and recurrence. Results-From 1992-2009, 916 NTD cases occurred in South Carolina with isolated defects comprising 79% of cases. The NTD rate decreased 58% during this period. There was one NTDaffected pregnancy among 418 subsequent pregnancies (0.2%) in mothers with previous NTDaffected pregnancies who consumed periconceptional FA supplements and four NTDs among 66 pregnancies (6.1%) in which the mother did not take FA supplements. Folic acid supplementation increased from 8% to 35% from 1992-2007 and knowledge of the protective benefits of FA increased from 8% to 65% in women of childbearing age. Conclusions-Increased periconceptional intake of FA appeared to reduce NTDs in a high prevalence region. The rate of spina bifida and anencephaly in South Carolina is now essentially the same (0.69 cases per 1000 live births and fetal deaths) as the 1998-2005 US rate (0.69). Keywords birth defects; folic acid; South Carolina; spina bifida; anencephaly; encephalocele Neural tube defects (NTDs) are serious forms of craniospinal birth defects that result from the failure of the neural tube to close during the first month of embryonic development. 1,2 The three major forms of NTDs are spina bifida, anencephaly, and encephalocele. Spina bifida usually results in paralysis below the level of the spinal lesion and hydrocephaly, whereas anencephaly results in death in utero or death shortly after birth, and the effects and outcome of encephalocele are variable. 2,3 Although specific genetic and environmental causes are known for a minority of NTDs, especially those with associated malformations,
Incidence and risk factors for neural tube defects in a Bosnian population
Journal of Health Sciences, 2021
Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3 rd and 4 th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation. Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica-Doboj, Unsko-Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health. Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%). Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.
Folic acid to reduce neonatal mortality from neural tube disorders
International Journal of Epidemiology, 2010
Background Neural tube defects (NTDs) remain an important, preventable cause of mortality and morbidity. High-income countries have reported large reductions in NTDs associated with folic acid supplementation or fortification. The burden of NTDs in low-income countries and the effectiveness of folic acid fortification/supplementation are unclear.
Descriptive Study on Neural Tube Defects in Argentina
Background: Neural tube defects (NTDs) are the most common congenital anomalies of the central nervous system. Prevalence of NTDs varies depending on geographic region and folic acid fortification. The main objectives of this study are to analyze the prevalences of NTDs reported to the National Registry of Congenital Anomalies of Argentina (RENAC) during the period 2009 to 2013, to compare them with data from other selected surveillance systems of the Americas, and to evaluate the impact of folic acid fortification on the prevalence of NTDs in Argentina. Methods: We analyzed changes in prevalence between 2009 and 2013 for the RENAC, and differences in prevalence between RENAC and other surveillance systems. We evaluated changes for the pre and postfortification time periods in Argentina. Results: In Argentina, anencephaly and spina bifida showed no statistically significant variation between 2009 and 2013, and encephalocele showed a statistically significant decline. The RENAC showed a statistically significant higher prevalence for all three defects when compared with surveillance systems from Chile, Colombia, and Costa Rica, and a statistically significant lower birth prevalence than Cuba for anencephaly. No differences were observed when comparing it to the Atlanta-USA and Mexico systems. A significant decrease in prevalence was observed for all three anomalies for the postfortification period in Argentina. Conclusion: The characteristics of cases reported to the RENAC are similar to those already reported in the literature. The differences in prevalence between the RENAC and other surveillance systems could be artifactual or real. We confirmed the decrease of prevalence of NTDs after folic acid fortification.
Determination of Risk Factors Associated with Neural Tube Defects in Infants
Neural tube defects (NTDs) are serious birth defects of the brain and spine, NTDs is the major cause of disabilities in developing countries, there are many risk factors for this problem such as folic acid deficiency, consanguinity, genetic factors, exposure to x-ray radiation, chronic disease such as maternal diabetes and treatment of epilepsy such as valporic acid. Material and Methods: A descriptive cross-sectional facilitybased study, the study population were all infants with NTDs who were coming to the neurosurgery clinic at the time of the study (June 2018 to September 2018) at Ibrahim Malik Teaching Hospital-Khartoum, the data were collected by questionnaire, by convenience sampling method, sample size is total coverage during the study period, data were analyzed by the computerized method Statistical Package for the Social Sciences (SPSS) version 20. The results: The current study revealed that most of all groups of infants were female (56%) their mean 1.56 ±. 501. The mothers whom conducted antenatal care and taking folic acid immediately after amenorrhea their mean 2.28 ± 1.29 & 3.58 ± 1.79 respectively. There is a significant relationship between early taking folic acid and mother education level p-value (. 000). 60% of children, their parent firstdegree cousin, there mean 1.62 ±. 83. Previous family history of NTDs in close sibling (46%) with mean 1.62 ±. 64. Mothers having a chronic disease (Diabetes mellitus & epilepsy) the mean 2.88 ±1. 37. (82%) of mothers, not exposed to x-ray radiation, their mean 1.82 ±. 39. Conclusion: The majority of mothers, not taking folic acid during pregnancy, their awareness is poor regarding the importance of taking folic acid and their husband were related to them.
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.