Incidence and Risk Factors of Neural Tube Defects in Kashan, Central Iran

Ahmad TALEBIAN, Babak SOLTANI, Mojtaba SEHAT, Abolfazl ZAHEDI, Akram NOORIAN, Motahhareh TALEBIAN

Abstract


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How to Cite This Article: Talebian A, Soltani B, Sehat M, Zahedi A, Noorian A, Talebian M. Incidence and Risk Factors of Neural Tube Defects in Kashan, Central Iran. Iran J Child Neurol. Summer 2015;9(3):50-56.

Abstract
Objective
Neural tube defects (NTDs) are the most common congenital defects of central
nervous system due to neural tube closure deficit during the third and fourth
weeks of gestational age. Our study was performed to detect the incidence and
risk factors of NTDs in Kashan, center of Iran.

Material & Methods
This case-control study was done on all pregnancies with NTD affected
neonates (n=91) and 209 pregnancies with normal neonates from February
2007 to December 2012 in three hospitals in Kashan, center of Iran. Annual and
the mean incidence of NTDs were calculated. Risk factors including neonatal
gender, maternal age, gravidity, maternal abortion history, maternal gestational
diabetes (GDM), folic acid use, familial marriage, maternal body mass index
(BMI), birth season and family history of NTDs were evaluated by interview
with mothers. Univariate and multivariate logistic regression were used to
analyze the risk factors.

Results
The mean incidence of NTDs was 2.33 per 1000 births. The multivariate analysis
indicated that maternal history of abortion (OR: 4.9, CI: 1.9-12.8), and maternal obesity (OR: 5.4, CI: 1.3-21.8) were significantly associated with NTDs.

Conclusion
Maternal history of abortion and BMI were the major risk factors of NTDs.


Keywords


Body mass index; Ethnicity; Neural tube defects; Abortion history; Incidence

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References


Gucciardi E, Pietrusiak MA, Reynolds DL, Rouleau J. Incidence of neural tube defects in Ontario, 1986-1999. CMAJ 2002; 167 (3): 237-40.

Kaufman BA. Neural tube defects. Pediatr Clin North Am 2004; 51 (2): 389-419.

Detrait ER, George TM, Etchevers HC, Gilbert JR, Vekemans M, Speer MC. Human neural tube defects:developmental biology, epidemiology, and genetics. Neurotoxicol Teratol 2005; 27 (3): 515-24.

De Marco P, Merello E, Calevo MG, Mascelli S, Pastorino D, Crocetti L, et al. Maternal periconceptional factors affect the risk of spina bifida-affected pregnancies: an Italian case-control study. Childs Nerv Syst 2011; 27 (7):1073-81.

Golalipour MJ, Mobasheri E, Vakili MA, Keshtkar AA. Epidemiology of neural tube defects in northern Iran, 1998-2003. East Mediterr Health J 2007; 13 (3): 560-6.

Doolin MT, Barbaux S, McDonnell M, Hoess K, Whitehead AS, Mitchell LE. Maternal genetic effects, exerted by genes involved in homocysteine remethylation, influence the risk of spina bifida. Am J Hum Genet 2002; 71 (5): 1222-6.

Cabrera RM, Hill DS, Etheredge AJ, Finnell RH. Investigations into the etiology of neural tube defects. Birth Defects Res C Embryo Today 2004; 72 (4): 330- 44.

Lu QB, Wang ZP, Gao LJ, Gong R, Sun XH, Zhao ZT. Previous abortion and the risk of neural tube defects: a case-control study. J Reprod Med 2011; 56 (9-10): 431- 6.

Smits LJ, Essed GG. Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion. Lancet 2001; 358 (9298): 2074-7.

Zhang T, Xin R, Gu X, Wang F, Pei L, Lin L, et al. Maternal serum vitamin B12, folate and homocysteine and the risk of neural tube defects in the offspring in a high-risk area of China. Public Health Nutr 2009; 12 (5): 680-6.

Golalipour MJ, Qorbani M, Mirfazeli A, Mobasheri E. Risk factors of neural tube defects in northern iran. Iran Red Crescent Med J 2014; 16 (6): e7940.

Director of Meteorology Bureau of Kashan, Kashan meteorological annual report. 2012; Available from: www.Kashanmet.ir.

Agopian AJ, Tinker SC, Lupo PJ, Canfield MA, Mitchell LE. Proportion of neural tube defects attributable to known risk factors. Birth Defects Res A Clin Mol Teratol 2013; 97 (1): 42-6.

Farhud DD, Hadavi V, Sadeghi H. Epidemiology of neural tube defects in the world and Iran. Iran J Public Health 2000; 29 (1-4): 83-90.

Afshar M, Golalipour MJ, Farhud D. Epidemiologic aspects of neural tube defects in South East Iran. Neurosciences (Riyadh) 2006; 11 (4): 289-92.

Rankin J, Glinianaia S, Brown R, Renwick M. The changing prevalence of neural tube defects: a populationbased study in the north of England, 1984-96. Northern Congenital Abnormality Survey Steering Group. Paediatr Perinat Epidemiol 2000; 14 (2): 104-10.

Tuncbilek E, Boduroglu K, Alikasifoglu M. Neural tube defects in Turkey: prevalence, distribution and risk factors. Turk J Pediatr 1999; 41 (3): 299-305.

Yin Z, Xu W, Xu C, Zhang S, Zheng Y, Wang W, et al. A population-based case-control study of risk factors for neural tube defects in Shenyang, China. Childs Nerv Syst 2011; 27 (1): 149-54.

Canfield MA, Annegers JF, Brender JD, Cooper SP, Greenberg F. Hispanic origin and neural tube defects in Houston/Harris County, Texas. I. Descriptive epidemiology. Am J Epidemiol 1996; 143 (1): 1-11.

Bianca S, Bianca M, Bonaffini F, Ettore G. The role of maternal reproductive history in the aetiology of neural tube defects. Med Hypotheses 2002; 58 (2): 113-4.

Horn F, Martinka I, Funakova M, Sabova L, Drdulova T, Hornova J, et al. [Epidemiology of neural tube defects]. Rozhl Chir 2011; 90 (5): 259-63.

Nili F, Jahangiri M. Risk factors for neural tube defects: a study at university-affiliated hospitals in Tehran. Arch Iran Med 2006; 9 (1): 20-5.

Marzullo G, Fraser FC. Similar rhythms of seasonal conceptions in neural tube defects and schizophrenia: a hypothesis of oxidant stress and the photoperiod. Birth Defects Res A Clin Mol Teratol 2005; 73 (1): 1-5.

Al-Ani ZR, Al-Hiali SJ, Al-Mehimdi SM. Neural tube defects among neonates delivered in Al-Ramadi Maternity and Children’s Hospital, western Iraq. Saudi Med J 2010; 31 (2): 163-9.

Canfield MA, Anderson JL, Waller DK, Palmer SE, Kaye CI. Folic acid awareness and use among women with a history of a neural tube defect pregnancy--Texas, 2000-2001. MMWR Recomm Rep 2002; 51 (RR-13):

-9.

Todoroff K, Shaw GM. Prior spontaneous abortion, prior elective termination, interpregnancy interval, and risk of neural tube defects. Am J Epidemiol 2000; 151 (5): 505- 11.

Evans MI, Llurba E, Landsberger EJ, O’Brien JE, Harrison HH. Impact of folic acid fortification in the United States: markedly diminished high maternal serum alpha-fetoprotein values. Obstet Gynecol 2004; 103 (3):

-9.

Salbaum JM, Kappen C. Neural tube defect genes and maternal diabetes during pregnancy. Birth Defects Res A Clin Mol Teratol 2010; 88 (8): 601-11.

Gao LJ, Wang ZP, Lu QB, Gong R, Sun XH, Zhao ZT. Maternal overweight and obesity and the risk of neural tube defects: a case-control study in China. Birth Defects Res A Clin Mol Teratol 2013; 97 (3): 161-5.




DOI: https://doi.org/10.22037/ijcn.v9i3.6995

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