Background:Neural tube defects (NTDs) including spina bifida and anencephaly are the second most common birth defects with 2.8 per 1000 births in northern Iran.Objectives:This study was conducted to determine the risk factors of neural tube defects in Gorgan, north of Iran.Patients and Methods:This hospital-based, case-control study was carried out on all NTD-affected pregnancies (n = 59) during February 2007 - August 2010, and 160 healthy pregnancies were selected via convenient sampling method in three hospitals in Gorgan, north of Iran. Risk factors including maternal body mass index (BMI), season of birth, gender of the newborn, mother’s age, ethnicity, consanguineous marriage, folic acid consumption, nutrition, habitat, and education, were assessed through interviews with mothers. Univariate and multivariate logistic regression analyses were used to estimate the risks by odds ratios (ORs) and 95% confidence intervals.Results:The multivariate analysis showed that maternal BMI (normal/underweight OR: 0.23, overweight/underweight OR: 0.15, obese/underweight OR: 0.13) and maternal ethnicity (Fars/Sistani OR: 3.49) and maternal nutrition (good/poor OR: 0.46) were significantly correlated with NTDs in the newborns.Conclusions:This study showed that maternal ethnicity, insufficient nutrition, and BMI, were the main risk factors of NTDs in northern Iran.

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The aim of this prospective study was to evaluate the prevalence and pattern of gastrointestinal malformations (GIM) among Iranian newborns in Gorgan, North of Iran. From 1998 through 2003, 37,951 live births in Dezyani hospital in Gorgan, North of Iran, were screened for gastrointestinal malformations. Clinical and demographic factors of diagnosed cases were recorded in a pre-designed questionnaire for analysis; sex, ethnicity, type of GIM and associated anomalies. The overall prevalence rate of gastrointestinal malformations was 10 per 10,000 births. The imperforate anus (5 per 10,000) was the commonest birth defect in gastrointestinal tract. The prevalence rate of GIM was 8.2 per 10,000 in males and 10.7 per 10,000 in females. According to the parental ethnicity, the prevalence rates of GIM were 6.7, 15.8 and 17.6 per 10,000 in Fars, Turkman, and Sistani, respectively. There were eight cases (21%) with associated anomalies. The prevalence rate of GIM in North of Iran is not similar to the previous studies in Iran and Middle East and ethnic background may be a causative factor in the rate of GIM in this area.

Context: Neural tube defects (NTDs) are one of the most common birth defects with a high rate of mortality. Several studies have shown the reduction of the rate of NTD due to preconceptional usage and flour fortification with folic acid. Objectives: The aim of this systematic literature review was to assess the appropriate information about the prevalence of Neural Tube Defects among the Iranian population, geographic areas of Iran. Data Sources: We searched PubMed, Embase, Scopus, and data banks in Iran, such as the scientific information database (SID), Magiran, and Barekat knowledge network system from January 1969 to February 2017. The following keywords were used to search all fields in the above databases ("Neural Tube Defects" OR "NTD" AND "Iran"). Study Selection: NTDs were classified as given by Moore to include anencephaly, spina bifida, encephalocele, iniencephaly, and craniorachischisis. Primary outcomes of interest for estimating the prevalences were the total number of births (including live and stillbirths if available separately) and the total number of NTD affected births (including live and stillbirths if available separately). Data Extraction: Data extracted from selected studies, included: first author, study design, city, sample size, duration of studies, and the prevalence of NTDs and subtypes of neural tube defects. Results: A total of 429 studies were initially identified in the databases. After excluding duplicate studies, 244 articles were retrieved and reviewed based on their titles and abstracts; 221 articles were excluded. Twenty-three articles were selected for a more detailed review.

Previous studies have shown a high rate of neural tube defects (NTD) in Gorgan, northern Islamic Republic of Iran. This case-control study during 2003-04 compared serum zinc levels and other variables in 23 mothers of neonates affected with NTD and 36 mothers with normal healthy neonates in Dezyani hospital in Gorgan. Mean serum zinc levels in the case and control groups were 13.43 µmol/L (SD 6.3) and 11.41 µmol/L (SD 6.3) respectively. Zinc deficiency was found in 13 (36.5%) of the cases and 7 (19.4%) of the controls. Logistic regression analysis showed an association between the presence of NTD and zinc deficiency (OR 5.06;