The precise etiology of neural tube defects (NTDs) is not known. There is some evidence that mutations in MTHFR gene provide susceptibility to NTDs in some populations; however, other studies have not found this association. One of the problems with previous studies is that they treat NTDs as a homogeneous group, when specific defects could have different etiologies. We conducted a case -control study specifically for anencephaly, based on the Mexican Epidemiological Surveillance System of Neural Tube Defects to evaluate its association with maternal MTHFR 677C > T and 1298A > C polymorphisms, in three states with high frequencies of NTDs: Puebla, Estado de México and Guerrero. We interviewed and collected blood samples from 118 case mothers and 112 control mothers. The questionnaire included information on their reproductive history, socioeconomic characteristics, prenatal care, tobacco and alcohol use, presence of chronic diseases, acute illnesses and fever, consumption of multivitamins and drugs during the periconceptional period. After adjusting for potential confounders, the risk from the mutated homozygous mothers (677TT genotype) was significantly higher than that from mothers with 677CC genotype (OR 3.16, 95% CI 1.29 -7.73); in the case of the heterozygous mothers, an increased risk of anencephaly was observed, even though this was not statistically significant (OR 1.81 95% CI 0.78-4.25). The association found between maternal 677TT genotype and anencephaly and the elevated presence of the 677T allele among Mexican women of fertile age urges intensifying folic acid supplementation which has proved to modify this genetic risk in other populations

ResumenSe analizaron las muertes registradas como homicidio en México de 1979México de -1992. El estudio se basó en fuente secundaria, siendo las variables analizadas: año, edad, sexo y causa externa de traumatismos y envenenamientos según CIE IX Rev.(E960-E969). Se utilizó un modelo de regresión Poisson para las causas más frecuentes, obteniendo riesgos relativos según edad y sexo. El grupo de referencia fue el de 10-14 años y el sexo femenino. Se registraron 198,485 muertes por Homicidio, con un promedio anual de 14,177 y diario de 39. La principal causa fue ataque con arma de fuego y explosivos(56%). El riesgo relativo más alto fue para el grupo de 35-39 años, con RR 15,4 IC(95%) 14,9-16,0, en comparación al de referencia. El sexo masculino presentó un riesgo relativo 10,1 veces mayor que el femenino, ajustado por edad IC10.0-10.3. Los resultados llaman la atención sobre la necesidad de profundizar y analizar el problema de los homicidios bajo una perspectiva multidisciplinaria. Homicidio, estadistica. Mortalidad. AbstractA study of homicide in the population of Mexico, was undertaken for the purpose of discovering the mortality panorama by this cause during [1979][1980][1981][1982][1983][1984][1985][1986][1987][1988][1989][1990][1991][1992]

Objective. The study was designed to evaluate the association between socioeconomic level (as measured by maternal education, maternal occupation, and monthly family income) and anencephaly. Methods. The authors conducted a case-control study using data from the Epidemiological Surveillance System Register for Neural Tube Defects for three states of the Mexican Republic: Puebla, Guerrero and the State of Mexico. Mothers of 151 cases of infants born with anencephaly and mothers of 151 control infants born during the period March 2000 to February 2001 were interviewed about their socioeconomic characteristics and other factors including reproductive history, use of prenatal care, use of tobacco and alcohol, fever during pregnancy, and folic acid supplementation. Results. After adjustment for potential confounders, a risk gradient was seen with decreasing maternal education. Women with less than a primary school education (adjusted odds ratio [OR] = 3.0; 95% confidence interval [CI] 1.2, 7.6) and women who had completed primary school but had not completed junior high school (adjusted OR=2.2; 95% CI 0.9, 5.7) had higher risks of giving birth to an infant with anencephaly, compared to women with a higher educational level. A monthly income ⩽1,000 pesos (approximately $100 U.S.) was also associated with a higher risk of anencephaly (OR=2.5; 95% CI 1.2, 5.1). Women employed in industry or agriculture during the acute risk period (three months prior to conception to one month after conception) had a risk 6.5 times (95% CI 1.4, 29.6) that of professional and business women. Conclusions. This study helps to identify groups that may be especially vulnerable to this type of congenital malformation so that primary and secondary preventive strategies can be targeted to these groups.

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