Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis

Abstract

Objective Neural tube defects [NTDs] are severe congenital anomalies. The etiology of NTDs is not fully known, and studies on the potential risk factors of NTDs present inconsistent results. Thus, we conducted a systematic review and meta‐analysis to investigate the maternal, paternal, and neonatal risk factors for NTDs. Study design We systematically reviewed relative original studies published through October 6, 2018 available in Pubmed, Embase and the Cochrane Library without restrictions for language. The selected studies measured maternal, paternal, and neonatal risk factors and examined their associations with NTDs. A meta‐analysis, including subgroup analysis and sensitivity analysis, was conducted to estimate the pooled effect measures. Two reviewers independently extracted data using a predesigned data collection form. Results Forty‐five studies were eligible for inclusion in the meta‐analysis, and twelve potential risk factors were analyzed. The factors that were associated with NTDs risk included stressful life events [odds ratio [OR],1.61; 95% confidence interval [CI], 1.24―2.08; p < 0.001; I2 = 59.2%], low maternal education level [OR, 1.42; 95% CI, 1.19―1.70; p < 0.001; I2 = 47.7%], pregestational diabetes [OR, 2.24; 95% CI, 1.21―4.12; p < 0.010; I2 = 56.3%], low paternal age [OR, 1.41; 95% CI, 1.10―1.81; p = 0.007; I2 = 0.0%], low birth weight [OR, 5.53; 95% CI, 1.95―15.70; p = 0.001; I2 = 98.5%], and neonatal female gender [OR, 1.54; 95% CI, 1.10―2.14; p = 0.012; I2 = 67.8%]. Conclusion Stressful life events, pregestational diabetes, low birth weight, and neonatal female gender are risk factors associated with NTDs. Low maternal education level and low paternal age are factors that are moderately associated with NTDs. Further cohort studies are required to verify the factors associated with NTDs and control the risk of this severe birth defect.

Folic Acid Rescues Valproic Acid-Induced Morphogenesis Inhibition in Neural Rosettes Derived From Human Pluripotent Stem Cells

“…NTDs are caused by the interaction of environmental and genetic factors. The environmental factors include medicine exposure, infection, and radiation ( Jia et al, 2019 ). Valproic acid (VPA) is one of the most commonly prescribed drugs to control epileptic seizures.…”

Preconception exposures and adverse pregnancy, birth and postpartum outcomes: Umbrella review of systematic reviews

“…The PRISMA flow diagram 30 in Figure 1 shows that we identified 4,004 articles and screened 3,592 abstracts. Of the 661 articles that underwent full‐text screening, 592 were ineligible and 22 were removed as they reported only associations covered by more comprehensive or Cochrane Reviews (see Table ), resulting in 47 reviews being included 12,31‐76 . Six eligible reviews were identified through citation tracking, 77‐82 resulting in a final sample of 53 reviews.…”

“…Figure 3 shows moderate‐certainty evidence that paternal age of ≥40 years is associated with a greater risk of miscarriage, and low‐certainty evidence that paternal age of 35–39 years may not be associated with greater or reduced risk of this outcome 42 . Low‐certainty evidence was found that paternal age of <20 years is associated with an increased risk of spina bifida, 51 that maternal age of ≥35 years is associated with a greater risk of urinary incontinence, 36 and that maternal age of ≥45 years is associated with increased risk of: an abnormal five‐minute Apgar score, foetal loss, pregnancy complications and caesarean delivery, relative to maternal age of <45 years 52 . Low‐certainty evidence was also found that interpregnancy intervals shorter than 6 months are associated with an increased risk of low weight, small‐for‐gestational‐age and preterm births, and that interpregnancy intervals of ≥60 months are also associated with an increased risk of these outcomes 38 .…”

Factores asociados al desarrollo de anomalías congénitas en la población neonatal atendida en un hospital de alta complejidad en Colombia: estudio de casos y controles

“…el las variables sociodemográficas se encontró baja escolaridad (5 años o menos) de padres tuvo una relación significativa con la incidencia de anomalías congénitas. Datos similares han arrojado otros estudios en los que se encontró una asociación entre la baja escolaridad materna y el desarrollo de defectos del tubo neural (OR: 1,42; IC95%: 1,19-1,70) 13 .…”