Proportion of neural tube defects attributable to known risk factors

Agopian, A. J.; Tinker, Sarah C.; Lupo, Philip J.; Canfield, Mark A.; Mitchell, Laura E.

doi:10.1002/bdra.23100

Cited by 102 publications

(83 citation statements)

References 16 publications

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“…15,16 The impact of folic acid supplementation is particularly salient. This public health intervention seems to have decreased initially the incidence of infants born with SB, but the most recent data indicate that the impact of this intervention may have plateaued.…”

Section: Discussionmentioning

confidence: 99%

The National Spina Bifida Patient Registry: Profile of a Large Cohort of Participants from the First 10 Clinics

Sawin

Liu

Ward

et al. 2015

The Journal of Pediatrics

127

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Objective To use data from the US National Spina Bifida Patient Registry (NSBPR) to describe variations in Contexts of Care, Processes of Care, and Health Outcomes among individuals with spina bifida (SB) receiving care in 10 clinics. Study design Reported here are baseline cross-sectional data representing the first visit of 2172 participants from 10 specialized, multidisciplinary SB clinics participating in the NSBPR. We used descriptive statistics, the Fisher exact test, χ2 test, and Wilcoxon rank-sum test to examine the data. Results The mean age was 10.1 (SD 8.1) years with slightly more female subjects (52.5%). The majority was white (63.4%) and relied upon public insurance (53.5%). One-third had sacral lesions, 44.8% had mid-low lumbar lesions, and 24.9% had high lumbar and thoracic lesions. The most common surgery was ventricular shunt placement (65.7%). The most common bladder-management technique among those with bladder impairment was intermittent catheterization (69.0%). Almost 14% experienced a pressure ulcer in the last year. Of those ages 5 years or older with bowel or bladder impairments, almost 30% were continent of stool; a similar percentage was continent of urine. Most variables were associated with type of SB diagnosis. Conclusion The NSBPR provides a cross section of a predominantly pediatric population of patients followed in specialized SB programs. There were wide variations in the variables studied and major differences in Context of Care, Processes of Care, and Health Outcomes by type of SB. Such wide variation and the differences by type of SB should be considered in future analyses of outcomes.

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Section: Discussionmentioning

confidence: 99%

The National Spina Bifida Patient Registry: Profile of a Large Cohort of Participants from the First 10 Clinics

Sawin

Liu

Ward

et al. 2015

The Journal of Pediatrics

127

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“…The total prevalence of NTD-affected pregnancies ranges between 0.4 and 2 per 1000 in European countries. The NTD process involves multiple genes, nutritional and environmental factors [23], and seems to be related to defects in the folate-methionine metabolic pathway, since vitamin B12 and folic acid preconception supplementation has been proven to substantially reduce the risk of having an NTD affected pregnancy [15,22-24]. …”

Section: Discussionmentioning

confidence: 99%

Malnutrition in pregnancy following bariatric surgery: three clinical cases of fetal neural defects

Pelizzo

Calcaterra

Fusillo

et al. 2014

Nutr J

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ObjectiveBariatric surgery results in decreased food intake and a variable degree of malabsorption. Without adequate supplementation, the most common complications of this surgery are nutritional disorders. Pregnancy following surgery for obesity is a particular condition requiring strict monitoring of nutrient intake necessary for fetal development and a favourable neonatal prognosis.PatientsMalnutrition in pregnancy and congenital neural malformations are reported in three women who had previously undergone bariatric surgery (1, 5 and 18 years before pregnancy, respectively). Two patients underwent the Roux en Y bypass and one bilio-pancreatic diversion with gastroplasty. None of the three received pre-conceptional nutritional counselling. Patients 1 and 2 did not undergo postoperative nutritional surveillance; nutrient supplementation was started at 22 and 20 weeks gestation, respectively. In patient 3, supplementation was stopped at six weeks gestation.ResultsNewborns 1 and 2 presented with dorsal myelomeningocele and ventricular dilation. Both underwent surgery and a ventriculo-peritoneal shunt was inserted in the first month of life. Newborn 3 had microcephaly, bilateral microphthalmia and sensorineural deafness.ConclusionsDiet and nutritional status, before and during pregnancy, play an important role in the early processes of fetal development and neonatal outcome. Women of childbearing age who have had bariatric surgery, should be encouraged to follow a well-balanced diet as part of a weight management strategy. They should be advised to take recommended maternal supplements.

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“…35,36 Diabetes mellitus is known to increase the 32 risk of some BDs, including both cardiac and noncardiac defects such as anencephaly, anotia/microtia, cleft lip and palate, limb anomalies, renal agenesis and anorectal atresia. 13,[37][38][39][40] Maternal obesity has been shown to increase the risk of spina bifida, heart defects, anorectal atresia, hypospadias, limb reduction defects, diaphragmatic hernia and omphalocele and has also been associated with increased risk of premature birth. 12,14 Maternal exposure to tobacco increases the risk of some BDs and prematurity and SGA.…”

Section: Discussionmentioning

confidence: 99%

A spectrum project: preterm birth and small-for-gestational age among infants with birth defects

et al. 2014

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OBJECTIVE: The aim of this study is to investigate the association between birth defects (BDs), prematurity and small-forgestational age (SGA) in a population-based sample. STUDY DESIGN: Participants were singleton live births enrolled in the National Birth Defects Prevention Study, including 18 737 case infants with one or more BD and 7999 controls. Logistic regression models to evaluate associations between BDs, prematurity and fetal growth were computed while adjusting for covariates. RESULT: Cases were significantly more likely to be born prematurely than controls, particularly at 24 to 28 weeks of gestation. The highest odds ratios for preterm birth were found for intestinal atresia, anencephaly, gastroschisis and esophageal atresia. Infants with BDs were also significantly more likely to be SGA than controls (17.2 and 7.8%). CONCLUSION: Infants with BDs are more likely than controls to be born prematurely and SGA. Findings from this study present additional evidence demonstrating a complex interaction between the development of BDs, prematurity and intrauterine growth.

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Proportion of neural tube defects attributable to known risk factors

Cited by 102 publications

References 16 publications

The National Spina Bifida Patient Registry: Profile of a Large Cohort of Participants from the First 10 Clinics

The National Spina Bifida Patient Registry: Profile of a Large Cohort of Participants from the First 10 Clinics

Malnutrition in pregnancy following bariatric surgery: three clinical cases of fetal neural defects

A spectrum project: preterm birth and small-for-gestational age among infants with birth defects

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