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      Neural Tube Defects in Native Fars Ethnicity in Northern Iran

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          Abstract

          Background:

          Neural tube defects (NTD) are one of the leading causes of infant mortality worldwide. This study was designed to determine the prevalence of NTDs among native Fars ethnic groups during 1998–2005, and to identify maternal and demographic factors associated with NTDs.

          Methods:

          We performed a descriptive cross-sectional hospital-based study in Dezyani Hospital, Gorgan, North of Iran, since January 1998 until December 2005. The design was based on a sample of 30,639 births of native Fars ethnic groups. Data were analyzed by using spss V13.5 software and were compared with the chi-square test.

          Results:

          The prevalence of NTDs in Native Fars during the 8-year period was 25.4 per 10000 births (95% confidence interval: 20.1–31.8). The prevalence of NTDs was 20.6/10000 and 30.6/10000 in males and females respectively but this difference was not significant. The prevalence of spina bifida, anencephaly and encephalocele were 12.7, 11.4 and 1.3 per 10000 respectively. The rate of NTD was 48.9/10000 in newborns with mothers aged > 35 years. The highest rate of NTDs and spina bifida was in 2002. The highest and lowest rate of anencephaly was in 2005 and 2003 respectively. Twenty eight percent of the parents had consanguineous marriages. Degree relatedness 3, 4, 5 and 6 of consanguineous marriages were 12.8%, 9%, 3.8%, 2.5%, respectively. Also 47.5% of the parents resided in rural areas.

          Conclusion:

          This investigation showed that the rate of NTDs in Native Fars was higher in Iran. In addition, this rate is higher than the Canada and Ukraine and lower than Chinese people.

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          Exposure to Fumonisins and the Occurrence of Neural Tube Defects along the Texas–Mexico Border

          Stacey Missmer, Lucina Suarez, Marilyn Felkner … (2005)
          Along the Texas–Mexico border, the prevalence of neural tube defects (NTDs) among Mexican-American women doubled during 1990–1991. The human outbreak began during the same crop year as epizootics attributed to exposure to fumonisin, a mycotoxin that often contaminates corn. Because Mexican Americans in Texas consume large quantities of corn, primarily in the form of tortillas, they may be exposed to high levels of fumonisins. We examined whether or not maternal exposure to fumonisins increases the risk of NTDs in offspring using a population-based case–control study. We estimated fumonisin exposure from a postpartum sphinganine:sphingosine (sa:so) ratio, a biomarker for fumonisin exposure measured in maternal serum, and from maternal recall of periconceptional corn tortilla intake. After adjusting for confounders, moderate (301–400) compared with low (≤ 100) consumption of tortillas during the first trimester was associated with increased odds ratios (ORs) of having an NTD-affected pregnancy (OR = 2.4; 95% confidence interval, 1.1–5.3). No increased risks were observed at intakes higher than 400 tortillas (OR = 0.8 for 401–800, OR = 1.0 for > 800). Based on the postpartum sa:so ratio, increasing levels of fumonisin exposure were associated with increasing ORs for NTD occurrences, except for the highest exposure category (sa:so > 0.35). Our findings suggest that fumonisin exposure increases the risk of NTD, proportionate to dose, up to a threshold level, at which point fetal death may be more likely to occur. These results also call for population studies that can more directly measure individual fumonisin intakes and assess effects on the developing embryo.
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            Mutated methylenetetrahydrofolate reductase as a risk factor for spina bifida.

            R Rozen, T K Eskes, J. Blom … (1995)
            Periconceptional folate supplementation reduces the risk of neural-tube defects. We studied the frequency of the 677C-->T mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene in 55 patients with spina bifida and parents of such patients (70 mothers, 60 fathers). 5% of 207 controls were homozygous for the 677C-->T mutation compared with 16% of mothers, 10% of fathers, and 13% of patients. The mutation was associated with decreased MTHFR activity, low plasma folate, and high plasma homocysteine and red-cell folate concentrations. The 677C-->T mutation should be regarded as a genetic risk factor for spina bifida.
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              Epidemiology of neural tube defects.

              Desta Frey, Andreas W Hauser (2002)
              Neural tube defects (NTDs)-malformations secondary to abnormal neural tube closure between the third and fourth weeks of gestational age-have a complex and imperfectly understood etiology in which both genetic and environmental factors appear to be involved. A number of specific chromosomal or single-gene disorders, presumably not affected by environmental influences, are associated with the development of NTDs, but such syndromal cases account for a small proportion of NTDs in live-born infants. Analysis of recurrence patterns within families and of twin-concordance data provides evidence of a genetic influence in nonsyndromal cases, but factors such as socioeconomic status and geographic area (independent of race or ethnicity) are also associated with variations in the incidence of NTDs. The prevalence at birth of both anencephaly and spina bifida has decreased, but the advent of antenatal diagnosis and elective termination of affected pregnancies has undermined the reliability of birth prevalence rate as an estimate of incidence. Some occupational and other exposures, including maternal use of antiepileptic drugs (AEDs), are associated with increased risk for NTDs. Among women who have had an NTD-affected pregnancy, recurrence risk is markedly higher than the risk for a first NTD-affected pregnancy in the general population. There is strong evidence, overall, for a protective effect of adequate folate consumption. In some high-risk groups, however, such as women taking AEDs, folate supplementation has not been proven to reduce NTD risk.
              Article 0 comments Cited 31 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Iran J Public Health
                Journal ID (iso-abbrev): Iran. J. Public Health
                Journal ID (publisher-id): IJPH
                Title: Iranian Journal of Public Health
                Publisher: Tehran University of Medical Sciences
                ISSN (Print): 2251-6085
                ISSN (Electronic): 2251-6093
                Publication date (Electronic): 30 September 2010
                Publication date Collection: 2010
                Volume: 39
                Issue: 3
                Pages: 116-123
                Affiliations
                [1 ]Gorgan Congenital Malformations Research Center, Gorgan University of Medical Sciences, Iran
                [2 ]Dept. of Social Medicine, Gorgan University of Medical Sciences, Iran
                Author notes
                [* ]Corresponding author: E-mail: mjgolalipour@ 123456yahoo.com
                Article
                Publisher ID: ijph-39-116
                PMC ID: 3481631
                PubMed ID: 23113030
                SO-VID: 8f6b2384-814a-4639-a806-5bf838f1e050
                Copyright © Copyright © Iranian Public Health Association & Tehran University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Date received : 19 February 2010
                Date accepted : 02 August 2010
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Public health
                Keywords: neural tube defects,iran,epidemiology,ethnicity
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: neural tube defects, iran, epidemiology, ethnicity

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