A Study on The Incidence of Neural Tube Defects in A Tertiary Care Hospital Over A Period of Five Years

Kandasamy, Vijayalakshmi; Subramanian, Manickam; Gnanasundaram, Vaithianathan; Ramanujam, Sailatha; Saktivel, Sathiya; Sivaanandam, Renuka

doi:10.7860/jcdr/2015/14815.6190

Cited by 10 publications

(7 citation statements)

References 15 publications

(2 reference statements)

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“…Kandasamy et al [ 26 ] reported a decline in overall NTD defects, as well as an increase in the proportion of male cases after preconceptional prescription of folic acid had started. Their sample size was, however, small and included associated anomalies.…”

Section: Discussionmentioning

confidence: 99%

Neural tube defects: Sex ratio changes after fortification with folic acid

Poletta

Rittler

Saleme³

et al. 2018

PLoS ONE

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BackgroundHistorically, neural tube defects (NTDs) have predominated in female infants but the reasons remain unclear. In South America, the pre- folic acid fortification (FAF) rates of NTDs were around 18/10,000 births for females and 12/10,000 births for males, with an estimated sex ratio (male/female) of 0.67. During the post- FAF period, unpublished routine reports have indicated changes in the sex ratio for these defects while some descriptive reports are controversial. To date and to our knowledge, however, no studies specifically focusing on these changes to test this hypothesis directly have been undertaken. The aim of this study was to analyze changes in the sex ratio of infants with NTDs after FAF in South American countries.Materials and methodsWith a descriptive cross-sectional study design, 2,597 infants with isolated NTDs born between 1990 and 2013 in 3 countries participating in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) network were included: (Chile N = 521 and Argentina N = 1,619 [with FAF policies]; Venezuela N = 457 [without FAF policies; used as control]; total births = 2,229,561). The differences-in-differences method and Poisson regressions were used to evaluate the sex ratio shift from female to male before vs. after FAF, and to assess whether these differences were related to the fortification.Results and conclusionsIn Chile and Argentina the prevalence of NTDs, particularly anencephaly and cervico-thoracic spina bifida, showed a greater reduction rate in females than in males after FAF, resulting in a change of the sex ratio of infants with NTDs. Some mechanisms possibly involved in this differential reduction are proposed which might be useful to identify the pathogenesis of NTDs as a whole and specifically of those susceptible to the protective effect of folic acid.

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Section: Discussionmentioning

confidence: 99%

Neural tube defects: Sex ratio changes after fortification with folic acid

Poletta

Rittler

Saleme³

et al. 2018

PLoS ONE

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“…The etiology of NTDs has been extensively studied and it is believed that they are multifactorial complex disorders. Genetic predisposition, socioeconomic status, diabetes mellitus, and environmental causes, such as nutritional deficiency, anticonvulsant agents, and hyperthermia, may affect the risk for NTDs [1,2]. The reported incidence of NTDs (of which myelomeningocele is the most common) varies between different geographic regions; the rate has been reported to be as low as 1 per 1,000 live births in European countries, and as high as 15 per 1,000 live births in some Asian countries, such as India [3].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

Tımur¹,

Tokmak

Yücel³

et al. 2016

Ginekol Pol

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Objectives: Various physiological and pathological conditions can induce significant variations in plasma concentrations of tumor markers, such as CA 19-9, which is present in the serum and amniotic fluid of pregnant women. Herein, we aimed to determine the clinical importance of maternal serum CA 19-9 levels in the diagnosis of neural tube defects (NTDs). Material and methods:A total of 100 women were included in this controlled cross-sectional study. Thirty-three patients whose pregnancies were complicated by isolated meningocele or meningomyelocele constituted the study group, whereas 33 normal, healthy pregnant women constituted the control group, and 34 age-and body mass index (BMI)-matched non-pregnant women were chosen for the validation group. Results:The mean maternal serum CA 19-9 levels were 17.2 ± 17.0 IU/mL, 7.1 ± 5.9 IU/mL, and 4.7 ± 3.6 IU/mL in the study, control, and validation groups, respectively (p < 0.001). ROC analyses showed that elevated CA 19-9 values may predict NTDs (p < 0.001). The cut-off value for CA 19-9 was found to be 9.6 IU/mL at 70% (51%-84%, 95% CI) sensitivity and 84% (74%-92%, 95% CI) specificity. Conclusions:CA 19-9 may be a promising noninvasive marker for NTDs. Further studies are needed to reveal the clinical applicability and diagnostic potential of maternal serum CA 19-9 levels in the identification of NTDs.

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“…3%) of Turkey. These numbers range from 0.46% to 0.27% in different countries (11)(12)(13). The importance of the environmental factors on the occurrence of NTD was confirmed.…”

Section: Discussionmentioning

confidence: 99%

Complex Nature of Neural Tube Defects: A Regional Experience

Turhan

Varol

Gürkan

et al. 2018

Gynecol Obstet Reprod Med

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Objective: The underlying gene-environment interaction of fetal neural tube defects is affected by several factors including geography, ethnicity and time. Local features of fetal neural tube defects were described. Study Design: A prospective cohort study of 48 fetal neural tube defects in a single tertiary medical center at the northwestern region of Turkey (2013-2015) was done via ultrasound, magnetic resonance imaging (MRI), conventional karyotyping, maternal methylenetetrahydrofolate reductase c.677C>T (rs1801133) single-nucleotide polymorphism and maternal serum levels of folic acid, vitamin B12 and zinc. For comparison of means, a Student’s T-Test was used.Results: The prevalence of neural tube defects was 11.4 per 10000 births (48/42000) in northwestern Turkey. The defects on the cranium (n=23; 47.9%) and spine (n=25; 52.1%) were ultrasonographically detected. MRI did not give additional benefit over the ultrasonography. The ratio of associated anomalies in neural tube defect group was 25%. Two fetal neural tube defects with Down syndrome were remarkable. The rate of homozygous methylenetetrahydrofolate reductase c.677C > T SNPs among the mothers of neural tube defect fetuses (n=20) was 15%. Comparing with gestationally matched healthy pregnancies, although maternal BMIs and periconceptional folate intake of neural tube defect group were significantly different, maternal serum folic acid, vitamin B12 and zinc levels were similar.Conclusion: The northwestern region appeared to be a relatively low prevalence area of Turkey for fetal neural tube defects. Any association with maternal serum folic acid, vitamin B12 and zinc levels could not be shown in this region.

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A Study on The Incidence of Neural Tube Defects in A Tertiary Care Hospital Over A Period of Five Years

Cited by 10 publications

References 15 publications

Neural tube defects: Sex ratio changes after fortification with folic acid

Neural tube defects: Sex ratio changes after fortification with folic acid

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

Complex Nature of Neural Tube Defects: A Regional Experience

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