Effect of Race and Gender on Neurological Level Myelomeningocele

Abstract

SUMMARY The association of race and gender with different neurological levels of myelomeningocele was studied in 251 patients. Over‐all, the white to black ratio was 3·6 and the male to female ratio was 0·86. However, the proportions of whites and females were significantly increased in thoracic‐level patients (white to black ratio 13·6, male to female ratio 0·43), whereas the lumbar‐level patients had sex and white to black ratios equivalent to the area population. This supports the concept that thoracic‐level myelomeningocele has a different pathogenesis from lumbar‐level. RÉSUMÉ Effets de la race et du sexe sur le niveau neurologlyue d'un myéloméningocèle La liaison entre la race, le sexe et les niveaux neurologiques d'un myéloméningocèle a étéétudiée chez 251 patients. Globalement, le ratio blanc/noir était de 3,6 et le ratio homme/femme de 0,86. Cependant, la proportion de blancs et de femmes etait significativement plus forte pour le niveau dorsal (ratio blanchoir de 13,6, ratio homme/femme de 0,43), alors que les ratios étaient comparables à ceux de la population générale pour le niveau lombiaire. Il faut en conclure que le myéloméningocèle de niveau thoracique a une pathogénie différente de celui du niveau lombaire. ZUSAMMENFASSUNG Einfluβ von Rasse und Geschlecht auf den neurologischen Grad der Myelorneningocele Bei 251 Patienten wurde untersucht, ob es eine Beziehung von Rasse und Geschlecht zu den verschiedenen neurologischen Erscheinungsformen der Myelomeningocele gibt. Insgesamt betrug das Verhältnis weiß/schwarz 3·6 und das Verhältnis männlich/weiblich 0·86. Bei der thorkalen Myelomeingocele erhöhte sich jedoch der Anteil von weßen und weiblichen Patientn signifikant Verhältnis weiß/schwarz 3·6 und das Verhältnis männlich/weiblich 0·86. Bei der thorkalen Myelomeningocele erhöhte sich jedoch der Anteil von weißen und weiblichen Patienten signifikant (weiß/schwarz 13·6, männlich/weiblich 0·43), während bei den Patienten mit lumbaler Myelomeningocele die Verhältnisse von Geschlecht und Rasse der Verteilung in der Allgemeinpopulation entsprachen. Dies spricht für die Annahme, daß die thorakale Myelomeningocele eine andere Pathogenese hat als die lumbale. RESUMEN Efecto de la raza y el sexo sobre en nivel neurológico en el mielomeningocele La asociación de la raza y sexo con los diferentes niveles neurológicos e el mielomeningocele se estudió en 251 pacientes. En conjunto la relación blanco/legro era de 3·6 y la varodhembra estaba aumentada significativamente en los pacientes con nivel torácico (relación blanco/negro 13·6, y varón/hembra 0·43) mientras que los pacientes con nivel lumbar la relación de sexos y raza era equivalente a la de la población del area. Esto apoya la idea de que el nivel toracico del mielomeningocele tiene una patogenia diferente del nivel lumbar.

Spina bifida subtypes and sub‐phenotypes by maternal race/ethnicity in the National Birth Defects Prevention Study

“…Several studies have assessed spina bifida lesion level and race/ethnicity, and have not identified consistent associations [Greene et al, 1991; Shaw et al, 1994; Shaw et al, 2000; Au et al, 2008; Mitchell, 2008]. However, many of these studies either were not population‐based or used less specific categories of lesion level (e.g., high vs. low) than the present study.…”

Interpreting changes in the epidemiology of anencephaly and spina bifida following folic acid fortification of the U.S. grain supply in the setting of long‐term trends, Atlanta, Georgia, 1968–2003

“…There is also evidence that the clinical and demographic characteristics associated with AN and SB have changed as the prevalence declined. Both AN and SB have been observed more frequently at birth in females than in males (Khoury et al, 1982; Sever, 1982; Dolk et al, 1991; Greene et al, 1991; Elwood et al, 1992; Yen et al, 1992), and among whites than among blacks or African Americans, with the highest prevalence among those of Hispanic or Latino ethnicity (Canfield et al, 1996; 2006; Shaw et al, 1997; Williams et al, 2005). Analyzing data from 1968 to 1989 using the Birth Defects Monitoring Program and the Metropolitan Atlanta Congenital Defects Program (MACDP), Yen et al (1992) showed that the prevalence of AN and SB was decreasing more rapidly in the U.S. among females, whites, those in whom AN or SB was the only defect, and those who lived in the eastern part of the country.…”

“…Analyzing data from 1968 to 1989 using the Birth Defects Monitoring Program and the Metropolitan Atlanta Congenital Defects Program (MACDP), Yen et al (1992) showed that the prevalence of AN and SB was decreasing more rapidly in the U.S. among females, whites, those in whom AN or SB was the only defect, and those who lived in the eastern part of the country. This suggests that AN and SB are etiologically heterogeneous, that the relative contribution of environmental and genetic factors can differ for different segments of the population, and that the characteristics associated with AN and SB can vary depending on their overall prevalence (high vs. low) (Khoury et al, 1982; Sever, 1982; Dolk et al, 1991; Greene et al, 1991; Yen et al, 1992; Wyszynski, 2006).…”

Retrospective evaluation of neonatal patients treated with the diagnosis of lumbosacral meningocele or meningomyelocele

“…Bu oran literatürle uyumludur (8). Toplamda cinsiyet dağılımına baktığımız zaman literatürle uyumlu olarak bu çalışmada da kız çocuklarında daha fazla görüldüğü tespit edilmiştir (9). Meningosel hastaları tek başına incelediğinde ise cinsiyet dağılımında eşitlik olduğu görüldü.…”

“…Meningosel hastaları tek başına incelediğinde ise cinsiyet dağılımında eşitlik olduğu görüldü. Literatürde bazı çalışmalarda belirgin cinsiyet farkı saptanmamış olsa da bir çok çalışmada kız hakimiyeti rapor edilmiştir (8,9). Çalışmada alt ekstremitede nörolojik defisiti en sık meningomyeloselli hastalarda tespit ettik.…”