Unusual Patterns of Neural Tube Defects in a High Risk Region of Northern China

Chen, Gong; Pei, Lijun; Huang, Jian; Song, Xiaomin; Lin, Liangming; Gu, Xue; Wu, Jianxin; Wang, Fang; Wu, Jilei; Chen, Jiapeng; Liu, Ju-Fen; Xin, Ruo-Lei; Zhang, Ting; Zheng, Xiaoying

doi:10.1016/s0895-3988(09)60065-9

Cited by 27 publications

(26 citation statements)

References 20 publications

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“…Other research has also revealed a significant decline in the United States between 1992 and 2009, since supplementation with folic acid in 1998, for the prevalence of isolated but not non-isolated NTDs [13]. Therefore, the evidence suggests that folic acid deficiency may affect isolated NTDs to a great extent [8]. Thus, our study supports the idea that it is important to distinguish isolated and non-isolated NTDs due to different epidemiological characteristics.…”

Section: Discussionsupporting

confidence: 83%

“…When compared with Europe, the prevalence found in the present study was intermediate between the higher rate reported in Turkey (35.9 per 10,000 live births) by Onrat and colleagues [11] in 2009 and the lower rate reported in Spain (1.3 per 10,000 live births) using the data in the EUROCAT network [12] for 2012. Furthermore, the prevalence for other provinces in China ranged from 0.3 per 10,000 live births reported in Beijing by Li and colleagues [9] in 2009 to 199.4 per 10,000 live births reported in Shanxi Province by Chen and colleagues [8] in 2009. Regarding the time trend in NTDs prevalence in Liaoning province, except for encephalocele, the prevalence of the other NTDs subtypes fluctuated but had an obvious downward trend after 2009, which was in accordance with the results of a study conducted by Liu and colleagues [10].…”

Section: Discussionmentioning

confidence: 99%

“…We further classified NTDs into isolated and non-isolated NTDs, with the latter defined as NTDs with additional major defects. Isolated NTDs were divided into single NTDs with malformations at one site, and multiple NTDs with malformations at two or more sites [8]. Single NTDs included anencephaly, spina bifida, encephalocele, and congenital hydrocephalus.…”

Section: Methodsmentioning

confidence: 99%

“…A similar phenomenon was also observed in China. For example, the prevalence of NTDs was 199.4 per 10,000 live births in Luliang Prefecture, a city in the Shanxi Province of China, from 2004 to 2005 [8]. By contrast, from 2003 to 2009, the prevalence was 0.3 per 10,000 live births in Beijing [9].…”

Section: Introductionmentioning

confidence: 99%

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Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study

Zhang

Gong

Chen³

et al. 2017

Oncotarget

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To evaluate the time trends in the prevalence of neural tube defects and all their subtypes as well as to identify the epidemiological characteristics of these malformations documented in the Liaoning Province of northeast China from 2006 to 2015. This was a population-based observational study using data from 3,248,954 live births as well as from 6217 cases of neural tube defects, 1,600 cases of anencephaly, 2,029 cases of spina bifida, 404 cases of encephalocele, and 3,008 cases of congenital hydrocephalus from 14 cities in Liaoning Province from 2006 to 2015. All analyses were conducted using SPSS software. During the observational period, the prevalence of neural tube defects, anencephaly, spina bifida, encephalocele, and congenital hydrocephalus was 19.1, 4.9, 6.2, 1.2, and 9.3 per 10,000 live births, respectively. Significantly decreasing trends were observed in the prevalence of all these malformations except for encephalocele. Notably, relatively higher prevalence rates were found in isolated compared with non-isolated malformations, with significant differences in selected characteristics (e.g., prognosis status, gestational age, and birth weight) between isolated and non-isolated cases of these malformations. The prevalence of neural tube defects showed a downward trend in Liaoning Province from 2006 to 2015. However, more attention should be focused on non-isolated cases in the future because of the severe clinical manifestations. Future prevention efforts should be strengthened to reduce the risk of these malformations, especially the non-isolated subtype, in areas with high prevalence.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study

Zhang

Gong

Chen³

et al. 2017

Oncotarget

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“…Furthermore, the focus of this cost-effectiveness study will be on China, and Shanxi Province in particular, where folate deficiency and NTDs are highly prevalent [29]. This is mainly due to the low awareness and use of folic acid pills [30], and suboptimal dietary folate intake levels of Shanxi women of childbearing age [31], which makes Shanxi an excellent region to explore the potential of this novel means to tackle folate deficiency.…”

Section: Introductionmentioning

confidence: 99%

Ex-ante Evaluation of Biotechnology Innovations: the Case of Folate Biofortified Rice in China

Steur

Blancquaert²,

Gellynck³

et al. 2012

CPB

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In order to valorize novel biotechnology innovations, there is a need to evaluate ex-ante their market potential. A case in point is biofortification, i.e. the enhancement of the micronutrient content of staple crops through conventional or genetic breeding techniques. In a recent article in Nature Biotechnology, for example, De Steur et al. (2010) demonstrated the large potential consumer health benefits of folate biofortified rice as a means to reduce folate deficiency and Neural-Tube Defects. By focusing on a Chinese high-risk region of Neural-Tube Defects, the current study defines the potential cost-effectiveness of this genetically modified crop where the need to improve folate intake levels is highest. Building on the Disability-Adjusted Life Years (DALY) approach, both the potential health impacts and costs of its implementation are measured and benchmarked against similar innovations. The results show that this transgenic crop could be a highly cost-effective product innovation (US$ 120.34 - US$ 40.1 per DALY saved) to alleviate the large health burden of folate deficiency and reduce the prevalence of neural-tube birth defects. When compared with other biofortified crops and target regions, folate biofortified rice in China has a relatively high health impact and moderate cost-effectiveness. This research further supports the need for, and importance of ex-ante evaluation studies in order to adequately market and, thus, valorize biotechnology innovations. Although the cost-effectiveness analysis enables to illustrate the market potential of innovative agricultural biotechnology research, further research is required to address policy issues on transgenic biofortification, such as biosafety regulatory requirements.

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High Ratios of C20:4n‐6/C20:5n‐3 and Thromboxane B₂/6‐Keto‐Prostaglandin F_1α in Placenta Are Potential Risk Contributors for Neural Tube Defects: A Case–Control Study in Shanxi Province, China

Zhang

Pei

et al. 2017

Birth Defects Research

Self Cite

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Unusual Patterns of Neural Tube Defects in a High Risk Region of Northern China

Cited by 27 publications

References 20 publications

Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study

Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study

Ex-ante Evaluation of Biotechnology Innovations: the Case of Folate Biofortified Rice in China

High Ratios of C20:4n‐6/C20:5n‐3 and Thromboxane B₂/6‐Keto‐Prostaglandin F_1α in Placenta Are Potential Risk Contributors for Neural Tube Defects: A Case–Control Study in Shanxi Province, China

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Unusual Patterns of Neural Tube Defects in a High Risk Region of Northern China

Cited by 27 publications

References 20 publications

Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study

Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study

Ex-ante Evaluation of Biotechnology Innovations: the Case of Folate Biofortified Rice in China

High Ratios of C20:4n‐6/C20:5n‐3 and Thromboxane B2/6‐Keto‐Prostaglandin F1α in Placenta Are Potential Risk Contributors for Neural Tube Defects: A Case–Control Study in Shanxi Province, China

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High Ratios of C20:4n‐6/C20:5n‐3 and Thromboxane B₂/6‐Keto‐Prostaglandin F_1α in Placenta Are Potential Risk Contributors for Neural Tube Defects: A Case–Control Study in Shanxi Province, China