Proportion of neural tube defects attributable to known risk factors
Agopian AJ, Tinker SC, Lupo PJ, Canfield MA, Mitchell LE, National Birth Defects Prevention Study
Birth defects research. Part A, Clinical and molecular teratology · 80 citations
How it was studied
- Design
- Case-control study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- National Institutes of Health
- Government
- Centers for Disease Control and Prevention
- Government
- Intramural CDC HHS
- Government
- NCBDD CDC HHS
- Grants
- Centers for Disease Control and Prevention (U01DD000494); National Institutes of Health (CC999999)
Based on 4 listed funder(s).
Publication
- Published
- 2012-11-27 · Birth Defects Res A Clin Mol Teratol · vol. 97 · issue 1 · pp. 42–46
- Cited
- 129 citations · more than 94% of similar papers · 4.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 17 works
- Access
- Open access (repository copy)
- Research areas
- Folate and B Vitamins Research · Spinal Dysraphism and Malformations · Fetal and Pediatric Neurological Disorders
- Keywords
- Anencephaly, Attributable risk, Medicine, Spina bifida, Population, Neural tube, Obesity, Risk factor, Pregnancy, Offspring, Ethnic group, Neural tube defect, Pediatrics, Environmental health, Obstetrics, Internal medicine, Fetus, Genetics, Biology
- MeSH
- humans, anencephaly, spinal dysraphism, pregnancy complications, obesity, risk assessment, risk factors, mothers, maternal exposure, causality, pregnancy, databases, factual, adult, united states, female, male, hispanic or latino
6 authors
From US
- A. J. AgopianCenter for Human Genetics; The University of Texas Health Science Center at Houston
- Sarah C. TinkerCenters for Disease Control and Prevention; National Center on Birth Defects and Developmental Disabilities
- Philip J. LupoThe University of Texas Health Science Center at Houston
- Mark A. CanfieldTexas Department of State Health Services
- Laura E. Mitchell · correspondingThe University of Texas Health Science Center at Houston
- and the National Birth Defects Prevention Study
Abstract
Background
Recognized risk factors for neural tube defects (NTDs) poorly predict population-level NTD risk. However, the proportion of NTDs that can be attributed to these risk factors is uncertain.
Methods
To determine the proportion of NTD cases that is attributable to known or suspected risk factors (i.e., female infant sex, family history of NTDs, and maternal Hispanic ethnicity, obesity, pregestational diabetes, gestational diabetes, low dietary folate intake, lack of folic acid supplementation, anticonvulsant use, and hot tub or sauna use), we estimated the adjusted population attributable fraction (aAF) for each factor, using the method of Eide and Geffler and data from the National Birth Defects Prevention Study.
Results
Our analyses of these data indicate that the proportion of cases of spina bifida and anencephaly that can be attributed to known risk factors is 28% and 44%, respectively. For spina bifida, the factor with the greatest attributable fraction was maternal obesity (aAF, 10%), whereas for anencephaly it was Hispanic ethnicity (aAF, 15%).
Conclusion
Our analyses indicate that known risk factors account for <50% of NTD cases. Hence, the majority of NTD cases are attributable to, as yet, unidentified factors. These findings highlight the need for continued research to identify genetic and additional nongenetic risk factors for NTDs. Further, these findings suggest that strategies that aim to reduce the risk of NTDs associated with maternal Hispanic ethnicity and obesity may have the greatest impact on the population prevalence of these conditions.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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