Proportion of neural tube defects attributable to known risk factors

A. J Agopian; Sarah C Tinker; Philip J Lupo; Mark A Canfield; Laura E Mitchell; National Birth Defects Prevention Study

doi:10.1002/bdra.23100

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Proportion of neural tube defects attributable to known risk factors

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Proportion of neural tube defects attributable to known risk factors

A. J Agopian, Sarah C Tinker, Philip J Lupo, Mark A Canfield, Laura E Mitchell and National Birth Defects Prevention Study

Birth Defects Research Part A: Clinical and Molecular Teratology, Vol.97(1), pp.42-46

01/2013

DOI: 10.1002/bdra.23100

PMCID: PMC4482342

PMID: 23427344

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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.

anencephaly

attributable fraction

congenital abnormalities

neural tube

spina bifida

Details

Title: Subtitle: Proportion of neural tube defects attributable to known risk factors
Creators: A. J Agopian - Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas
Sarah C Tinker - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Philip J Lupo - Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas
Mark A Canfield - Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
Laura E Mitchell - Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas
National Birth Defects Prevention Study
Contributors: Paul A Romitti (Contributor) - University of Iowa, Epidemiology
Resource Type: Review
Publication Details: Birth Defects Research Part A: Clinical and Molecular Teratology, Vol.97(1), pp.42-46
DOI: 10.1002/bdra.23100
PMID: 23427344
PMCID: PMC4482342
NLM abbreviation: Birth Defects Res A Clin Mol Teratol
ISSN: 1542-0752
eISSN: 1542-0760
Publisher: Wiley Subscription Services, Inc., A Wiley Company; Hoboken
Number of pages: 5
Language: English
Date published: 01/2013
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9984214950202771

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