Handan ÇELİK, Ömer Salih AKAR, Ümmet ABUR, Miğraci TOSUN, Engin ALTUNDAĞ, Aslıhan SANRI, Metin KARAYEL, Canan AYGÜN, Gönül OĞUR

Samsun ilinde nöral tüp defekti sıklığı ve nöral tüp defekti için risk faktörleri

Amaç: Nöral tüp defektleri (NTD), hem genetik hem de çevresel katkılar gibi pekçok faktör nedeni ile oluşan, kompleks ve ağır konjenital malformasyonladır. Bu çalışmada Samsun ili için NTD sıklığını belirlemek, ailelerinin sosyodemografik özellikleri, maternal beslenme alışkanlıkları, maternal serum folik asit ve vitamin B12 düzeyleri ile NTD arasındaki ilişkiyi değerlenmek amaçlandı. Yöntem: Temmuz 2007 ile Eylül 2008 tarihleri arasında NTD'li bebek doğuran ve NTD'li fetus nedeniyle gebelikleri sonlandırılan kadınlar çalışmaya dahil edildi. Samsun ilindeki tıbbi kayıtlardan NTD sıklığı hesaplandı. Çalışma grubunun sosyodemografik özellikleri, beslenme durumu, obstetrik öyküleri, teratojen maruziyeti ile vitamin B12 ve folik asit düzeyleri kontrollerle karşılaştırıldı. Bulgular: Çalışma döneminde 63 izole NTD'li fetus kaydedildi. Samsun bölgesinde NTD sıklığı % o3,4 idi. Çalışma grubunda, aile gelirleri, anne eğitimi, et, süt, yumurta, peynir, sebze ve baklagillerin tüketimi kontrol grubundan daha düşüktü (p

Frequency and risk factors of neural tube defects in Samsun province

Objective: Neural tube defects (NTD) are a group of severe human congenital malformations and complexdisorders appear to be affected by multiple factors, both genetic and environmental contributions.To asses the frequency of NTD in Samsun province and investigate the relationship between NTD andsociodemographic properties of families, maternal eating habits, maternal serum folic acid, and vitamin B12 levels.Method: The women who gave birth to infants with NTDs and whose pregnancies were terminated due to havingfetuses with NTDs between July 2007 and September 2008 were included in the study.The frequency of NTD wascalculated from medical records for Samsun province.Sociodemographic characteristics,nutritional status, obstetrichistories, teratogen exposure and vitamin B12 and folic acid levels of study group were compared with controls.Results: In the study period, 63 fetuses with isolated NTD were noted. The frequency of NTD in Samsun region was%o3,4. In the study group, family incomes, maternal education and consumption of meat, milk, egg, cheese, vegetable,and legumes were lower than the control group (p

PDF

___

Detrait ER, George MT, Etchevers CH, et al. Human neural tube defects: Developmental biology, epidemiology, and genetics. Neurotoxicology and teratology 2005; 27: 515- 524.
Nikkila A, Rydhström H, Kallen B. The incidence of spina bifida in Sweden 1973-2003: The effect of prenatal diagnosis. European Journal of Puplic Health 2006; 16(6): 660-662
Li Z, Ren A, Zhang L, Ye R, Li S, Zheng J, Hong S, Wang T, Li Z. Extremely high prevelance of neural tube defects in a 4-county area in shanxi province, China. Birth Defects Research 2006; 76 (Part A): 237-240
Block G, Gillespie C, Rosenbaum HE,et al: A Rapid Food Screener to Assess Fat and Fruit and Vegatable İntake. AM J Prev Med 2000; 18(4): 284-288
Tunçbilek E. Türkiye'deki yüksek nöral tüp defekti sıklığını ve önlemek için yapılabilecekler. Çocuk Sağlığı ve Hastalıkları 2004; 47: 79-84.
Akar N, Çavdar A and Arcasoy A: High Incidence of Neural Tube Defects in Bursa, Turkey. Pediatric and Perinatal Epidemology 1998; 2: 89-92
Say B, Tunçbilek E, Balcı S,et al. Incidence of congenital malformations in a sample of the Turkish population. Hum Hered 1973; 23: 434- 441
Mocan H, Bozkaya H, Özbay G, et al. Neural Tube Defects in eastern Black Sea region in1990. Pediatr Perinat Epidemiol 1992; 6: 465
Himmetoğlu O, Tiras MB. The incidence of congenital malformation in a Turkish population. Int J Gynecol Obstet 1996; 55: 117-121.
Suitor CW. Nutrition fo rwomen in their child bearing years: a review of thel iterature and a summary of expert recommendations. Nutr Clin Care 1999; 2: 11-45.
Bussel G, Marlow N. The dietary beliefs and attrtudes of women who have had a low –birth weight baby: a retrospective preconception study. J Hum Nutr Dietet 2000; 13: 29-39
Mandıracıoğlu A, Ulman İ, Lüleci E, Ulman C. The incidence and risk factors of neural tube defects in İzmir, Turkey: a nested case-contro lstudy. TheTurkish of Pediatrics 2004; 46: 214- 220
Farley TF, Hambidge SJ, Daley MF. Assosiation of low maternal education with neural tube defects in Colarado, 1989-1998. Public Health 2002; 116: 89-94.
Muthinick O, Orozco E, Lisker R, et al. Risk factors associated with neural tube defects: exposure during the first trimester of gestation. Gaceta Medica de Mexico 1996;126: 227-3
Lynberg MC, Khoury MJ, Lu X, et al. Maternal flu, fever, and the risk of tube defects: a population-based case-control study. Am J Epidemiol 1994; 140: 244-255
Richards ID. Congenital malformations and environmental influences in pregnancy. Br j Prev Soc Med 1969; 23: 218-225
Rasmussen AS, Chu SY, Kim SY, et al. Maternal obesity and risk of neural tube defects: a metaanalysis. Am J Obstet Gynecol 2008; 198(6): 611-619
Suarez L, Felkner M, Brender JD, et al. Maternal exposures to cigarette smoke, alcohol, and street drugs and neura ltube defect occurrence in offspring. Matern Child Health J 2008;12: 394– 401
Behrman ER, Kliegman RM, Jenson HB. Nelson Textbook of Pediatrics, 17 thEdition 2004: 1983-1987
Mitchell LE, Adzick SN, Melchionne J, etal. Spina bifida. Lancet 2004; 364:1885-95
Berg KF, Oppen ACCV, Holthe W, Schielen PCJI, et al. Neural tube defects associated with prenatal exposure to antiepileptic drugs. ReproductiveToxicology 2007; 24:57–8032.
Li Z, Ren A, Liu J, et al. Maternal flu or fever, medication use, and neural tube defects: A population-based case –control study in northen China. Birth Defects Research (Part A) 2007; 79: 295-300
Lynberg MC, Khoury MJ, Lu X, et al. Maternal flu, fever, andthe risk of tube defects: a population-based case-control study. Am J Epidemiol 1994; 140: 244-255
Zhang L, Ren AG, Li ZW, et al. Plazma and red blood cell folate level among women in their first trimester of pregnancy from rural areas with high or low prevalance of neural tube defects, China. Zhonghua Liu Xing Bing Xue ZaZhi 2006; 27(8): 659-63
Kirke PN, Molloy AM, Daly LE, et al. Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects. Q J Med 1993; 86(11): 703-8
Groenen PMW, Rooij IALMV, Peer PGM, at al. Marginal maternal vitamin B12 status increases the risk of off spring with spina bifida. American Journal of Obstetrics and Gynecology 2004; 191: 11-7
Adams MJ, Khoury MJ, Scanlon KS, etal. Elevated midtrimester serum methylmalonicacid levels as a risk factor for neural tube defects. Teratology 1995; 51(5): 311-7 67
Vander put NM, Thomas CMG, Eskes TKAB, et al. Altered folate and vitamin B12 metabolism in families with spina bifida offspring. Q J Med 1997; 90: 505-510
Schorah C J, Smithells RW, Scott J. Vitamin B12 and anencephaly. Lancet 1980;19: 880
Ray J G, Wyatt P R, Miles D T, Marian J V, Cris M, Pui-Yuen W, Sandra A F, David ECC. Vitamin B12 and the risk of neural tube defects in a folic-acid –fortified population. Epidemiology 2003; 18(3): 362-366