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González-Ramos L, Martínez-Sanz E, García-Serradilla M, García-de-Pereda M, Maldonado E. Frequency of gastroschisis and omphalocele and possible influence of maternal folic acid supplementation. A narrative review. Congenit Anom (Kyoto) 2024; 64:190-198. [PMID: 38897927 DOI: 10.1111/cga.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/26/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
There is an increase in the worldwide prevalence of congenital abdominal wall defects (CAWD), with gastroschisis (GS) and omphalocele (OC) being the most common. It is widely accepted that folic acid supplementation (FAS) in the maternal diet decreases the incidence of anomalies such as neural tube defects, but there is controversy regarding the possible beneficial role for other congenital malformations. Several epidemiological studies raise controversy regarding a possible relationship between vitamin supplementation with the occurrence of abdominal wall malformations. The aim of the present study is to obtain an updated review of the global frequency of CAWD in neonates and the relationship with FAS in the mothers. For this we have carried out a systematic search of epidemiological studies in different article databases between 2011 and 2022. The analysis of 25 studies conducted in different countries where cases of OC and/or GS are registered directly or together with other congenital defects shows that 60% inquire into the relationship of FAS with the incidence of CAWD. Half of them proposes a beneficial effect of FAS and the other half find no association, concluding that there is no unanimous evidence that FAS in the maternal diet decreases the incidence of CAWD. However, it seems that an influential factor to take into account is the nutritional habits of the mothers.
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Affiliation(s)
- Laura González-Ramos
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
| | - Elena Martínez-Sanz
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
- Research Group UCM 920202, Ciudad Universitaria, Madrid, Spain
| | - Moisés García-Serradilla
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
- Research Group UCM 920202, Ciudad Universitaria, Madrid, Spain
| | - Miquel García-de-Pereda
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
| | - Estela Maldonado
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
- Research Group UCM 920202, Ciudad Universitaria, Madrid, Spain
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Chen LJ, Chen PJ, Huang JY, Yang SF, Chen JY. Reducing Birth Defects by Decreasing the Prevalence of Maternal Chronic Diseases-Evaluated by Linked National Registration Dataset. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121793. [PMID: 36553237 PMCID: PMC9776563 DOI: 10.3390/children9121793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
Birth defects (BDs) are an important cause of abortion, stillbirth, and infant mortality that may cause lifelong disability. The defects can be caused by genetics, environmental exposure, or maternal chronic diseases. We conducted a study to analyze the association between maternal chronic diseases and BDs and to evaluate the effect of decreasing the prevalence of maternal chronic diseases on reducing BDs. The data of newborns and their mothers were concatenated and analyzed from three national population databases: the National Health Insurance Research Database, the Birth Certificate Application, and the Birth Registration Database in Taiwan during the period of 2005 to 2014. Codes 740-759 of the International Classification of Diseases 9th Revision—Clinical Modification (ICD-9-CM) were used as the diagnosis of BDs. The prevalence of BDs was 2.72%. Mothers with cardiovascular diseases, hypertension, anemia, genitourinary tract infections, renal diseases, neurotic or psychotic disorders, gestational diabetes mellitus (DM), and pregestational type 1 or type 2 DM had a significantly higher prevalence of BDs. The population attributable risk percent (PAR%) of BDs was 1.63%, 0.55%, 0.18%, 1.06%, 0.45%, 0.22%, 0.48%, and 0.24% for maternal hypertension, cardiovascular disease, renal disease, genitourinary infection, anemia, neurotic and psychotic disorders, gestational DM, and pregestational type 1 or type 2 DM, respectively. The percentage change (−1%, −5%, and −10% of prevalence in 2034 compared with the prevalence in 2005−2014) of maternal disease and the predicted number of live births was used to estimate the decrease in the number of newly diagnosed BDs in 2034. By using the middle-estimated number of live births in 2034, we predicted that the number of BDs would decrease by 302, 102, 33, 196, 83, 41, 89, and 44 with a −5% prevalence of maternal hypertension, cardiovascular disease, renal disease, genitourinary infection, anemia, neurotic and psychotic disorders, gestational DM, and pregestational type 1 or type 2 DM, respectively. We conclude that mothers with chronic diseases, including cardiovascular diseases, hypertension, anemia, genitourinary tract infections, renal diseases, neurotic or psychotic disorders, gestational DM, and pregestational type 1 or type 2 DM, have a significantly higher (p < 0.01) prevalence of having offspring with BDs. Mothers with chronic diseases are associated with BDs. It is very important to set up a policy to decrease the prevalence of these maternal chronic diseases; then, we can reduce the incidence of BDs.
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Affiliation(s)
- Lih-Ju Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Division of Neonatology, Changhua Christian Children’s Hospital, Changhua 50050, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Ping-Ju Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Department of Dentistry, Changhua Christian Hospital, Changhua 50050, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Jia-Yuh Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Division of Neonatology, Changhua Christian Children’s Hospital, Changhua 50050, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Correspondence: ; Tel.: +886-4-723-8595 (ext. 1903)
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Chen LJ, Chiou JY, Huang JY, Su PH, Chen JY. Birth defects in Taiwan: A 10-year nationwide population-based, cohort study. J Formos Med Assoc 2019; 119:553-559. [PMID: 31477483 DOI: 10.1016/j.jfma.2019.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/20/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND/PURPOSE Birth defects (BDs) are main causes of mortality and disability in infants and children. The aims of this study were to analyze the prevalence, types and risk factors of BDs in Taiwan. METHODS Data of all births (including live and stillbirths), types, characteristics, and associated risk factors of BDs were obtained from the National Birth Registry and National Health Insurance Research Data base in Taiwan between 2005 and 2014. Birth defects were coded according to International Classification of Diseases 9th Revision-Clinical Modification codes 740-759. RESULTS A total of 55,299 infants were diagnosed as having BDs among 2,033,004 births. The prevalence of BDs was 271.66 per 10,000 births. The prevalence of BDs did not change significantly between 2005 and 2014, there was a higher birth rate and lower BDs in 2012 (year of dragon) in Taiwan. The most common type of BDs was cardiovascular abnormalities, and ventricular septal defect was the most common disease. Extreme maternal age (<18 years or ≧30 years), preterm, and low birth weight were associated with BDs. Maternal diseases associated with BDs included hypertension, cardiovascular diseases, renal diseases, genitourinary infections, anemia, mental disorders, and diabetes mellitus. CONCLUSION The prevalence of BDs was 271.66 per 10,000 births. The most common types of BDs were cardiovascular abnormalities. If we can reduce maternal chronic diseases, we will decrease the prevalence of BDs.
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Affiliation(s)
- Lih-Ju Chen
- Division of Neonatology, Changhua Christian Children's Hospital, Changhua City, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jeng-Yuan Chiou
- School of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Clinical Research Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Pen-Hua Su
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jia-Yuh Chen
- Division of Neonatology, Changhua Christian Children's Hospital, Changhua City, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Risk Factors for hypospadias in Northwest Russia: A Murmansk County Birth Registry Study. PLoS One 2019; 14:e0214213. [PMID: 30946760 PMCID: PMC6448815 DOI: 10.1371/journal.pone.0214213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 03/10/2019] [Indexed: 11/19/2022] Open
Abstract
Background Hypospadias is the most common congenital anomaly of the penis, but its causes are mainly unknown. Of the risk factors identified, the most plausible are hormonal and genetic. The aim of this study was to identify risk factors for hypospadias in Northwest Russia based on registry data. Methods The study population included male infants registered in the Murmansk County Birth Registry between 1 January 2006 and 31 December 2011 (n = 25 475). These infants were followed-up for 2 years using the Murmansk Regional Congenital Defects Registry to identify cases of hypospadias not diagnosed at birth. We used logistic regression analysis to examine the contributions of hypospadias risk factors. Results Out of 25 475 male infants born during the study period, 148 had isolated hypospadias. The overall prevalence rate was 54.2 (95% CI 53.6–54.8) per 10 000 male infants. Those born to mothers with preeclampsia (OR = 1.65; 95% CI 1.03–2.66) or infant birthweight < 2500 g (OR = 2.06; 95% CI 1.18–3.60) exhibited increased risk for hypospadias. Maternal age, smoking during pregnancy, folic acid intake during pregnancy or hepatitis B surface antigen positivity did not associate with increased risk of hypospadias. Conclusions Combining data from a birth registry with those from a congenital defects registry provided optimal information about the prevalence of hypospadias and its association with low infant birthweight and preeclampsia. These factors have in common changes in hormone levels during pregnancy, which in turn may have contributed to hypospadias development.
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Kovalenko AA, Anda EE, Odland JØ, Nieboer E, Brenn T, Krettek A. Risk Factors for Ventricular Septal Defects in Murmansk County, Russia: A Registry-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071320. [PMID: 29937526 PMCID: PMC6069126 DOI: 10.3390/ijerph15071320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/14/2018] [Accepted: 06/22/2018] [Indexed: 12/13/2022]
Abstract
Cardiovascular malformations are one of the most common birth defects among newborns and constitute a leading cause of perinatal and infant mortality. Although some risk factors are recognized, the causes of cardiovascular malformations (CVMs) remain largely unknown. In this study, we aim to identify risk factors for ventricular septal defects (VSDs) in Northwest Russia. The study population included singleton births registered in the Murmansk County Birth Registry (MCBR) between 1 January 2006 and 31 December 2011. Infants with a diagnosis of VSD in the MCBR and/or in the Murmansk Regional Congenital Defects Registry (up to two years post-delivery) constituted the study sample. Among the 52,253 infants born during the study period there were 744 cases of septal heart defects (SHDs), which corresponds to a prevalence of 14.2 [95% confidence interval (CI) of 13.2–15.3] per 1000 infants. Logistic regression analyses were carried out to identify VSD risk factors. Increased risk of VSDs was observed among infants born to mothers who abused alcohol [OR = 4.83; 95% CI 1.88–12.41], or smoked during pregnancy [OR = 1.35; 95% CI 1.02–1.80]. Maternal diabetes mellitus was also a significant risk factor [OR = 8.72; 95% CI 3.16–24.07], while maternal age, body mass index, folic acid and multivitamin intake were not associated with increased risk. Overall risks of VSDs for male babies were lower [OR = 0.67; 95% CI 0.52–0.88].
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Affiliation(s)
- Anton A Kovalenko
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
- International School of Public Health, Northern State Medical University, 163000 Arkhangelsk, Russia.
| | - Erik Eik Anda
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
| | - Jon Øyvind Odland
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
| | - Evert Nieboer
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, L9H 6C6 ON, Canada.
| | - Tormod Brenn
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
| | - Alexandra Krettek
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, 54128 Skövde, Sweden.
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 41390 Gothenburg, Sweden.
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