EXPLORING MODIFIABLE FACTORS FOR FOLIC ACID RESISTANT SPINA BIFIDA

 描述（由申请人提供）：自叶酸强化以来，脊柱裂的患病率有所下降，但在美国，估计每年有800例妊娠受到至少摄入推荐每日叶酸量（400微克）的女性的影响。由于脊柱裂是一种严重的疾病，对家庭和社会产生重大影响，因此需要采取进一步的预防战略。利用从1976年至今的一项大型美国病例对照研究中收集的数据，将确定叶酸耐药脊柱侧弯的可预防风险因素。波士顿大学斯隆流行病学中心出生缺陷研究是一个独特的资源，详细的数据对母亲的1100多例脊柱裂病例和9000控制叶酸摄入量。这些数据允许母亲根据围产期叶酸摄入量充足或不足进行分类。此外，还有关于许多其他潜在风险因素的详细数据。在这个项目中，我们将探讨孕妇叶酸摄入量是否改变脊柱裂风险与孕妇早孕抗癫痫药使用、抗菌药物使用和口服避孕药使用失败之间的关联。此外，我们还将探讨母亲叶酸摄入量、体力活动、饮食质量或妊娠间隔是否会改变脊柱裂风险与母亲西班牙裔种族、低社会经济地位指标、肥胖和早孕热之间的关联。此外，对照组妇女的叶酸摄入模式将根据母亲的职业类别和类型以及产次和怀孕间隔时间进行评估，以确定干预措施的目标妇女群体。最后，国家出生缺陷预防研究的结果将与Slone流行病学出生缺陷研究关于母亲使用抗组胺药、抗组胺药和非甾体抗炎药的数据复制。从这个项目的结果将导致消除脊柱裂的发生的最终目标。

 DESCRIPTION (provided by applicant): The prevalence of spina bifida has decreased since folic acid fortification, but an estimated 800 pregnancies are affected each year in the US to women who ingested at least the recommended daily amount (400 micrograms) of folic acid. Because spina bifida is a serious condition that has substantial impacts on families and society, further strategies for prevention are warranted. Using data collected in a large US case-control study from years 1976 to the present, preventable risk factors for folic acid-resistant spina bifid will be identified. The Boston University Slone Epidemiology Center Birth Defects Study is a unique resource with detailed data on mothers of over 1100 spina bifida cases and 9000 controls on folic acid intakes. These data allow mothers to be classified according to sufficient o insufficient intake of folic acid during the periconceptional period. Further, detailed data are available on many other potential risk factors. In this project, we will explore whether maternal folic acid intake modifies associations between spina bifida risks and maternal early pregnancy antiepileptic use, antimicrobial use, and failed oral contraceptive use. In addition, we will exploe whether maternal folic acid intake, physical activity, diet quality, or inter-pregnancy interval modifies associations between spina bifida risk and maternal Hispanic ethnicity, indicators of low socioeconomic status, obesity, and early pregnancy fever. Further, patterns of folic acid intake among control women will be assessed, according to maternal occupational class and type and by parity and inter-pregnancy interval lengths, to identify target groups of women for interventions. Lastly, findings from National Birth Defects Prevention Study will be replicated with Slone Epidemiology Birth Defects Study data on maternal use of antihistamines, anti-nauseants, and non-steroidal anti-inflammatory drugs. Findings from this project will lead toward the ultimate goal of eliminating the occurrence of spina bifida.