EXPLORING MODIFIABLE FACTORS FOR FOLIC ACID RESISTANT SPINA BIFIDA

 描述(由申请人提供)：自从强化叶酸以来，脊柱裂的患病率有所下降，但在美国，估计每年有800名妇女因叶酸摄入量至少达到推荐量(400微克)而受到影响。由于脊柱裂是一种严重的疾病，对家庭和社会有重大影响，因此有必要采取进一步的预防策略。使用从1976年至今的一项大型美国病例对照研究中收集的数据，将确定叶酸抗性脊柱裂的可预防的危险因素。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，拥有超过1100例脊柱裂母亲和9000名叶酸摄入量对照的详细数据。这些数据允许根据围孕期叶酸摄入量充足或不足对母亲进行分类。此外，还有许多其他潜在风险因素的详细数据。在这个项目中，我们将探索母亲叶酸摄入是否会改变脊柱裂风险与母亲早期妊娠抗癫痫药物使用、抗微生物药物使用以及口服避孕药使用失败之间的关系。此外，我们还将探索母亲叶酸摄入量、体力活动、饮食质量或孕期间隔是否会改变脊柱裂风险与母亲拉美裔种族、低社会经济地位指标、肥胖和早孕热之间的关联。此外，将根据产妇职业类别和类型以及产次和孕期间隔长度评估对照妇女的叶酸摄入模式，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数据重复，这些数据涉及母亲使用抗组胺药、抗恶心药和非类固醇抗炎药。这个项目的发现将导致最终目标，消除脊柱裂的发生。

 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.