RISK FACTORS FOR FOLIC ACID-RESISTANCE 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例出生于至少摄入推荐每日叶酸量（400 ug）的女性。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1988年至今的一项美国大型病例对照研究中收集的数据，将确定叶酸耐药脊柱裂的可预防风险因素。波士顿大学斯隆流行病学中心的出生缺陷研究是一个独特的资源，提供了关于脊柱裂病例母亲的详细数据，以及维生素补充和饮食摄入的对照。这些数据可以根据围受孕期叶酸摄入充足或不足对母亲进行分类。此外，还有关于许多其他潜在风险因素的详细数据。多达463例叶酸耐药脊柱裂病例的母亲将与两个不同的对照组进行比较。一个对照组将包括摄入叶酸量不足的脊柱裂后代的母亲，另一个对照组将包括摄入叶酸量充足的非畸形后代的母亲。将对以前被认为是神经管缺陷或脊柱裂风险因素的因素进行比较，包括肥胖，糖尿病，上呼吸道疾病，发烧，热源暴露，不孕症，辅助生殖技术，吸烟，酒精，咖啡因和药物暴露。此外，为了进行假设检验，将筛选所有风险因素数据，包括所有药物、疾病和营养素，以确定新的可预防风险因素。

DESCRIPTION (provided by applicant): The prevalence of spina bifida has decreased since folic acid fortification, but an estimated 800 cases are born each year in the US to women who ingested at least the recommended daily amount (400 ug) 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 1988 to the present, preventable risk factors for folic acid-resistant spina bifida will be identified. The Boston University Slone Epidemiology Center Birth Defects Study is a unique resource with detailed data on mothers of spina bifida cases and controls for vitamin supplementation and dietary intakes. These data allow mothers to be classified according to sufficient or insufficient intake of folic acid during the periconceptional period. Further, detailed data are available on many other potential risk factors. The mothers of as many as 463 folic acid resistant spina bifida cases would be compared to two different control groups. One control group would comprise mothers of spina bifida offspring who ingested insufficient amounts of folic acid and the other would comprise mothers of non-malformed offspring who ingested sufficient amounts of folic acid. Comparisons will be made for factors that have previously been suggested as risk factors for neural tube defects or spina bifida, including obesity, diabetes, upper respiratory illness, fever, heat source exposure, infertility, assisted reproductive technology, smoking, alcohol, caffeine, and medication exposures. In addition, to hypothesis testing, all risk factor data, including all medications, illnesses, and nutrients, will be screened to identify new preventable risk factors.