RISK FACTORS FOR FOLIC ACID-RESISTANCE SPINA BIFIDA

描述(申请人提供)：自从补充叶酸以来，脊柱裂的患病率有所下降，但据估计，在美国，每年有800例女性出生，她们至少摄入了推荐的每日叶酸剂量(400微克)。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1988年至今的一项大型美国病例对照研究中收集的数据，将确定叶酸抵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，提供了有关脊柱裂母亲的详细数据以及维生素补充剂和饮食摄入量的对照数据。这些数据允许根据围孕期叶酸摄入量的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。多达463名叶酸抵抗型脊柱裂患者的母亲将与两个不同的对照组进行比较。一组对照组将由摄入不足叶酸的脊柱裂后代的母亲组成，另一组将包括摄入足够叶酸的非畸形子女的母亲。将对以前被认为是神经管缺陷或脊柱裂的危险因素进行比较，包括肥胖、糖尿病、上呼吸道疾病、发烧、热源暴露、不孕、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，将对所有风险因素数据进行筛选，包括所有药物、疾病和营养物质，以确定新的可预防的风险因素。

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.