بررسي ميزان نقايص لوله عصبي و فاكتورهاي موثر در بروز آن در زنان باردار مراجعه كننده به زايشگاه شاهرود

Surveying the frequency of neural tube defects and the effective factors in pregnant women refereed to Fatemiyeh Hospital in Shahrud

Background; After cardiac defects, neural-tube defects (NTD) are the most congenital structural defects with a worldwide incidence of 1.4 to 2 per 1000 live births. This defect is due to failure of the neural tube to close spontaneously between the 3rd and 4th wk of uterine development. The control of risk factors related to NTD, may reduce the associated psychologic problems. Materials and methods: For this case-control study, women referred to delivery room in Fatemiyeh Hospital in Shahrud were enrolled. Totally, 100 women with normal fetus or neonate in a systematic randomized sampling were chosen as a control group. Control group were compared with women who delivered fetus or neonate with NTDs in foresaid time for the following factors: drug use, overt diabetes, getting fever and receiving X-ray around the conceptionʹs time. Results: During 4.5 years, 55 women (3.7 in 1000) had fetus or neonate with NTD. According to determined odds ratio, none of the surveyed factors were effective. There were no statistical difference between two groups in folic acid consuming and all women consumed folic acid after third month of pregnancy. Hydramniose, as a complication of NTDs, was more frequent in case group than controls (20.9 vs 0.01, p<0.001). Conclusion; Although the precise cause of neural tube defects remains unknown, some factors may influence normal development of CNS. In our study none of the surveyed factors were affective, thus, epidemiological studies are recommended. According to studies, more than half of NTDs could be prevented with daily intake of folic acid throughout the conceptional period, so intake of 400jacg folic acid daily (according to CDC and ACOG recommendations) is offered in all women in reproductive age who referred to the health care settings in Iran.