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The Demographics of Cases with Neural Tube Defects in Kahramanmaras

Year 2022, Volume: 17 Issue: 2, 160 - 166, 15.07.2022
https://doi.org/10.17517/ksutfd.837546

Abstract

Objective: We aimed to determine the features and prevalence of new-borns with neural tube defects (NTD) in Kahramanmaras. We evaluated the sociodemographical features of families, possible teratogenic causes which had been encountered in the first trimester of the pregnancy.
Material and Methods: Records of live and still births between January 2000 and December 2013, as well as records of patients diagnosed with NTD at the Sutcu Imam University Medical Faculty Hospital and neighbouring hospitals with neurosurgery clinics in Kahramanmaras were analysed an evaluated.
Questionnaires were used to collect data on the socıo-demographic factors, teratogenic factors encountered in the first trimester of pregnancy, the professions of the parents as well as their kinship status. The rate of febrile illness, alchol and drug use of the mothers were also evaluated.
Results: Nine hundred and seven patients with NTD were evaluated. Seven hundred and two of them had spina bifida (77,4 %), 528 of them had meningomyelocele (58.2%), 134 had meningocele (14.8%), 40 had dermal sinus tract (4.4%), 107 of them had anencephaly (11.8 %), and 98 of them were diagnosed
with encephalocele (10.8%).The frequency of NTD in Kahramanmaras was ‰3. In our study, 574 of the patients were females (63.2%), 333 of them were males (36.8%).When the parental occupations were evaluated unemployed or those that worked only o few days a month were significantly higher .The
income levels of the parents and the education levels of the mothers were low .The rate of folic acid preparation used by mothers with babies with NTD was considered to be extremely low.
Conclusion: The NTD incidence in Kahramanmaras was found relatively high when compared to similar studies in our country. It has been determined that NTD is more common in individuals with low levels of education, low income , poor nutrition and low occupational status. Folic acid supplementation before
and during pregnancy is known to be very important however the rate of folic acid intake in Kahramanmaras is low and the importance of vitamin supplements is not widely known. In addition, it has been concluded that patients may have additional pathologies that may have occurred during birth or after birth and hence these patients must be followed and treated with a multidisciplinary approach by experienced clinics.

References

  • Fuchs HE. Congenital abnormalities. Sabiston DC (ed). Textbook of Surgery, 15. th edition, W.B. Saunders Company, Philedelphia, 1997:1374-1381.
  • French BN. Midline fusion defects and defects of formation. Youmans JR (ed) Neurological Surgery, 3. th edition, W.B. Saunders Company, Philedelphia, 1990:1081-1095.
  • Northrup H, Volcik KA. Spina bifida and other neural tube defects. Curr Probl Pediatr 2000;30:313-332.
  • Wasserman CR, Shaw GM, Selvin S, Gould JB, Syme SL. Socioeconomic status, neighborhood social conditions, and neural tube defects. Am J Public Health 1998;88:1674-1680.
  • Larsen WJ. The third week. Gastrulation, formation of the trilaminar germ disc and initial development of the somites and neural tube. Larsen WJ (ed). Human Embriology kitabından, 2. baskı, Churchill Livingstone Inc, United Kingdom, 199749-72.
  • Wen SW, Liu S, Joseph KS, Rouleau J, Allen A. Patterns of infant mortality caused by major congenital anomalies. Teratology 2000;61:342-346.
  • Güvenc H, Uslu MA, Güvenç M, Ozekici U, Kocabay K, Bektaş S. Changing trend of neural tube defects in eastern Turkey. J Epidemiol Community Health 1993;47(1):40-41.
  • Hacımustafaoğlu K M, Nöral tüp defektlerinde anne ve çocukta serum folatı, eritrosit folatı ve serum B12 vitamin değerleri ve karşılıklı ilişkileri. Uzmanlık Tezi 1989.
  • Mocan H, Bozkaya H, Özbay G, Mocan MZ, Aydemir V. Neural Tube Defects in eastern Black Sea region in1990. Pediatr Perinat Epidemiol 1992;6:465.
  • Himmetoğlu O, Tiras MB. The incidence of congenital malformation in a Turkishpopulation. Int J Gynecol Obstet 1996;55:117-121.
  • Unusan N. Assesment of Turkish women’s knowledge concerning folic acid and prevention of birth defects. Public Health Nutrition 2004;7(7):851-855.
  • Liu J, Yang GZ, Zhou LJ, Cao SP, Chau DHW, Kung HF et al. Prevelance of neural tube defects in economically and socially deprived area of china. Childs Nerv Syst 2007;23:1119-1124.
  • EORACAT Working group. Prevelance of neural tube defects in 20 regions of Europe and impact of prenatal diagnosis, 1980-1986. Journal of Epidemiology and Community Health 1991;45:52-58.
  • Suitor CW. Nutrition for women in their childbearing years: a review of the literatureand a summary of expert recommendations. Nutr Clin Care 1999;2:11-45.
  • Bussel G, Marlow N. The dietary beliefs and attrtudes of women who have had a low –birtweight baby: A retrospective preconception study. J Hum Nutr Dietet 2000;13:29-39.
  • Tunçbilek E, Boduroğlu K, Alikaşifoğlu M. Neural tube defects in Turkey:Prevelance, distrubiton and risk factors. Turk J Pediatr 1999;41:299-305.
  • Kramer MS, Sequin L, Lydon J, Goulet L. Socioeconomic disparities in pregnancy outcomes: why do the poor fare so poorly. Paediatric&Perinatal Epidemiology 2000;14(3):194-210.
  • Mandıracıoğlu A, Ulman İ, Lüleci E, Ulman C. The incidence and risk factors of neural tube defects in İzmir, Turkey: A nested case-control study. The Turkish of Pediatrics 2004;46:214-220.
  • Muthinick O, Orozco E, Lisker R, Babinsky V, Núñez C. Risk factors associated with neural tube defects: exposure during the first trimester of gestation. Gaceta Medica de Mexico 1996;126:227-234.
  • Hauser AW. Epidemiology of Neural Tube Defects. Epilepsia 2003;44(3): 4-13
  • Kramer MS, Sequin L, Lydon J, Goulet L. Socioeconomic disparities in pregnancy outcomes: why do the poor fare so poorly. Paediatric&Perinatal Epidemiology 2000;14(3):194-210.
  • Gaber KR, Farag MK, Soliman SE et al. Maternal vitamin B12 and the risk of fetal neural tube defects in Egyptian patients. Clin Lab 2007;53(1-2):69 75
  • Li Z, Ren A, Zhang L, Ye R, Li S, Zheng J, Hong S, Wang T, Li Z. Extremely high prevelance of neural tube defects in a 4-county area in shanxi province, China. Birth Defects Research 2006;76:237-240.
  • Nikkila A, Rydhström H, Kallen B. The incidence of spina bifida in Sweden 1973-2003:The effect of prenatal diagnosis. European Journal of Puplic Health 2006;16(6):660-662.
  • Cherian A, Seena S. Bullock RK, Cntony AC. Incidence of neural tube defects in the least-developed area of India: a population- based study. The Lancet 2005;366:930-931.
  • Adams MJ, Khoury MJ, Scanlon KS, Stevenson RE, Knight GJ, Haddow JE et al. Elevated midtrimester serum mrthylmalonic acid levels as a risk factor for neural tube defects. Teratology 1995;51(5):311-317
  • Ray JG, Wyatt PR, Miles DT, Marian JV, Cris M, Pui-Yuen W et al. Vitamin B12 and the risk of neural tube defects in a folic- acid–fortified population. Epidemiology 2003;18(3):362-366.
  • Elwood JM, Little J, Elwood JH. Epidemiology and control of neural tube defects. Oxford (UK): Oxford University Press;1992:442-444.
  • Feldman JG, Stein SC, Klein RJ, Kohl S, Casey G. The prevalence of neural tube defects among ethnic groups in Brooklyn, New York. J Chron Dis 1982;35:5360.
  • Lynberg MC, Khoury MJ, Lu X, Cocian T . Maternal flu, fever, and the risk of tube defects: a population-based case-control study. Am J Epidemiol 1994;140:244-255.
  • Shaw G, Todorof K, Velie ME, Lammer JE. Maternal illness, including fever and medication use as risk factors for neural tube defects. Teratology 1998;57:1-7.
  • Li Z, Ren A, Liu J, Pei L, Zhang L, Guo Z. Maternal flu or fever, medication use, and neural tube defects: A population-based case –control study in northen China. Birth Defects Research 2007;79:295-300.

Kahramanmaraş İlinde Nöral Tüp Defekti Olgularının Demografik Özellikleri

Year 2022, Volume: 17 Issue: 2, 160 - 166, 15.07.2022
https://doi.org/10.17517/ksutfd.837546

Abstract

Amaç: Bu çalışmada Kahramanmaraş ili sınırları içerisinde doğan bebeklerde nöral tüp defekti (NTD) sıklığının belirlenmesi, NTD’li bebeğe sahip ailelerin sosyo-demografik özelliklerinin, annelerin gebelikleri süresince özellikle ilk trimestrda teratojen etkenlere maruz kalıp kalmadığının araştırılmasıdır.
Gereç ve Yöntemler: Ocak 2000-Aralık 2013 tarihleri arasında Kahramanmaraş ili sınırları içerisindeki canlı ve ölü doğum kayıtları retrospektif olarak değerlendirilmiş ve Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Hastanesi Nöroşirurji kliniği dahil Kahramanmaraş ilinde Nöroşirurji kliniği barındıran tüm hastanelerde NTD tanısı alan hastalar incelenmiştir. Sosyodemografik özellikler, gebeliğin ilk trimestrında karşılaşılan teratojen etkenler, anne ve babaların meslekleri, aylık maddi gelirleri ve akrabalık durumları, annelerin ateşli hastalık geçirme öyküsü, ilaç ve alkol kullanımları anket yöntemiyle
değerlendirildi.
Bulgular: Çalışmamızda 907 NTD’li hasta değerlendirildi. Hastaların 702’sinde (%77.4), spina bifida, 528’inde (%58.2) meningomyelosel,134’ünde (%14.8) meningosel, 40’ında (%4.4) dermal sinüs traktı, 107’sinde (%11.8) anensefali, 98’inde (%10.8) ensefalosel tanısı mevcuttu. Kahramanmaraş ilinde NTD sıklığı
‰3.83 olarak bulundu. Hastalardan 574’ü (%63.2) kadın, 333’ü (%36.8) erkek cinsiyetteydi. Olguların ebeveyn meslekleri değerlendirildiğinde işsizler veya ayda birkaç gün işçi olarak çalışanlar anlamlı oranda yüksekti. Ailenin gelir seviyesi ve annelerin eğitim seviyesi düşüktü. NTD’li bebeğe sahip annelerin
gebelikleri sırasında folik asit preperatı kullanım oranının ise çok düşük olduğu görüldü (%11.4).
Sonuç: Çalışmamızda Kahramanmaraş ilinde NTD görülme sıklığı ülkemizdeki benzer çalışmalar içinde göreceli olarak yüksek bulunmuştur. NDT’li bebeklerin ailelerinin düşük sosyoekonomik düzeyde olması ve annelerin yetersiz eğitim seviyeleri sonucu gebelik öncesi dönemde veya gebelik esnasında folik asit
kullanımının ilimizde ciddi olarak düşük olması bu yüksek NTD sıklığının sebebi olabilir. Ayrıca NTD hastalarında doğumda veya sonradan ortaya çıkabilecek ek patolojiler olabileceği ve bu hastaların multidisipliner yaklaşımla, deneyimli kliniklerce takip ve tedavisinin yapılması gerektiği sonucuna ulaşılmıştır.

References

  • Fuchs HE. Congenital abnormalities. Sabiston DC (ed). Textbook of Surgery, 15. th edition, W.B. Saunders Company, Philedelphia, 1997:1374-1381.
  • French BN. Midline fusion defects and defects of formation. Youmans JR (ed) Neurological Surgery, 3. th edition, W.B. Saunders Company, Philedelphia, 1990:1081-1095.
  • Northrup H, Volcik KA. Spina bifida and other neural tube defects. Curr Probl Pediatr 2000;30:313-332.
  • Wasserman CR, Shaw GM, Selvin S, Gould JB, Syme SL. Socioeconomic status, neighborhood social conditions, and neural tube defects. Am J Public Health 1998;88:1674-1680.
  • Larsen WJ. The third week. Gastrulation, formation of the trilaminar germ disc and initial development of the somites and neural tube. Larsen WJ (ed). Human Embriology kitabından, 2. baskı, Churchill Livingstone Inc, United Kingdom, 199749-72.
  • Wen SW, Liu S, Joseph KS, Rouleau J, Allen A. Patterns of infant mortality caused by major congenital anomalies. Teratology 2000;61:342-346.
  • Güvenc H, Uslu MA, Güvenç M, Ozekici U, Kocabay K, Bektaş S. Changing trend of neural tube defects in eastern Turkey. J Epidemiol Community Health 1993;47(1):40-41.
  • Hacımustafaoğlu K M, Nöral tüp defektlerinde anne ve çocukta serum folatı, eritrosit folatı ve serum B12 vitamin değerleri ve karşılıklı ilişkileri. Uzmanlık Tezi 1989.
  • Mocan H, Bozkaya H, Özbay G, Mocan MZ, Aydemir V. Neural Tube Defects in eastern Black Sea region in1990. Pediatr Perinat Epidemiol 1992;6:465.
  • Himmetoğlu O, Tiras MB. The incidence of congenital malformation in a Turkishpopulation. Int J Gynecol Obstet 1996;55:117-121.
  • Unusan N. Assesment of Turkish women’s knowledge concerning folic acid and prevention of birth defects. Public Health Nutrition 2004;7(7):851-855.
  • Liu J, Yang GZ, Zhou LJ, Cao SP, Chau DHW, Kung HF et al. Prevelance of neural tube defects in economically and socially deprived area of china. Childs Nerv Syst 2007;23:1119-1124.
  • EORACAT Working group. Prevelance of neural tube defects in 20 regions of Europe and impact of prenatal diagnosis, 1980-1986. Journal of Epidemiology and Community Health 1991;45:52-58.
  • Suitor CW. Nutrition for women in their childbearing years: a review of the literatureand a summary of expert recommendations. Nutr Clin Care 1999;2:11-45.
  • Bussel G, Marlow N. The dietary beliefs and attrtudes of women who have had a low –birtweight baby: A retrospective preconception study. J Hum Nutr Dietet 2000;13:29-39.
  • Tunçbilek E, Boduroğlu K, Alikaşifoğlu M. Neural tube defects in Turkey:Prevelance, distrubiton and risk factors. Turk J Pediatr 1999;41:299-305.
  • Kramer MS, Sequin L, Lydon J, Goulet L. Socioeconomic disparities in pregnancy outcomes: why do the poor fare so poorly. Paediatric&Perinatal Epidemiology 2000;14(3):194-210.
  • Mandıracıoğlu A, Ulman İ, Lüleci E, Ulman C. The incidence and risk factors of neural tube defects in İzmir, Turkey: A nested case-control study. The Turkish of Pediatrics 2004;46:214-220.
  • Muthinick O, Orozco E, Lisker R, Babinsky V, Núñez C. Risk factors associated with neural tube defects: exposure during the first trimester of gestation. Gaceta Medica de Mexico 1996;126:227-234.
  • Hauser AW. Epidemiology of Neural Tube Defects. Epilepsia 2003;44(3): 4-13
  • Kramer MS, Sequin L, Lydon J, Goulet L. Socioeconomic disparities in pregnancy outcomes: why do the poor fare so poorly. Paediatric&Perinatal Epidemiology 2000;14(3):194-210.
  • Gaber KR, Farag MK, Soliman SE et al. Maternal vitamin B12 and the risk of fetal neural tube defects in Egyptian patients. Clin Lab 2007;53(1-2):69 75
  • Li Z, Ren A, Zhang L, Ye R, Li S, Zheng J, Hong S, Wang T, Li Z. Extremely high prevelance of neural tube defects in a 4-county area in shanxi province, China. Birth Defects Research 2006;76:237-240.
  • Nikkila A, Rydhström H, Kallen B. The incidence of spina bifida in Sweden 1973-2003:The effect of prenatal diagnosis. European Journal of Puplic Health 2006;16(6):660-662.
  • Cherian A, Seena S. Bullock RK, Cntony AC. Incidence of neural tube defects in the least-developed area of India: a population- based study. The Lancet 2005;366:930-931.
  • Adams MJ, Khoury MJ, Scanlon KS, Stevenson RE, Knight GJ, Haddow JE et al. Elevated midtrimester serum mrthylmalonic acid levels as a risk factor for neural tube defects. Teratology 1995;51(5):311-317
  • Ray JG, Wyatt PR, Miles DT, Marian JV, Cris M, Pui-Yuen W et al. Vitamin B12 and the risk of neural tube defects in a folic- acid–fortified population. Epidemiology 2003;18(3):362-366.
  • Elwood JM, Little J, Elwood JH. Epidemiology and control of neural tube defects. Oxford (UK): Oxford University Press;1992:442-444.
  • Feldman JG, Stein SC, Klein RJ, Kohl S, Casey G. The prevalence of neural tube defects among ethnic groups in Brooklyn, New York. J Chron Dis 1982;35:5360.
  • Lynberg MC, Khoury MJ, Lu X, Cocian T . Maternal flu, fever, and the risk of tube defects: a population-based case-control study. Am J Epidemiol 1994;140:244-255.
  • Shaw G, Todorof K, Velie ME, Lammer JE. Maternal illness, including fever and medication use as risk factors for neural tube defects. Teratology 1998;57:1-7.
  • Li Z, Ren A, Liu J, Pei L, Zhang L, Guo Z. Maternal flu or fever, medication use, and neural tube defects: A population-based case –control study in northen China. Birth Defects Research 2007;79:295-300.
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Araştırma Makaleleri
Authors

Emrullah Cem Kesilmez 0000-0003-3905-2206

Zafer Yüksel 0000-0002-9234-5908

Early Pub Date July 11, 2022
Publication Date July 15, 2022
Submission Date December 8, 2020
Acceptance Date January 16, 2021
Published in Issue Year 2022 Volume: 17 Issue: 2

Cite

AMA Kesilmez EC, Yüksel Z. Kahramanmaraş İlinde Nöral Tüp Defekti Olgularının Demografik Özellikleri. KSU Medical Journal. July 2022;17(2):160-166. doi:10.17517/ksutfd.837546