Neural tube defects and maternal intake of micronutrients related to one-carbon metabolism or antioxidant activity.

Chandler AL, Hobbs CA, Mosley BS, Berry RJ, Canfield MA, Qi YP, Siega-Riz AM, Shaw GM; National Birth Defects Prevention Study. (2012) Neural tube defects and maternal intake of micronutrients related to one-carbon metabolism or antioxidant activity. Birth defects research. Part A, Clinical and molecular teratology. 2012 Aug 29.

BACKGROUND:

Maternal nutritional status has been evaluated to clarify its role in development of neural tube defects (NTDs). Maternal folate intake during pregnancy has been closely evaluated for its association with NTDs. The study objective was to examine associations between NTDs and other dietary periconceptional micronutrient intake, particularly nutrients involved in one-carbon metabolism or antioxidant activity.

METHODS:

Using data from the National Birth Defects Prevention Study, 1997-2005, logistic regression models were used to estimate the relative risk of NTDs based on maternal micronutrient intake.

RESULTS:

Results were stratified according to folic acid supplement use, race/ethnicity, and maternal body mass index. Analyses included 954 cases (300 with anencephaly, 654 with spina bifida) and 6268 controls. Higher intakes of folate, thiamin, betaine, iron, and vitamin A were associated with decreased risk of anencephaly among some ethnic and clinical groups. In some groups, higher intakes of thiamin, riboflavin, vitamin B(6) , vitamin C, vitamin E, niacin, and retinol were associated with decreased risk of spina bifida.

CONCLUSION:

In addition to folic acid, other micronutrients, including thiamin, betaine, riboflavin, vitamin B(6) , vitamin C, vitamin E, niacin, iron, retinol, and vitamin A, may decrease the risk of NTD occurrence. Birth Defects Research (Part A) 2012. © 2012 Wiley Periodicals, Inc.

PMID: 22933447

Health risk behaviors among young adults with spina bifida.

Soe MM, Swanson ME, Bolen JC, Thibadeau JK, Johnson N. (2012) Health risk behaviors among young adults with spina bifida. Developmental Medicine & Child Neurology. 2012 Sep 3.

Aim  Persons with spina bifida who adopt unhealthy lifestyles could be at increased risk of adverse health outcomes because the presence of spina bifida may magnify this risk. We estimated overall and age-specific prevalence of selected health risk behaviors (HRBs) in young people with spina bifida and examined the association between HRBs and depression. Method  We performed analyses on data obtained from individuals with spina bifida (n=130; mean age 23y SD 4y 5mo; 64 males, 66 females; 64% lumbosacral lesion; 77% with shunt) who participated in a population-based survey conducted by the Arkansas Spinal Cord Commission in 2005. Results  Compared with national estimates, young people with spina bifida tend to eat less healthy diets, do less exercise, and engage in more sedentary activities. Respondents were less likely to use substances (alcohol, tobacco, illegal drugs), which peaked among 25 to 31 year olds. About 90% saw a doctor in the previous year. Nearly one half reported mild or major depressive symptoms. In the logistic regression analysis after controlling for potential confounders (age, sex, ethnic group, education, employment, marital status, living arrangement, level of lesion, presence of shunt, mobility, self-rated health and healthcare utilization), major depressive symptoms were associated with current alcohol drinking (adjusted odds ratio: 4.74; 95% CI 1.18-19.04). Interpretation  Young adults with spina bifida exhibit unhealthy behaviors that continue into their late 20s. The findings highlight the need to increase awareness of their health risk profiles in the spina bifida community and show opportunities for mental health and health risk screening and counseling by healthcare providers.

 

PMID:22937873

Interhemispheric Effective and Functional Cortical Connectivity Signatures of Spina Bifida Are Consistent with Callosal Anomaly.

Malekpour S, Li Z, Cheung BL, Castillo EM, Papanicolaou AC, Kramer LA, Fletcher JM, Van Veen BD. (2012) Interhemispheric Effective and Functional Cortical Connectivity Signatures of Spina Bifida Are Consistent with Callosal Anomaly. Brain Connectivity 2012 Jun 28.

 

Department of Electrical and Computer Engineering, University of Wisconsin , Madison, Wisconsin.

Abstract

The impact of the posterior callosal anomalies associated with spina bifida on interhemispheric cortical connectivity is studied using a method for estimating cortical multivariable autoregressive models from scalp magnetoencephalography data. Interhemispheric effective and functional connectivity, measured using conditional Granger causality and coherence, respectively, is determined for the anterior and posterior cortical regions in a population of five spina bifida and five control subjects during a resting eyes-closed state. The estimated connectivity is shown to be consistent over the randomly selected subsets of the data for each subject. The posterior interhemispheric effective and functional connectivity and cortical power are significantly lower in the spina bifida group, a result that is consistent with posterior callosal anomalies. The anterior interhemispheric effective and functional connectivity are elevated in the spina bifida group, a result that may reflect compensatory mechanisms. In contrast, the intrahemispheric effective connectivity is comparable in the two groups. The differences between the spina bifida and control groups are most significant in the θ and α bands.

PMID:22571349

 

Factors Associated With Strabismus in Spina Bifida Myelomeningocele.

Anderson HA, Stuebing KK, Buncic R, Mazow M, Fletcher JM. (2012) Factors Associated With Strabismus in Spina Bifida Myelomeningocele. Journal of Pediatric Ophthalmology and Strabismus. 2012 May 8:1-6.

Abstract

PURPOSE:

Higher prevalence of strabismus in individuals with spina bifida myelomeningocele (SBM) has previously been attributed to hydrocephalus; however, SBM is associated with many other complications. This study investigates the relation between strabismus and other factors in SBM.

METHODS:

Children aged 3 to 18 years with SBM (n = 112) received an eye examination including assessment of ocular alignment by cover or Hirschberg test. Gestational age, respiratory distress at birth, birth weight, maternal age at birth, number of shunt revisions, and spinal lesion level were also obtained. The relation between these factors and strabismus was analyzed.

RESULTS:

Forty-two participants had strabismus. Maternal age (P = .4) and respiratory distress (P = .6) were not significantly related to strabismus. Lower birth weight was suggestive of a relation with strabismus (logistic regression, P = .05) and younger gestational age was related to strabismus (logistic regression, P = .01). Participants who had at least one shunt revision were more likely to have strabismus (Fisher's exact test, P = .038). Spinal lesion level was significantly related to strabismus with increased likelihood of strabismus for spinal lesions closer to the brain (Wald chi-square, 1,100 = 4.29, P = .038).

CONCLUSION:

These findings indicate that several factors are associated with strabismus in SBM. Some of these factors (lower birth weight and younger gestational age) are associated with strabismus in the general population, whereas the association of strabismus and level of spinal lesion may be unique to SBM and may be related to the more severe brain dysmorphology associated with upper level spinal lesions.
Copyright 2012, SLACK Incorporated.

PMID: 22588727

Maternal tea consumption during early pregnancy and the risk of spina bifida.

Yazdy MM, Tinker SC, Mitchell AA, Demmer LA, Werler MM.  (2012) Maternal tea consumption during early pregnancy and the risk of spina bifida. Birth Defects Research. Part A, Clinical and Molecular Teratology. 2012 May 29

Slone Epidemiology Center at Boston University, Boston, Massachusetts. mahsa@bu.edu.

Abstract

Studies have demonstrated that catechin, an antioxidant found in tea, can reduce the bioavailability of folate. Because periconceptional folic acid intake has been demonstrated to reduce the risk of spina bifida, tea consumption may put pregnant women at risk because of its possible antifolate properties. Using data collected in the Slone Epidemiology Center Birth Defects Study, we examined whether tea consumption during early pregnancy was associated with an increased risk of spina bifida. Mothers of 518 spina bifida cases and 6424 controls were interviewed within 6 months after delivery about pregnancy events and exposures. Data on tea intake were collected during three periods (1976-1988, 1998-2005 and 2009-2010). Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for study center. Intake of both periconceptional food folate and diet and supplemental folic acid were examined as a potential effect modifier. For 1976 to 1988, ORs were not elevated for daily tea intake. For 1998 and onward, ORs were also close to 1.0, but there was a modest increase for those who drank more than 3 cups/day (OR, 1.92; 95% CI, 0.84-4.38). Among women with total folic acid intake greater than 400 μg, consumption of 3 cups or more of tea per day was associated with an increased risk of spina bifida in 1976 to 1988 (OR, 2.04; 95% CI, 0.69-7.66) and in the later periods (OR, 3.13; 95% CI, 0.87-11.33). Our data do not support an overall association between tea consumption and spina bifida, but there is a suggestion of a possible interaction between higher levels of folic acid intake and tea consumption. Birth Defects Research (Part A) 2012.

PMID:22641606

The history of the surgical repair of spina bifida.

McClugage SG, Watanabe K, Shoja MM, Loukas M, Tubbs RS, Oakes WJ. (2012) The history of the surgical repair of spina bifida. Child's Nervous System. 2012 Jun 6.

Pediatric Neurosurgery, Children's Hospital, Birmingham, AL, 35233, USA.

Abstract

INTRODUCTION: The history of surgical spina bifida repair has seen many successes and failures. Many early surgeons attempted treatment of open spina bifida defects before a clear understanding of the disease process or pathology had been discovered.

CONCLUSIONS: The attempts, while often fruitless, served to better our understanding of the disease and represent stepping-stones to the treatment we successfully use today. The present paper reviews the history of the surgical treatment of myelomeningoceles.

PMID:22669521

Functional disability of children with spina bifida: It's impact on parents' psychological status and family functioning.

Ulus Y, Tander B, Akyol Y, Ulus A, Tander B, Bilgici A, Kuru O, Akbas S. (2012) Functional disability of children with spina bifida: It's impact on parents' psychological status and family functioning. Developmental Neurorehabilitation. 2012 Jun 19.

Department of Physical Medicine and Rehabilitation .

Abstract

Objective: To evaluate the impact of functional disability of Turkish children with spina bifida (SB) on parents' psychological status and family functioning. Methods: Fifty-four children with SB and parents were included. The Functional Measure for Children (WeeFIM), Beck Depression Inventory (BDI), and Family Assessment Device (FAD) were used. Results: Mothers' BDI scores were significantly higher than fathers' (p < 0.001). No significant effects of the knowledge of having children with SB before birth and the number of children in families on BDI scores and FAD sub-scores were found (p > 0.05). According to multiple regression analysis; significant correlations with fathers' BDI were problem-solving (p = 0.012) and general functioning (p = 0.037) and with mothers' BDI was roles (p = 0.018). Only childrens age was found to be an influential variable on WeeFIM scores (p < 0.001). Conclusion: Spina bifida healthcare should include psychological support to parents of these children and this support should be independent from disability level of children.

PMID:22712551