Pérez-Molina J Jesús, Alfaro-Alfaro Noé, Ochoa-Ponce Cristina
División de Pediatría, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Departamento de Clínicas de la Reproducción Humana y Crecimiento infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco.
Ginecol Obstet Mex. 2002 Sep;70:443-50.
To determine the prevalence of upper and lower neural tube defects and identify its association with the exposure to illnesses and drugs during pregnancy.
This is a case-control study of 107 newborns with upper neural tube defects, 59 with lower neural tube defects, and 166 newborns without malformations, in 56,926 consecutive births between 1989 and 1997. The exposure was documented by a direct interview to the mother of those subject of study. The association was measured by the odds ratios, with confidence interval of 95%.
The prevalence of upper neural tube defects was of 1.9 for 1,000 newborn (alive or dead) and of lower neural tube defects of 1.0 for 1,000. The exposure to illnesses of less than a month of duration was associated with upper neural tube defects (OR = 3.11; IC = 1.34-7.39) the most important was flu; also the exposure to drugs (OR = 5.85; IC = 2.97-11.62), the most prominent was acetaminophen. These factors of risk were not associated with lower neural tube defects. The mother's occupation, illness of more than a month of duration and X-ray exposure were not associated with of upper and lower neural tube defects.
More studies are needed in the association among illnesses of less than a month of duration and drugs with upper neural tube defects. The different exposure frequencies between upper and lower neural tube defects suggest heterogeneity.
确定神经管上、下缺陷的患病率，并确定其与孕期疾病暴露和药物暴露的关联。
这是一项病例对照研究，研究对象为1989年至1997年间连续出生的56926例新生儿，其中107例患有神经管上缺陷，59例患有神经管下缺陷，166例无畸形。通过对研究对象的母亲进行直接访谈来记录暴露情况。通过比值比来衡量关联，置信区间为95%。
每1000例新生儿（存活或死亡）中神经管上缺陷的患病率为1.9，神经管下缺陷的患病率为1.0。持续时间不足一个月的疾病暴露与神经管上缺陷相关（比值比=3.11；置信区间=1.34-7.39），其中最重要的是流感；药物暴露（比值比=5.85；置信区间=2.97-11.62）也与之相关，最突出的是对乙酰氨基酚。这些风险因素与神经管下缺陷无关。母亲的职业、持续时间超过一个月的疾病以及X线暴露与神经管上、下缺陷均无关。
需要对持续时间不足一个月的疾病和药物与神经管上缺陷之间的关联进行更多研究。神经管上、下缺陷的不同暴露频率表明存在异质性。
