Canfield Mark A, Ramadhani Tunu A, Shaw Gary M, Carmichael Suzan L, Waller D Kim, Mosley Bridget S, Royle Marjorie H, Olney Richard S
Birth Defects Epidemiology and Surveillance Branch, MC 1964, Texas Department of State Health Services, P.O. Box 149347, Austin, TX 78714-9347, USA.
Birth Defects Res A Clin Mol Teratol. 2009 Jul;85(7):637-46. doi: 10.1002/bdra.20582.
We used data from the multisite National Birth Defects Prevention Study for expected delivery dates from October 1997 through 2003, to determine whether the increased risk in anencephaly and spina bifida (neural tube defects (NTDs)) in Hispanics was explained by selected sociodemographic, acculturation, and other maternal characteristics.
For each type of defect, we examined the association with selected maternal characteristics stratified by race/ethnicity and the association with Hispanic parents' acculturation level, relative to non-Hispanic whites. We used logistic regression and calculated crude odds ratios (ORs) and their 95% confidence intervals (CIs).
Hispanic mothers who reported the highest level of income were 80% less likely to deliver babies with spina bifida. In addition, highly educated Hispanic and white mothers had 76 and 35% lower risk, respectively. Other factors showing differing effects for spina bifida in Hispanics included maternal age, parity, and gestational diabetes. For spina bifida there was no significant elevated risk for U.S.-born Hispanics, relative to whites, but for anencephaly, corresponding ORs ranged from 1.9 to 2.3. The highest risk for spina bifida was observed for recent Hispanic immigrant parents from Mexico or Central America residing in the United States <5 years (OR = 3.28, 95% CI = 1.46-7.37).
Less acculturated Hispanic parents seemed to be at highest risk of NTDs. For anencephaly, U.S.-born and English-speaking Hispanic parents were also at increased risk. Finally, from an etiologic standpoint, spina bifida and anencephaly appeared to be etiologically heterogeneous from these analyses.
我们使用了多中心全国出生缺陷预防研究中1997年10月至2003年的预期分娩日期数据，以确定西班牙裔无脑儿和脊柱裂（神经管缺陷（NTDs））风险增加是否可由选定的社会人口学、文化适应及其他母亲特征来解释。
对于每种类型的缺陷，我们研究了与按种族/民族分层的选定母亲特征的关联，以及与西班牙裔父母文化适应水平的关联（相对于非西班牙裔白人）。我们使用逻辑回归并计算粗比值比（OR）及其95%置信区间（CI）。
报告收入水平最高的西班牙裔母亲生出脊柱裂患儿的可能性低80%。此外，受过高等教育的西班牙裔和白人母亲生出脊柱裂患儿的风险分别降低76%和35%。在西班牙裔中，其他对脊柱裂有不同影响的因素包括母亲年龄、产次和妊娠期糖尿病。对于脊柱裂，在美国出生的西班牙裔相对于白人没有显著升高的风险，但对于无脑儿，相应的OR范围为1.9至2.3。对于居住在美国不到5年的来自墨西哥或中美洲的西班牙裔新移民父母，观察到脊柱裂的风险最高（OR = 3.28，95% CI = 1.46 - 7.37）。
文化适应程度较低的西班牙裔父母似乎患神经管缺陷的风险最高。对于无脑儿，在美国出生且说英语的西班牙裔父母患病风险也增加。最后，从病因学角度来看，这些分析表明脊柱裂和无脑儿在病因上似乎是异质性的。
