Zaheri Farzaneh, Ranaie Fariba, Shahoei Roonak, Hasheminasab Leila, Roshani Daem
Lecturer, School of Nursing & Midwifery, Kurdistan University of Medical Sciences (KUMS), Sanandaj, Iran.
Associate Professor, School of Nursing & Midwifery, Kurdistan University of Medical Sciences (KUMS), Sanandaj, Iran.
Electron Physician. 2017 Jun 25;9(6):4636-4642. doi: 10.19082/4636. eCollection 2017 Jun.
Neural tubes defects (NTDs) are known to be the second most prevalent congenital disorder worldwide whose risk factors have not been explicitly addressed yet.
To determine the risk factors affecting NTDs among infants who referred to obstetrical centers in Kurdistan, a western province of Iran.
This prospective case-control study was conducted in the form of prospective case-control. Sample population included all women (27,153 cases) who referred to obstetrical centers in Kurdistan for either delivery or abortion during 2013 and 2014. Inclusion criterion was the presence of a known NTD in infants, and exclusion criterion was the reluctance of patients to participate in the study. Accordingly, 46 cases participated in the study as the case group, and 138 cases (three times higher than case group) were selected to be the control group. Case and control groups were matched in terms of the number of pregnancies and place of birth. The variables investigated in the present study were as follows: age, occupation, BMI, abortion history, family relation with husband, fetus' sex, number of twins, history of previous children with NTD, receiving prenatal surveillance, consumption of folic acid and multivitamins, smoking, alcohol drinking, passive smoking, and suffering from such diseases as epilepsy and diabetes. Data were analyzed using various statistical tests, including chi-square, Fishers' exact test, multiple logistic regression analysis using SPSS version 20. In the study group, inclusion criteria included all women who had an infant with tube defects that their total number was 46 individuals. In the control group inclusion criteria included mothers with healthy infants who were similar to the study group in terms of birth place and frequency of pregnancy.
The results of the present study demonstrated that prenatal surveillance (p<0.002), multivitamin consumption (p<0.001), history of having a child with NTD (p<0.001), alcohol drinking (p<0.014), and passive smoking were related to NTDs (p<0.001).
Before fertilization and during pregnancy, mothers should be examined in terms of exposure to harmful agents, diet, and nutritional status in order to identify possible risk factors and find opportunities to prevent NTDs in infants.
神经管缺陷（NTDs）是全球第二常见的先天性疾病，但其风险因素尚未得到明确阐述。
确定转诊至伊朗西部省份库尔德斯坦产科中心的婴儿中影响神经管缺陷的风险因素。
本前瞻性病例对照研究以前瞻性病例对照的形式进行。样本人群包括2013年和2014年期间转诊至库尔德斯坦产科中心分娩或流产的所有女性（27153例）。纳入标准为婴儿存在已知的神经管缺陷，排除标准为患者不愿参与研究。据此，46例作为病例组参与研究，138例（比病例组多两倍）被选为对照组。病例组和对照组在妊娠次数和出生地方面进行匹配。本研究调查的变量如下：年龄、职业、体重指数、流产史、与丈夫的家庭关系、胎儿性别、双胞胎数量、既往有神经管缺陷孩子的病史、接受产前监测、叶酸和多种维生素的摄入、吸烟、饮酒、被动吸烟以及患有癫痫和糖尿病等疾病。使用包括卡方检验、费舍尔精确检验、使用SPSS 20版进行的多元逻辑回归分析等各种统计检验对数据进行分析。在研究组中，纳入标准包括所有生育有神经管缺陷婴儿的女性，其总数为46人。在对照组中，纳入标准包括生育健康婴儿的母亲，她们在出生地和妊娠频率方面与研究组相似。
本研究结果表明，产前监测（p<0.002）、多种维生素摄入（p<0.001）、有神经管缺陷孩子的病史（p<0.001）、饮酒（p<0.014）和被动吸烟与神经管缺陷有关（p<0.001）。
在受精前和怀孕期间，应检查母亲接触有害因素、饮食和营养状况，以识别可能的风险因素并找到预防婴儿神经管缺陷的机会。
