Welderufael Abadi Leul, Berihu Birhane Alem, Berhe Yibrah, Magana Tony, Asfaw Selemawit, Gebreselassie Kibrom, Belay Ezra, Kebede Hayelom, Mulugeta Afework
Department of Pediatrics and child health, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Department of Anatomy, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Brain Dev. 2019 May;41(5):406-412. doi: 10.1016/j.braindev.2018.12.005. Epub 2019 Jan 14.
Nutritional deficiency in pregnant women is a confirmed cause of neural tube defects (NTDs). Alongside to this background, We sought to determine the nutritional status and level of awareness on the issue of the NTDs as well as folic acid (FA) utilization among women who born infants with NTDs in Tigray region of Ethiopia.
A standard interviewer and a food frequency questionnaire was used to obtain information from mothers of cases with neural tube defects (n = 205) and their controls (n = 412). Demographic information, weekly food frequency consumption, information on awareness on the issue of the NTDs as well as folic acid (FA) use was collected.
The mean age of the mothers of the cases and controls was 26.5 years (range 17-43 years) and 26.05 years (range 18-40 years), respectively. Approximately 92.2% (189/205) of the cases and 90.5% (373/412) control mothers do not know the term folic acid (FA). Notably, all participant mothers (100%) did not understand that NTDs are a serious health problem associated with inadequate intake of FA and none of them used FA prior to conception. Food frequency analysis revealed that except for cereals (p = 0.12) and milk products (p = 0.8), the proportion of the consumed food type within seven days recalls period showed a statistically significant difference (p < 0.05) as compared with controls. The dietary diversity score assessment showed those attained low and high dietary diversity score were a statistically significant difference (p = 0.0003) and (p = 0.0002) respectively) as compared with controls, but the medium dietary diversity score no significant variation was found (p = 0.35).
This study has shown none of the study participants do understand that NTDs are a serious health problem associated with inadequate intake of FA. Dietary diversity score was significantly associated with incidence of NTDs. This Ethiopian study also highlighted the need of considering the basic food in future programs of food fortification with folic acid, preconceptional folic acid supplementation and adequate dietary intake counseling. Advance research is required to find out the gene-nutrient and gene environment interactions, as well as particular causative factors associated with NTDs in Ethiopia.
孕妇营养缺乏是神经管缺陷（NTDs）的一个已证实的病因。在此背景下，我们试图确定埃塞俄比亚提格雷地区生育神经管缺陷婴儿的妇女的营养状况、对神经管缺陷问题的认知水平以及叶酸（FA）的使用情况。
使用标准访谈者和食物频率问卷从神经管缺陷病例的母亲（n = 205）及其对照（n = 412）那里获取信息。收集人口统计学信息、每周食物频率消费情况、关于神经管缺陷问题的认知信息以及叶酸（FA）的使用情况。
病例组和对照组母亲的平均年龄分别为26.5岁（范围17 - 43岁）和26.05岁（范围18 - 40岁）。大约92.2%（189/205）的病例组母亲和90.5%（373/412）的对照组母亲不知道叶酸（FA）这个术语。值得注意的是，所有参与研究的母亲（100%）都不理解神经管缺陷是与叶酸摄入不足相关的严重健康问题，并且她们在怀孕前都没有使用叶酸。食物频率分析显示，除了谷物（p = 0.12）和奶制品（p = 0.8）外，在7天回忆期内所消费食物类型的比例与对照组相比有统计学显著差异（p < 0.05）。饮食多样性评分评估显示，与对照组相比，获得低饮食多样性评分和高饮食多样性评分的情况分别有统计学显著差异（p = 0.0003）和（p = 0.0002），但中等饮食多样性评分没有发现显著差异（p = 0.35）。
本研究表明，没有一名研究参与者理解神经管缺陷是与叶酸摄入不足相关的严重健康问题。饮食多样性评分与神经管缺陷的发生率显著相关。这项埃塞俄比亚的研究还强调了在未来的叶酸食物强化计划、孕前叶酸补充以及充足饮食摄入咨询中考虑基础食物的必要性。需要进一步研究以找出基因 - 营养素和基因 - 环境相互作用，以及埃塞俄比亚与神经管缺陷相关的特定致病因素。
