Risk Factors of Neural Tube Defects in a Sample of ‎Iranian Population from Southern Iran; a Hospital-‎Based Investigation

Abstract

Background & Aim: The risk factors of the neural tube defects (NTD) have been previously described but there are ethnic and geographical variations. Data from the Iranian population is still scarce. The aim of the current study was to determine the NTDs risk Factors in a large sample of Iranian patients admitted to a single center. Methods: This case-controlled study was conducted during a 5-year period from 2012 to 2017 in Namazi hospital of Shiraz, a tertiary healthcare referral center for all the neonatal anomalies in southern Iran. We included a total number of 100 newborns with NTDs as the case group and 200 healthy newborns as the control group. We recorded the baseline characteristics including the maternal variables (age, weight, height, previous pregnancy and gravid, gestational age), newborn information (birth weight, clinical diagnosis, clinical finding in examination, clinical finding in radiologic test) and medical history of the perinatal period. Results: The baseline characteristics of the mothers were matched in the two study groups. NTDs were associated with lower folic acid intake during pregnancy (66% vs. 78%; p=0.030; OR95% CI=1.82) and before pregnancy (p=0.002; OR95% CI= 2.36). The prevalence of neural tube defects was significantly higher in patients who lived in hot climates (p=0.001). Conclusion: Taking adequate folic acid supplement before and during pregnancy can reduce the risk of NTDs in Iranian population. Hot climate zones were associated with increased risk of NTDs in Iran.

Keywords

• neural tube defect
• risk factors
• folic acid
• geographic distribution