Spina Bifida Phenotypes and Sex‐Specific Prevalence Among Offspring of Folic Acid Users
Notice bibliographique
Résumé
Background Periconceptional consumption of folic acid can reduce a woman's risk of having a neural tube defect (NTD)‐affected pregnancy, particularly in high‐prevalence areas such as northern China; however, information about the effect of folic acid on sex‐specific or phenotype‐specific spina bifida prevalence is lacking. Methods We used data from the China‐U.S. NTD Prevention Project during which women were asked to take a daily pill containing 400 μg of folic acid without other vitamins to reduce their risk of having an NTD‐affected pregnancy. We used data from birth defect surveillance and births from 1993 through 1996 from a high‐prevalence region located in five counties in northern China to evaluate these effects. We also examined the distribution of spina bifida phenotypes‐‐categorizing lesions in the cervicothoracic region as high lesions and those in the lumbosacral region as low lesions. Results Among 21,536 women who took folic acid at any time before and during early pregnancy and 56,541 women who did not take folic acid, we identified 18 and 115 women, respectively, with spina bifida‐affected pregnancies of ≥ 20 weeks’ gestation. Among the women who did and did not take any folic acid, the prevalences of spina bifida were 8.4 per 10,000 pregnancies and 20.3 per 10,000, respectively (risk reduction ~59%). Among women who did and did not take any folic acid as part of the prevention project, the spina bifida prevalences among female offspring were 8.8 and 24.2 per 10,000 pregnancies, respectively (risk reduction ~64%), and the prevalences among male offspring were 8.0 and 17.0 per 10,000, respectively (risk reduction ~53%). Among women who did and did not take any folic acid, the prevalences of high spina bifida lesions among offspring were 3.3 and 11.0 per 10,000 pregnancies, respectively (risk reduction ~70%), and prevalences of low spina bifida lesions among offspring were 4.6 and 8.5 per 10,000 pregnancies, respectively (risk reduction ~45%). This difference was statistically significant at p<0.01 and among women with female offspring, the risk reduction was even greater for high lesions vs. low lesions. Discussion and Conclusions These findings suggest that the folic acid effect on neural tube closure is not limited to any one spina bifida phenotype; however, it appears that the effect may differ by level of lesion and offspring sex. Among women who consumed 400 μg of folic acid daily, compared with those with male offspring those with female offspring experienced a greater reduction in risk of spina bifida this reduction in risk among female offspring was greater for high lesions than for low lesions. The findings are also consistent with observations in seven Canadian provinces where the proportion of cervicothoracic lesions decreased in all regions after fortification. Examination of these variations in folic acid effects may be helpful in identifying factors important in the pathogenesis of spina bifida and other neural tube defects. Support or Funding Information CDC internal funding only
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».