A post Hurricane Gilbert increase in neural tube defects in Jamaica, associated with a diet comparatively low in folate, in the periconceptional period - abstract

An increase in obvious live-birth neural tube defects (NTDs), spina bifida cystica and encephalocelle, occurring in Jamaica 11-18 months post-Hurricane Gilbert and periconceptionally coinciding with a rise in megaloblastic change in sickle-cell (SS) patients, was investigated by a retrospective case-control study. A detailed health, environmental and dietary history was done on each of the 17 affected mothers (cases) and 51 controls, matched for 5 variables. The Group I (cases) reported a significantly lower mean score in dietary folate intake in the periconceptional period (154) than Group 2 (controls) (254), p < 0.0001). Trauma was high among the cases, p < 0.0005. There was no association with maternal smoking, alcohol, ganja or other substance abuse, pesticide exposure, intake of previously suspected teratogenic foods, bush teas, pica, sources of drinking water, clinic attendance, environmental or psychosocial stress, hyperemesis, hypertension, spacing of pregnancies, incestuous parenting or previous birth defects. The results show that this NTD increase was associated with maternal diets comparatively low in folate in the periconceptional period. (AU)

Neural tube defects in Trinidad - abstract

All cases of neural tube defects (NTD) at the Port-of-Spain General and Mount Hope Hospital for Women from June 1980 to July 1983 were studied retrospectively with respect to sex distribution, ethnic group, social class of parents, area of residence, birth weight, birth order, maternal age, associated congenital abnormalities, family history, annual incidence and other factors. There were 71 NTD with no sex predominance. Twenty-six were of African descent and 38 of East Indian descent and 7 of mixed ethnic origin. The incidence in Trinidad of NTD per thousand total births 1.52 overall, 1.40 in the African and 2.05 in the East Indian, was much lower than in countries of similar ethnic groups - 2.74 Pretoria, South Africa in the Bantu and 3.75 in Bombay, India. In Trinidad, the incidence of anencephalus was particularly low in the African. The incidence of hydrocephalus, hydrocephalus with spina bifida, occiptal meningocele and other neural tube defects was about the same in both ethnic groups, while spina bifida incidence was relatively higher in the East Indian. Those of African descent were clustered in the Belmont-Laventille-Morvant area, while those of East Indian descent were clustered in the Chaguanas and in the San Juan to Tunapuna area, and the occurence in these areas was disproportionately high and not totally explained by population distribution. Other positive findings were low birth weight and being first-born with anencephalus, and social classes 4 and 5 in parents of patients with NTD. This study shows a low Trinidad incidence of NTD, differing ethnic incidence and distribution, and suggests a multifcatorial aetiology (AU)