Association of sociodemographic and nutritional factors with risk of neural tube defects in the North Indian population: a case-control study.

OBJECTIVE: To assess the role of sociodemographic and nutritional factors in the incidence of births affected by neural tube defects (NTD) in the North Indian population. DESIGN: Case-control study. SETTING: Government hospitals of Delhi, India. SUBJECTS: Subjects comprised 284 mothers of NTD children (cases) and 568 mothers of healthy children (controls). RESULTS: Significant differences were found between case and control mothers with respect to maternal age (P = 0·005), type of drinking water (P = 0·03) and consumption of milk (P = 0·01). Univariate and multivariate analysis suggested an association of unpasteurized milk use, low consumption of vegetables, low consumption of fruits and vegetarian dietary habits with NTD births. Further, variation in the risk factors for upper and lower NTD types was also observed, pointing towards phenotypic heterogeneity in the aetiology. CONCLUSIONS: The results of the present study suggest an increased risk of NTD infants in mothers with low consumption of vegetables, fruits and milk and having vegetarian dietary habits. So, in order to reduce these devastating birth defects in future offspring, better nutritional care should be provided to mothers by suggesting dietary modifications and augmenting additional micronutrient supplementation during the periconceptional period.

Sickness Status and Neural Tube Defects: A Case-Control Study in a North Indian Population.

BACKGROUND: The prevalence of neural tube defects (NTDs) in India is high in comparison to other regions in the world, with the Northern part reporting the highest prevalence. METHODS: To explore the risk factors for NTDs, a case-control study was carried out in Delhi from January 2008 to June 2011. Using multivariate logistic regression model analysis, 308 cases were compared with 580 controls and adjusted odds ratio (AOR) was calculated using SPSS version 17. RESULTS: Maternal factors that were significantly associated with increased risk of NTDs were inter-pregnancy interval (AOR = 3.175; 95% confidence interval [CI], 2.007-5.024), hyperthermia during the first trimester (AOR = 2.07; 95% CI, 1.131-3.788), maturation ill pregnancy (AOR = 1.956; 95% CI, 1.385-2.763), chronic illness (AOR = 1.648; 95% CI, 1.103-2.462), and use of antibiotics (AOR = 5.589; 95% CI, 1.789-17.455). Differences in the risk were also found between upper and lower NTD. It was observed that all of the former five variables, except for chronic illness, were associated with risk for upper NTDs (AOR = 1.532; 95% CI, 0.916-2.563). In contrast, hyperthermia before conception (and not during the first trimester) was found to be additionally associated with risk for lower NTDs (AOR = 2.782; 95% CI, 1.302-5.944). CONCLUSION: These findings highlight heterogeneity in the etiology of upper and lower NTDs. The study also highlights the risk factors that should be considered in combating the risk of NTDs. Birth Defects Research 109:1393-1399, 2017.© 2017 Wiley Periodicals, Inc.