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

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)