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[Mortality from neural tube defects in Mexico, 1980-1997]
José A Ramírez-Espitia1, Fernando G Benavides, Marina Lacasaña-Navarro
1Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Centro de Salud Ambiental INSP/OPS, Avenida Universidad 655, I er. Piso, colonia Santa María Ahuacatitlán 62100 Cuernavaca, Morelos, México.
Objective:
To describe the mortality due to neural tube defects (NTD) in Mexico for the 1980-1997 period.
Material And Methods:
The annual NTD mortality rates per 10000 liveborn infants were calculated by state and for the country. The time trend was evaluated with the annual percent change (APC) obtained using a Poisson regression model. The NTD mortality ratio was calculated using the average national rate as reference. NTD mortality rates and ratios were graphically displayed on maps.
Results:
During the 1980-1997 period the gross NTD mortality rate was 5.8 per 10000 live-born infants. Anencephaly (International Classification of Diseases ICD-9 740.0) was the most frequent type of NTD (37.7%), followed by spina bifida without hydrocephaly (CIE9 741.9) (31.6%). The national trend of NTD mortality increased between 1980 and 1990 (APC 7.5 95% CI 6.5, 8.6) and decreased between 1990 and 1997 (APC-2.3 95% CI-3.6, -0.9).
Conclusions:
The high NTD mortality rates were related to the high frequency of anencephaly. Also, the increase observed is not only attributable to diagnostic factors or to improved reporting. In Mexico, the influence of some NTD-associated factors such as specific genetic polymorphisms, folic acid deficit, maternal obesity, occupational exposure to pesticides, and poverty, should be assessed in specific studies.