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The effects of preconception examinations on neural tube defects and the primary preventive measures: case-control
Rui Gong1,2,3, Zhi-Ping Wang1, Meng Wang4
1a Department of Epidemiology and Health Statistics , School of Public Health, Shandong University , Jinan , China .
Insights
Preconception examinations significantly reduce neural tube defects (NTDs) by improving adherence to preventive measures like folic acid. These exams play a critical role in NTD prevention.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Genetics and Genomics
Background:
- Neural tube defects (NTDs) pose a significant public health challenge.
- Compliance with recommended preventive measures for NTDs in China remains suboptimal.
- Understanding factors influencing NTD prevention is crucial for improving outcomes.
Purpose of the Study:
- To analyze the impact of preconception examinations on neural tube defects (NTDs).
- To evaluate the effect of preconception examinations on the uptake of primary preventive measures for NTDs.
- To assess the combined preventive effects of preconception examinations and other NTD interventions.
Main Methods:
- A 1:1 hospital-based case-control study was conducted.
- 459 women with NTD-affected infants/fetuses were matched with controls.
- Multivariate conditional logistic regression analysis was employed.
Main Results:
- Preconception examinations, health education, folic acid supplementation, and diet adjustment were associated with reduced NTDs.
- Women undergoing preconception examinations showed higher rates of folic acid use and health education.
- Combined effects of preconception examinations with folic acid supplementation yielded the greatest NTD prevention (OR=0.04).
Conclusions:
- Preconception examinations are effective in preventing NTDs.
- These examinations significantly enhance compliance with other NTD preventive strategies.
- Preconception care and associated measures demonstrate synergistic effects in NTD prevention.
Background:
Preventive measures for neural tube defects (NTDs) have been recommended for many years in China, but the compliance with these measures is unsatisfactory. This study aims to analyze the effects of preconception examinations on NTDs and its primary preventive measures.
Methods:
A 1:1 hospital-based case-control study was conducted. Four hundred and fifty-nine women who delivered or gestate infants/fetuses with NTDs from January 2006 to December 2008 were randomly selected and matched with women who delivered babies without obvious birth defects as controls in Shandong and Shanxi province. Multivariate conditional logistic regression was adopted.
Results:
Significant associations were shown between preconception examinations (OR = 0.461), health education (OR = 0.336), periconceptional folic acid supplement (OR = 0.295), periconceptional rational diet adjustment (OR = 0.278) and NTDs. In the case group, the rates of periconceptional folic acid supplement and health education conduction by women who had preconception examinations were significantly higher than that of those who had not, OR being 3.04 and 4.55, respectively (p < 0.05). Among the preventive effects on NTDs, preconception examinations and other NTDs primary preventive measures had significant combined effects and the combined effects with periconceptional folic acid supplement were the greatest, with OR of 0.04.
Conclusion:
Preconception examinations have preventive effects on NTDs and can significantly improve the compliance of other NTDs primary preventive measures. In addition, preconception examinations and these measures have synergetic prevention effects, indicating the critical role played by preconception examinations on NTDs prevention.
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