Influencing factors of neural tube malformation: a systematic review and meta-analysis

Neural tube malformation is a common congenital malformation and its influencing factors were still unclear. This paper aims to explore the main influencing factors of neural tube malformation, and provide reference for the primary prevention of neural tube malformation.

Case-control literatures on the influencing factors of neural tube malformation from 1990 to 2021 were searched from Chinese and English websites. The quality of the included literatures was evaluated according to Newcastle-Ottawa Scale (NOS) scale and data were extracted. Meta-analysis was performed on the data using funnel plot and Egger's est evaluated publication bias, and sensitivity analysis was performed by eliminating individual studies one by one.

A total of 49 case-control studies were included. Meta-analysis showed that the main influencing factors of neural tube malformation were folic acid (odds ratio (OR)OR=0.31, 95%CI: 0.20-0.47), fever (OR=3.02, 95%CI: 2.38-3.83), obesity (OR=1.76, 95%CI: 1.39-2.21), passive smoking (OR=1.91, 95%CI: 1.52-2.40). Antiepileptic drugs (OR=6.10, 95%CI: 2.58-14.43); Heavy metals (Zinc: OR=2.37, 95%CI: 1.06-5.30, mercury: OR= 4.61, 95%CI: 2.85-7.47).

Prenatal supplementation with folic acid and zinc has been shown to reduce the risks of neural tube defects. It is recommended that women of childbearing age take folic acid and zinc supplements before and during pregnancy. Other factors such as fever, obesity, passive smoking, antiepileptic drugs, and mercury exposure have been associated with an increased incidence of neural tube abnormalities. Neurological tube abnormalities can be reduced by folic acid and zinc, which act as protective factors. The incidence of neural tube abnormalities is increased by fever, obesity, passive smoking, antiepileptic drugs, and mercury.