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The prevalence of neural tube defects among ethnic groups in Brooklyn, New York
Insights
Infants born to Puerto Rican mothers had higher rates of neural tube defects (NTDs). Socioeconomic status, not ethnicity, explained the difference in NTD prevalence.
Area of Science:
- Perinatal epidemiology
- Congenital anomalies research
- Public health surveillance
Background:
- Congenital neural tube defects (NTDs) represent a significant global health concern.
- Previous studies suggest ethnic and socioeconomic disparities in NTD prevalence.
- Understanding these disparities is crucial for targeted public health interventions.
Purpose of the Study:
- To investigate the prevalence of congenital neural tube defects (NTDs) among different ethnic groups in Brooklyn.
- To examine the association between NTD prevalence and maternal ethnicity, socioeconomic status, and other demographic factors.
- To identify trends in NTD prevalence over time.
Main Methods:
- Retrospective analysis of birth records from six Brooklyn hospitals (1968-1976).
- Inclusion of nearly 174,000 consecutive births.
- Statistical adjustment for variables including ethnicity, socioeconomic status, parity, and gravidity.
Main Results:
- Combined prevalence of anencephaly, myelomeningocele, and occipital encephalocele was higher in infants of Puerto Rican mothers compared to non-Puerto Rican whites or blacks.
- This ethnic disparity in NTD prevalence diminished significantly after adjusting for private or service birth status.
- No significant differences in NTD prevalence were observed between white and black ethnic groups.
- Significant associations were found between NTD prevalence and parity, gravidity, and economic status, with variations across ethnic groups.
- A declining trend in myelomeningocele prevalence was noted across all ethnic groups.
Conclusions:
- Socioeconomic status, rather than ethnicity, appears to be a primary driver of observed disparities in NTD prevalence.
- Parity, gravidity, and economic status are significant factors associated with NTD prevalence.
- Public health strategies should consider socioeconomic determinants when addressing NTD disparities.
Abstract:
Records of almost 174,000 consecutive births at six Brooklyn hospitals during the years 1968-1976 were reviewed for congenital neural tube defects. Prevalence of anencephaly, myelomeningocele and occipital encephalocele combined was significantly higher in infants delivered to mothers born in Puerto Rico than in offspring of non-Puerto Rican whites or blacks. The association of prevalence rates with ethnicity remained significant after adjustment for several variables. However, when adjustment was made for private or service status the difference between Puerto Ricans and whites, although still appreciable, was no longer statistically significant. No significant differences in prevalence rates between whites and blacks were observed. Sex ratios of affected infants were close to unity in each ethnic group. Statistically significant associations were found between the prevalence of neural tube defects and parity, gravidity and economic status. The patterns of these associations varied among the ethnic groups. A declining trend in the prevalence of myelomeningocele was observed for all ethnic groups.