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Prevalence and Risk Factors for Spina Bifida in Latino Populations

Prevalence and Risk Factors for Spina Bifida in Latino Populations. Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology and Surveillance Branch Texas DSHS. Association of Spina Bifida with Maternal Race/Ethnicity . *Compared to the referent category of non-Hispanic whites .

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Prevalence and Risk Factors for Spina Bifida in Latino Populations

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  1. Prevalence and Risk Factors for Spina Bifida in Latino Populations Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology and Surveillance Branch Texas DSHS

  2. Association of Spina Bifida with Maternal Race/Ethnicity *Compared to the referent category of non-Hispanic whites 1Canfield et al. 2009. Pediatr Perinatal Epidemiol. 2Carmichael et al. 2003. BDRA. 3Canfield et al. 2006. BDRA.

  3. Association of Race/Ethnicity with Spina Bifida Stratified by Clinical Subtype, 1997-2005 1PR = Prevalence ratio 2SBM = Myelomeningocele, meningocele, and myelocele 3SBL =Lipomyelomeningocele and lipomeningocele Agopian et al. 2011. Am J Med Genet A.

  4. Association of Race/Ethnicity with Spina Bifida Stratified by Infant Sex, 1997-2005 1PR=Prevalence ratio 2SBM=Myelomeningocele, meningocele, and myelocele Agopian et al. 2011. Am J Med Genet A.

  5. Association of Maternal and Paternal Hispanic Birthplace/Immigration Factors with Spina Bifida, 1997–2003 *MX/CA = Mexico/Central America Canfield et al. 2009. BDRA.

  6. Decline in the Prevalence of Spina Bifida by Race/Ethnicity US, 1995–2002 Fortification Williams et al. 2005. Pediatrics.

  7. Prevalence of Spina Bifida in 10 US Regions, 2002 *Adjusted for maternal age Shin et al. 2010. Pediatrics.

  8. Association of Race/Ethnicity with Selected Self-reported Preconception Health Indicators– Texas Pregnancy Risk Assessment Monitoring System, 2002–2010 * Association is statistically significant in multivariate models that included age, race/ethnicity, education, insurance, Medicaid, and pregnancy intent. CDC. 2012. Publication pending.

  9. The Association of Nativity with Selected Maternal Factors, Hispanic NBDPS Controls, 1997–2005 *Odds ratio adjusted for maternal age, education, and pregnancy intention, referent group is U.S. born Ramadhani et al. 2011. BDRA.

  10. Folic Acid Awareness and Use Among Women with a History of an NTD-Affected Pregnancy Texas, 2000–2001 Canfield et al. 2002. MMWR.

  11. Texas Neural Tube Defect Project–Mexican Americans on TX-US Border, 1994-2000 • Cluster: Brownsville, Texas 1991 • 24 peer reviewed articles on risk factors • NTD risk factors for folic acid deficient population: • Low serum B12 • Periconceptional hyperthermia • Exposure to nitrosatable drugs with high nitrate/nitrite intake • Periconceptional diarrhea • Exposure to fumonisins • Hyperinsulinemia • Passive smoke exposure

  12. Summary • Relative to whites, Latinos are: • Only at modestly elevated risk of spina bifida, regardless of clinical phenotype or pattern • At greater risk if one/both parents foreign born • Less likely to be exposed to smoke • (Foreign-born>US-born) • Less likely to supplement • (Foreign-born>US-born) • More likely to be obese • (US-born>Foreign-born)

  13. THANK YOU Mark A Canfield, PhD, Manager Birth Defects Epidemiology and Surveillance Branch Texas Department of State Health Services Phone: (512) 776-6158 Email: mark.canfield@dshs.state.tx.us Web site: http://www.dshs.state.tx.us/birthdefects/

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