Spina Bifida and Maternal Weight: Moving from Association to Prevention

脊柱裂和母亲体重：从关联转向预防

• 批准号: 9020605
• 负责人: LAURA E. MITCHELL
• 金额: $ 24万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9020605
• 关键词: Spina; Bifida; Maternal; Weight; Moving

 DESCRIPTION (provided by applicant): Spina bifida, a birth defect involving the spinal cord, is common, life-threatening and permanently disabling. Although mandatory folic acid fortification of food supplies has been associated with reductions in the prevalence spina bifida (38% in the United States), spina bifida is far from being eradicated. Consequently, identifying additional interventions to reduce the prevalence of spina bifida remains a public health priority. Maternal weight is a potential target for such an intervention because: (i) the risk of spina bifida has consistently been observed to be increased in the offspring of obese women (BMI > 30 kg/m2), as compared to the offspring of women who fall in the normal BMI category (18.5<BMI<25.0 kg/m); (ii) overweight and obesity are common - present in approximately 50% of women prior to pregnancy and; (iii) weight can be modified. However, as the observed associations are insufficient to establish a causal connection between spina bifida and maternal weight, it is unclear whether pre-pregnancy weight loss will reduce the risk of spina bifida. The lack of strong evidence that maternal weight loss will result in decreased risk of spina bifida is a significant impediment to prevention efforts. The proposed studies will help to establish a causal connection between weight loss and spina bifida and are thus directly responsive to RFA-DD-001, "Public Health Research of Modifiable Risk Factors for Spina Bifida". These studies leverage existing data from the Texas Birth Defects Registry (TBDR), which is the largest, active surveillance Registry in the United States. Specifically, a case- control study, using data from the TBDR and Texas vital statistics, will be conducted to evaluate the association between maternal inter-pregnancy change in body mass index and spina bifida. This study will help to establish whether maternal weight change prior to pregnancy is a potential target for reducing the risk of spina bifida. The successful completion of these analyses will fill a major gap in our understanding of the association between maternal weight and spina bifida and will thus provide important direction for future prevention efforts.

 描述（由适用提供）：脊柱裂，一种涉及脊髓的先天缺陷，是常见的，威胁生命并永久性禁用。尽管强制性叶酸的粮食供应与脊柱裂的患病率降低有关（美国38％），但脊柱裂却远非被放射性。因此，确定降低脊柱裂率的其他干预措施仍然是公共卫生的重点。母体体重是进行这种干预措施的潜在目标，因为：（i）与肥胖妇女的后代（BMI> 30 kg/m2）的后代相比，与落在正常BMI类别的女性相比（18.5 <bmi <bmi <25.0 kg/m）相比（ii）超重和肥胖很常见 - 怀孕前约有50％的妇女存在； （iii）可以修改重量。但是，由于观察到的关联不足以在脊柱裂和产妇体重之间建立因果关系，因此尚不清楚怀孕前体重减轻是否会降低脊柱裂的风险。缺乏强烈的证据表明，减肥会导致脊柱裂的风险下降是预防工作的重大障碍。拟议的研究将有助于建立体重减轻与脊柱裂之间的因果关系，因此直接响应RFA-DD-001，“对脊柱裂的可修改风险因素的公共卫生研究”。这些研究利用了德克萨斯州出生缺陷注册中心（TBDR）的现有数据，该数据是美国最大的主动监视注册中心。具体而言，将进行一项使用TBDR和Texas重要统计数据的病例对照研究，以评估体重指数和Spina bifida的孕妇怀孕变化之间的关联。这项研究将有助于确定孕妇在怀孕前的体重改变是否是降低脊柱裂风险的潜在目标。这些分析的成功完成将填补我们对Mater重量与脊柱裂之间关联的理解的重大空白，因此将为未来的预防工作提供重要的方向。