title: Risk factors associated with lipomyelomeningocele: a case-control study.
abstract: BACKGROUND
  In general, it seems that both genetic and environmental factors play important roles in the induction of neural tube defects. Lipomyelomeningocele (LipoMMC) is a rather common type of closed neural tube defect, but only limited studies have investigated the potential risk factors of this anomaly. Therefore, the purpose of this case-control study was to investigate the risk factors involved in LipoMMC formation.
  
  
  METHODS
  Various risk factors were evaluated in 35 children between 1 month and 10 years of age with LipoMMC in a hospital-based case-control study. The 2 control arms consisted of 35 children with myelomeningocele (MMC group) and 35 children with congenital anomalies other than central nervous system problems (control group). All groups were matched for age and visited the same hospital. A structured questionnaire was used for the collection of all data, including the mothers' weight and height during pregnancy, education, reproductive history, previous abortions, and socioeconomic status, as well as the parents' consanguinity and family history of the same anomalies.
  
  
  RESULTS
  Univariate analysis of the children with LipoMMC compared to the control group showed that the use of periconceptional folic acid supplementation was significantly lower in the MMC and LipoMMC groups compared to the control group. In addition, comparison of the MMC and control groups revealed statistically significant differences regarding the use of folic acid and maternal obesity. In multivariate analysis, use of folic acid in the periconceptional period and during the first trimester was an independent risk factor for LipoMMC and MMC. Furthermore, maternal obesity was a significantly positive risk factor for MMC.
  
  
  CONCLUSIONS
  The probable risk factors for LipoMMC were investigated in this case-control study. Consumption of folic acid in the periconceptional period and during the first trimester is an independent protective factor against LipoMMC. It seems that larger studies are needed to examine other possible risk factors.
authors.affiliation: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Esmaeili
authors.forename: Sara
authors.initials: S
authors.lastname: Hanaei
authors.forename: Kaveh
authors.initials: K
authors.lastname: Fadakar
authors.forename: Sahar
authors.initials: S
authors.lastname: Dadkhah
authors.forename: Mahdi
authors.initials: M
authors.lastname: Arjipour
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Habibi
authors.forename: Farideh
authors.initials: F
authors.lastname: Nejat
authors.forename: Mostafa
authors.initials: M
authors.lastname: El Khashab
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000209:etiology* / Q000517:prevention & control; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D065840:Protective Factors; D012307:Risk Factors; D014803:Vitamin B Complex / Q000008:administration & dosage*
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid