title: Risk factors for neural tube defects in Riyadh City, Saudi Arabia: Case-control study.
abstract: Both genetic and non-genetic environmental factors are involved in the etiology of neural tube defects (NTD) which affect 0.5-2/1000 pregnancies worldwide. This study aimed to explore the risk factors for the development of NTD in Saudi population, and highlight identifiable and preventable causes. Similar studies are scarce in similar populations ofthe Arabian Peninsula and North Africa. This is an unmatched concurrent case-control study including NTD cases born at King Khalid University Hospital, Riyadh during a 4-year period (2002-2006). The case-control study included 25 cases and 125 controls (case: control ratio of 1:5). Years of formal education, employment, household environment (including availability of air conditioning) and rate of parental consanguinity did not differ between mothers of cases and controls. Significantly higher proportion of mothers of cases had history of stillbirth compared to control mothers (16% vs 4.1%, P=0.02). Also family history of hydrocephalus and congenital anomalies were more prevalent in cases than controls (P values=0.0000 and 0.003, respectively). There was significant protective effect of periconceptional folic acid consumption both prior to conception (OR 0.02, 95% CI 0.00-0.07) and during the first 6 weeks of conception (OR 0.13, 95% CI 0.04-0.39). Further research, including a larger cohort, is required to enable ascertainment of gene-nutrient and gene environment interactions associated with NTD in Saudi Arabia.
authors: (1) Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors: Mustafa A M
authors: MA
authors: Salih
authors: (2) Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. (Currently, Neurosurgery Department, College of Medicine, Taibah University, Al-Madinah Al-Munawarrah, Saudi Arabia).
authors: Waleed R
authors: WR
authors: Murshid
authors: (3) Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors: Ashry Gad
authors: AG
authors: Mohamed
authors: (4) Neonatal Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors: Lena C
authors: LC
authors: Ignacio
authors: (4) Neonatal Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors: Julie E
authors: JE
authors: de Jesus
authors: (4) Neonatal Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors: Rubana
authors: R
authors: Baabbad
authors: (5) Epidemiology Research Unit, Department of Biostatistics, Epidemiology and Scientific Computing, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. (Currently, WHO Representative, Saudi Arabia).
authors: Hassan M
authors: HM
authors: El Bushra
keywords: Folic acid supplementation; Genetics; Neural tube defects; Risk factors; Saudi Arabia