Serum copper and zinc levels in mothers and cord blood of their newborn infants with neural tube defects: A case-control study.

Objectives: To measure the cord blood and maternal serum levels of folic acid, vitamin B12, zinc, copper, selenium and lead in infants born with neural tube defect (NTD), and to examine a possible relationship between the nutriture of these micronutrients and occurrence of neural tube defect. Design: Case-control study. Methods: Maternal serum and cord blood samples were obtained at delivery from 70 healthy mothers and 74 mothers who had a newborn with NTD. Results: The mean (± SD) maternal serum zinc level in the NTD group was significantly lower than that of the control group (835.6 µg/L ±333.8 µg/L vs. 1035.7 µg/L ± 299.8 µg/L, P=0.004, respectively). The mean maternal and cord serum copper levels in the NTD group were significantly higher when compared to the control group (2831.1 µg/L ± 1017 µg/L vs. 2402 µg/L ± 744.2 µg/L; P=0.03; and 789.8 µg/L vs 517.2 µg/L, P<0.001, respectively). There was a negative correlation between the cord levels of folic acid and copper in the NTD group with the respective maternal serum levels (r=-0.289; P=0.018). Conclusions: High maternal serum levels of copper and lower level of zinc during pregnancy associated with NTD in newborn.

Relación entre los niveles de ácido fólico, vitamina B12 y homocisteína materna y los defectos de tubo neural y labio hendido / Relation between levels of folic acid, vitamin B12 and maternal homocysteine with neural tube defects and cleft lip

El objetivo del trabajo fue determinar la asociación entre los niveles de ácido fólico, vitamina B (Vit B12) y homocisteína (Hci) maternos, con defectos del tubo neural (DTN) y labio hendido (LH) con y sin paladar hendido (c/s PH). Se realizó un estudio tipo casos y controles. Casos, con diagnóstico de DTN y LH c/s PH (n=36) y cuatro controles hospitalarios por caso (n=141). Se incluyeron recién nacidos (RN) y lactantes hasta 12 meses de edad. Las variables de pareamiento fueron: edad del RN o lactante, etnia y hospital. Un 23 por ciento de etnia Tarahumara y 77 por ciento mestizos. Se determinó ácido fólico intraeritrocitario (AFI), plasmático (AFP) y Vit B12 por radioinmunoensayo, la Hci por inmunoensayo de fluorescencia polarizada. Se consideró deficiencia si el AFI fue <160 ng/mL, AFP <3.5 ng/ mL y la Vit B12 <200 pg/mL e hiperhomocisteinemia, si Hci >15 J.mol/L. El análisis estadístico se realizó a través de regresión logística condicionada. Se identificó deficiencia de AFI en el 22 por ciento de las mujeres cuyos recién nacidos o lactantes presentaron algún tipo de defecto congénito y en el 12 por ciento de los controles. La relación entre AFI y DTN, LH c/s PH ajustada por edad materna, exposición a plaguicidas y zona de residencia fue RM 2,96 (IC 95 por ciento 0,92-9,46). No se encontraron diferencias en los niveles de Hci ni de Vit B12. Conclusiones: Nuestros resultados sugieren que RN cuyas madres cursan con una deficiencia de AFI tienen mayor riesgo de presentar DTN y LH c/s PH.

Objective: To determine the association between maternal folate deficiency, neural tube defects (NTDs), and cleft lip, with and without cleft palate (CL/P). Material and methods: A case/control study was conducted. The cases included subjects with diagnoses of NTD and CL/P (n=36) and four hospital controls per case (n=141); the study included newborns (NBs) and nursing babies up to 12monthsof age. The parameter variables were the following: the age of the NB or nursing baby, the ethnic group, and the hospital of origin. The Tarahumara ethnic group made up 23 percent of the cases, while 77 percent were mestizos. The red cell folate (RCF), the plasma folie acid (PFA), and the vitamin B12 levels were determined by radioimmunoassay and the homocysteine levels by polarized fluorescence immunoassay. A deficiency was considered to be present if the RCF were <160 ng/mL, the PFA <3.5 ng/mL and the vitamin B <200 pg/ mL; hyperhomocysteinemia was defined as HC >15 J,mol/L. The statistical analysis was carried out through of conditional logistic regression. Results: An RCF deficiency was identified in 22 percent of the women whose newborn or nursing babies presented with some type of congenital defect and in 12 percent of the controls. The correlation adjusted by maternal age, exposure to pesticides and zone of residence was OR 2.96 (CI 95 percent 0.92-9.46). There was no difference in vitamin B12 or homocysteine levels between groups. Conclusions: Our results suggest that newborns whose mothers present with an RCF deficiency have an increased risk of displaying NTD and CL/P.

Evaluation of methods using maternal serum alpha-fetoprotein for antenatal screening of pregnancies for open neural tube defects in east Azerbaijan province of Iran

Neural tube defects, resulting from failure of the neural tube to close during the fourth week of embryogenesis, are the most common severely disabling birth defects in most populations. We assayed alpha fetoprotein [AFP] in serum samples of pregnant women during 15 to 20 weeks of gestation using immuno-enzymatic method [Eliza] in east Azerbaijan/Iran. The results obtained from the first 100 samples were used to calculate the median levels of maternal serum AFP in our ethnic population and the resulted Multiple of Median [MOM] were employed in Prisca software to obtain the likelihood ratio for each pregnancy. Among the 300 pregnancies which were screened for Neural Tube Defects [NTDs], 9 were detected as screen positives. The following targeted ultrasonography revealed fetuses affected by open neural defects in two pregnancies, polyhydraminous with no NTDs in two others and bilateral cleft lip in the one. The screening results were confirmed by clinical examination of the aborted fetuses or newborns. The outcome of the last pregnancy showed bilateral cleft lip + cleft palate and congenital pyloric stenosis at birth. The newborns resulted from two other screen positive pregnancies were normal. No information was obtained from the two remaining pregnancies after the ultra-sound scanning. The median weight of pregnant mothers in sample population was 63.34 +/- 10/66, in screen positive patients 61/11 +/- 11.92 and in screen negative patients 63.30 +/- 10.63. The results obtained from antenatal maternal serum screening in the present study compares favorably with the results from reference centers using similar screening strategies. The method employed in this research is reliable and can be readily applied for screening of a large population of pregnant women for open NTDs

Serum zinc levels in newborns with neural tube defects.

Neural tube defects (NTD) comprise of a group of congenital malformations that include spina bifida, anencephaly and encephalocele. Reports have implicated zinc deficiency as one of the causative factors of NTDs. We compared the serum zinc level of 23 newborns having neural tube defects with 35 healthy controls by spectrophotometery during 2003-2004. Zinc deficiency was documented in 43.5% of the cases and 8.6% of the controls (P = 0.002). Multivariate logistic regression analysis revealed a significant association between the presence of NTDs and zinc deficiency (OR = 8.2, 95% Cl: 1.9-34.7).