Arsenic modifies the effect of folic acid in spina bifida prevention, a large hospital-based case-control study in Bangladesh
Rattachement africain : us, bd. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: Spina bifida, a developmental malformation of the spinal cord, is associated with high rates of mortality and disability. Although folic acid-based preventive strategies have been successful in reducing rates of spina bifida, some areas continue to be at higher risk because of chemical exposures. Bangladesh has high arsenic exposures through contaminated drinking water and high rates of spina bifida. Methods: We conducted a hospital-based case-control study at the National Institute of Neurosciences & Hospital (NINS&H) in Dhaka, Bangladesh, between December 2016 and December 2022. Cases were infants under age one year with spina bifida and further classified using data from observations by neurosurgeons and available imaging. Controls were drawn from children who presented to NINS&H or Dhaka Shishu Hospital (DSH) during the same study period. Mothers reported folic acid use during pregnancy, and we assessed folate status with serum assays. Arsenic exposure was estimated in drinking water using graphite furnace atomic absorption spectrophotometry (GF-AAS) and in toenails using inductively coupled plasma mass spectrometry (ICP-MS). Results: We evaluated data from 294 cases of spina bifida and 163 controls. We did not find a main effect of mother's arsenic exposure on spina bifida risk. However, in stratified analyses, folic acid use was associated with lower odds of spina bifida (adjusted odds ratio [OR]: 0.50, 95% confidence interval [CI]: 0.25-1.00, p = 0.05) among women with toenail arsenic concentrations below the median, and no association was seen among mothers with toenail arsenic concentrations higher than median (adjusted OR: 1.09, 95% CI: 0.52-2.29, p = 0.82). Conclusions: Mother's arsenic exposure modified the protective association of folic acid with spina bifida. Increased surveillance and additional preventive strategies, such as folic acid fortification and reduction of arsenic, are needed in areas of high arsenic exposure.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Arsenic modifies the effect of folic acid in spina bifida prevention, a large hospital-based case-control study in Bangladesh
- Date Crossref
- 29/02/2024
- Éditeur
- Research Square Platform LLC
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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National Institute of Neurosciences & Hospital pays non établi dans la noticeÉtablissement de santé
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Bangladesh Medical University pays non établi dans la noticeUniversité ou école supérieure
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Bangladesh Shishu (Children) Hospital & Institute pays non établi dans la noticeÉtablissement de santé
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Stanford University pays non établi dans la noticeUniversité ou école supérieure
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Boston Children's Hospital pays non établi dans la noticeÉtablissement de santé
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Boston Children's Museum pays non établi dans la noticeInstitution
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Harvard T.H. Chan School of Public Health pays non établi dans la noticeUniversité ou école supérieure
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Dhaka Shishu Hospital pays non établi dans la noticeÉtablissement de santé
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Bangabandhu Sheikh Mujib Medical University (BSMMU) pays non établi dans la noticeUniversité ou école supérieure
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School of Public Health Research pays non établi dans la noticeUniversité ou école supérieure
Harvard University, National Institute of Neurosciences & Hospital et Bangladesh Medical University, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.