The Investigation Of Interventional Status And The Studies Of Enviroment And Heredity Risk Factors Of Neural Tube Defects

Objects (1)To investigate the general distribution and environmental risk factors of neural tube defects in Guangxi province. (2)To understand corelationship of health women's mutations of the methylenetetrahydrofolate reductase (MTHFR) gene in Guangxi and the MTHFR C677T mutation and pregnancy outcomes.(3)To assess the awareness of NTDs among the reproductive-aged women and their initiative and compliancy about using folic acid to prevent the NTDs. Spread the knowledge about NTDs to the reproductive-aged women and assess the effects.(4)To make the people attach important to taking folic acid to prevent NTDs and try to find out a more effective intervention model for NTDs preventing.Methods (1)Investigate the parents of casese and controls by phone or visitation and obtain the material whether they have contacted the relevant risk factor or not, then use the logistic regression model to analyze these material and risk factors. (2)Collect 200 women' blood sample to extract whole blood DNA and examine the MTHFR C677T mutations. Compare the pregnant outcome of three groups. (3)Design the investigate questionnaire of NTDs knowledge and investigate 250 reproductive-aged women as well as investigate other 250 reproductive-aged women after they have been taught the knowledge about how to prevent NTDs. Compare the investigate results of two groups.(4)Tthe investigate questionnaire was design for basic information connection of folic acid taking among pregnant women and 554 women randomly choose to fill it. (5)Collect 560 pregnant women who took folic acid and 600 pregnant women who did not take it, compare their pregnant outcomes. Analyze these datum by х2 test and one-way ANOVA.Result (1)The incidence rate of neural tube defects is 0.987‰. Prevalence in country are higher than in city. The result of logistic regression analysis revealed that mother malnutrition, hyperemesis gravidarum ,fever and father alcoholism are factors which positively relative to neural tube defects. (2)The result of mutation of MTHFR C677T is C\C 59.5%,C/T 34.0%,T/T 6.5%.The difference of birth weight and Apgar abnormal rate of three groups have no significant meaning.(3)In the 554 pregnant women,83 (15%)women took folic acid everyday from 3 months before pregnancy to 3 months after pregnancy, 122 (22.2%)women took folic acid after pregnancy, 27 (4.9%)women took folic acid only when they did not forgot it. The ratio of folic-acid-taking in lower educated subjects level such as only obtain junior middle school and below middle school is the lowest ,33.3% and 33.1%;the ratio of the junior college is 48.9%%,the rate of university is 65.0%.(4)The rate of reproductive-aged women who know that folic acid can prevent NTDs is 48%,who know taking folic acid must before pregnancy is only 13.4%,who plan to take folic acid before pregnancy is only 23.0%;who know the types of NTDs is 15.0%,who know the possible reasons of NTDs is 26.2%.After we past these information on some reproductive women ,those knowledge rates are significant enhanced and over 78.0%.The rate of reproductive-aged women whose knowledge level is junior middle school and below junior middle school and who realize taking folic acid can reduce NTDs is 14.28%.The rate of planning to take folic acid before pregnancy of these women is 7%,however,the ratio of such two situations of university level women are separately 86.89%,73.91%.(5)The congenital defects rate of group which took folic acid is 8.96‰,the average birth weight of them is 3237.0g,the premature baby ratio is 6.43‰.These three kinds of data of untaking folic acid group is 13.33‰,3119.3g and 8.50‰,respectively.The difference of average birth weight between two groups is significant .Conclusion (1) In order to reduce the incidence rate of neural tube defects ,child-bearing aged women should not only increase the folic acid intake but also avoid to exposure under enviromental risk factors. (2)The mutations of MTHFR C677T varied between places and people. The result of MTHFR C677T m...