Full Access
The prevalence of anencephalus and spina bifida in New Zealand
B. BORMAN,
C. CRYER,
Corresponding Author
B. BORMAN
Public Health Commission, Wellington, New Zealand
Dr B. Borman, Public Health Commission, PO Box 1795, Wellington, New Zealand.Search for more papers by this authorC. CRYER
South-East Institute of Public Health, Tunbridge Wells, England
Search for more papers by this authorB. BORMAN,
C. CRYER,
Corresponding Author
B. BORMAN
Public Health Commission, Wellington, New Zealand
Dr B. Borman, Public Health Commission, PO Box 1795, Wellington, New Zealand.Search for more papers by this authorC. CRYER
South-East Institute of Public Health, Tunbridge Wells, England
Search for more papers by this authorC. Cryer, PhD, Statistician. B. Borman, PhD, Epidemiologist.
Abstract
Despite the plethora of epidemiological research conducted on anencephalus and spina bifida, few of the studies have used multiple source case ascertainment and controlled for the effect of possible confounding factors. This paper reports the results from a study of the relationships between various risk factors and the prevalence of anencephalus and spina bifida in New Zealand during 1978-82, using case data obtained from multiple sources and a national cohort of births as the denominator. The rates of anencephalus and spina bifida in New Zealand were 0.78/1000 and 0.94/1000 total births, respectively. The rate of a neural tube defect (NTD) birth for Maori parents was less than for their non-Maori counterparts. Paternal ethnic origin and maternal ethnic origin made similar contributions to the model of anencephalus rates, but the results suggest that paternal ethnic origin is a less important risk factor in the prevalence of spina bifida. The rate of both NTD was high among female infants and low among births to women born in countries other than the British Isles and New Zealand. The rate of anencephalus showed a distinct north-south gradient, but there was no evidence of effects for maternal or paternal age, parity, urban-rural place of residence, nuptiality, social class or season of birth in the prevalence of either NTD in New Zealand.
References
- 1 Mortimer E. A. The puzzling epidemiology of neural tube defects. Pediatrics 1980; 65: 636–8.
- 2 Emanuel I., Sever L. E. Questions concerning the possible association of potatoes and neural tube defects, and an alternative hypothesis relating to maternal growth and development. Teratology 1973; 8: 325–32.
- 3 Elwood J. H., Elwood J. M. Investigation of area differences in the prevalence at birth of anencephalus in Belfast. Int. J. Epidemiol. 1984; 13: 45–52.
- 4 Elwood J. M., Mousseau G. Geographical, secular and ethnic influences in anencephalus. J. Chron. Dis. 1978; 31: 483–91.
- 5 Elwood J. M., Raman S., Mousseau G. Reproductive history in the mothers of anencephalics. J. Chron. Dis. 1978; 31: 473–81.
- 6 Elwood J. M., Elwood J. H. Epidemiology of Anencephalus and Spina Bifida. Oxford University Press, Oxford . 1980.
- 7 Elwood J. M., Elwood J. H. International variation in the prevalence at birth of anencephalus in relation to maternal factors. Int. J. Epidemiol. 1982; 11: 132–7.
- 8 Strassburg M. A., Greenland S., Portigal L. D., Sever L. E. A population-based case control study of anencephalus and spina bifida in a low-risk area. Dev. Med. Child Neurol. 1983; 25: 632–41.
- 9 MRC Vitamin Study Research Group. Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. Lancet 1991; 338(i): 131–7.
- 10 Borman B., Smith A. H., Howard J. K. Risk factors in the prevalence of anencephalus and spina bifida in New Zealand. Teratology 1986; 33: 221–30.
- 11 Borman B. Risk factors in the prevalence of anencephalus and spina bifida in New Zealand. PhD thesis, University of Otago, New Zealand . 1987.
- 12 OPCS. Classification of Occupations. Office of Population Censuses and Surveys (OPCS), HMSO, London . 1980.
- 13 Elley W. B., Irving J. C. Revised socio-economic index for New Zealand. NZ J. Educ. Stud. 1976; 11: 25–36.
- 14 Mantel N., Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J. Natl Can. Inst. 1959; 22: 719–48.
- 15 Harrell F. The LOGIST procedure. In SUGI Supplemental Library User's Guide, Version 5, SAS, Gary. North Carolina . 1986; 268–93.
- 16 Field B. Surveillance of malformations in Sydney. Med. J. Aust. 1977; 2: 797–99.
- 17 Bower C., Hobbs M., Carney A., Simpson D. Neural tube defects in Western Australia 1966–81 and a review of Australian data 1942–81. J. Epidemiol. Community Health 1984; 38: 208–13.
- 18 Imaizumi Y. Statistical analysis on anencephaly, spina bifida and congenital hydrocephaly in Japan. Jpn J. Hum. Genet. 1974; 19: 115–35.
- 19 Sever L. E. An epidemiological study of neural tube defects in Los Angeles County. II Etiological factors in an area with low prevalence at birth. Teratology 1982; 25: 323–4.
- 20 Hay S. Incidence of selected congenital malformations in Iowa. Am. J. Epidemiol. 1971; 94: 572–84.
- 21 Trimble B. K., Baird P. A. Congenital anomalies of the central nervous system incidence in British Columbia, 1952–1972. Teratology 1978; 17: 43–50.
- 22 Borman B., Cryer C. Fallacies in the international and national comparisons of disease occurrence in the epidemiology of neural tube defects. Teratology 1990; 42: 405–12.
- 23 Borman B., Howard J. K., Chapman C. J. Secular trends in the prevalence of anencephalus in New Zealand. NZ Med. J. 1986; 99: 183–5.
- 24 Creasy M. R., Alberman E. D. Congenital malformations of the central nervous system in spontaneous abortions. J. Med. Genet. 1976; 13: 9–16.
- 25 Hook E. B. Incidence and prevalence as measures of the frequency of birth defects. Am. J. Epidemiol. 1982; 116: 743–7.
- 26 Shapiro S., Bross D. Risk factors for fetal death in studies of vital statistics data: Inference and limitations. In I. H. Porter, E. B. Hook eds. Human Embryonic and Fetal Death. Academic Press, New York . 1980; 89–106.
- 27 Baker P. A. Cost benefit analysis of screening spina bifida. NZ Med. J. 1981; 93: 386–9.
- 28 Howie R. N., Phillips L. I. Congenital malformations in the newborn: A survey at the National Women's Hospital 1964–1967. NZ Med. J. 1970; 71: 65–71.
- 29 Buckfield P. Major congenital faults in newborn infants: A pilot study in New Zealand. NZ Med. J. 1973; 78: 195–204.
- 30 Legge M. Incidence of central nervous system abnormalities in newborn infants born at the Christchurch Women's Hospital between 1970 and 1975. NZ Med. J. 1982; 95: 417–18.
- 31 Hanify J. A., Metcalf P., Nobbs C. L., Worsley K. J. Congenital malformations in the newborns in Northland. NZ Med. J. 1980; 92: 245–8.
- 32 Hook E. B. Problems in the interpretation of birth prevalence rates of neural tube defects. Teratology 1983; 27: 125–6.
- 33 Morton N. E., Chung C. S., Mi M. Genetics of inter-racial crosses in Hawaii. Monogr. Hum. Genet. 1967; 3: 1–158.
- 34 Naggan L., MacMahon B. Ethnic differences in the prevalence of anencephaly and spina bifida in Boston, Massachusetts. N. Engl. J. Med. 1967; 277: 1119–23.
- 35 Gunn T. R., Hayden J. E. A comparison of Pacific Islander and European stillbirths. NZ Med. J. 1981; 94: 294–7.
- 36 Stevenson A. C., Johnson H. A., Stewart M. I. P., Golding D. R. Congenital malformations—a report of a study of series of consecutive births in 24 centres. Bull. World Health Organ. 1966; 34: 1–125.
- 37 Horowitz I., McDonald A. D. Anencephaly and spina bifida in the province of Quebec. Can. Med. Assoc. J. 1969; 100: 748–55.
- 38 Naggan L. Anencephaly and spina bifida in Israel. Pediatrics 1971; 47: 577–86.
- 39 Granroth G., Hakama M., Saxen L. Defects of the central nervous system in Finland: I. Variations in time and space, sex distribution. Br. J. Prev. Soc. Med. 1977; 31: 164–70.
- 40 Czeizel A., Revesz C. Major malformations of the central nervous system in Hungary. Br. J. Prev. Soc. Med. 1970; 24: 205–22.
- 41 Granroth G., Haapakoski J., Hakama M. Defects of the central nervous system in Finland. II. Birth order, outcome of previous pregnancies and family history. Teratology 1978; 17: 213–22.
- 42 Turnbull C. D., Scurletis T. D., Danielson A. H. Anencephalus in North Carolina: A 25 years experience. N. C. Med. J. 1977; 38: 713–18.
- 43 Sandahl B. Seasonal incidence of some congenital malformations in the central nervous system in Sweden, 1965–1972. Acta Paediatr. Scand. 1977; 66: 65–72.
- 44 Dallaire L., Melancon S. B., Potier M., Mathieu J. P., Ducharme G. Date of conception and prevention of neural tube defects. Clin. Genet. 1984; 26: 304–7.
- 45 Fraser F. C., Frecker M., Allderdice P. Seasonal variation of neural tube defects in Newfoundland and elsewhere. Teratology 1986; 33: 299–303.
- 46 Pleydell M. J. Anencephaly and other congenital abnormalities: an epidemiological study in Northamptonshire. Br. Med. J. 1960; 1: 309–15.
- 47 Elwood J. H. Anencephaly and spina bifida in the British Isles. In S. Kelly, E. B. Hook, D. T. Janerich eds Birth Defects: Risks and Consequences. Academic Press, New York . 1976; 21–39.
- 48 Hunter A. G. W. Neural tube defects in Eastern Ontario and Western Quebec: Demography and family data. Am. J. Med. Genet. 1984; 19: 45–63.
- 49 Crowe C. A., Heuther C. A., Oppenheimer S. G., Barth L. D., Jeffrey E., Reinhart S. The epidemiology of spina bifida in South-western Ohio—1970–1979. Dev. Med. Child Neurol. 1985; 27: 176–82.
- 50 Fedrick J. Anencephalus in Scotland, 1961–72. Br. J. Prev. Soc. Med. 1976; 30: 132–7.
Citing Literature
