Prevalence and Risk Factors for Spina Bifida in Latino Populations Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology and Surveillance Branch Texas.

Slides:

Advertisements

Similar presentations

The Burden of Obesity in North Carolina Obesity-Related Chronic Disease.

Advertisements

Preterm is less than 37 completed weeks gestation. Source: National Center for Health Statistics, final natality data. Retrieved May 14, 2014, from

Folic Acid and Pregnancy Data from the Pregnancy Risk Assessment Monitoring System (PRAMS)

Associations between Obesity and Depression by Race/Ethnicity and Education among Women: Results from the National Health and Nutrition Examination Survey,

Overcoming Childhood Obesity: The Lifecourse Framework Rafael Pérez-Escamilla, PhD Professor of Epidemiology & Public Health

Wisconsin HIV/AIDS Surveillance Annual Review: Slide Set New diagnoses, prevalent cases, and deaths through December 2014 April 2015 P Wisconsin.

Preterm is less than 37 completed weeks gestation. Source: National Center for Health Statistics, final natality data. Retrieved March 25, 2015, from

Sexually Transmitted Disease Surveillance 2013 Division of STD Prevention.

What is Epidemiology? The study of the distribution and determinants of diseases and injuries in human populations. Source: Mausner and Kramer, Mausner.

Predictors of epidural and spinal anesthesia use: A population-based analysis of Washington State, Molly Altman, MN, CNM.

Nutrition Framing Maternal & Infant Nutrition.

Associations between gestational weight gain and child BMI at age 5 Author 1 Author 2 December 5, 2007 PH 251.

Emerging Trends of HIV/AIDS in New York City Chris Williams, MPH NYC DOHMH.

Routine HIV Screening in Health Care Settings David Spach, MD Clinical Director Northwest AIDS Education and Training Center Professor of Medicine, Division.

Trends in Health and Aging Major Trends and Patterns in Health and Aging July 2007.

Presenting Statistical Aspects of Your Research Analysis of Factors Associated with Pre-term Births in North Carolina.

Increasing Folic Acid Awareness and Knowledge of Future Health Care Providers to Reduce the Incidence of Neural Tube Birth Defects Increasing Folic Acid.

Preconception Health: Has the 2006 Call to Action Been Acted Upon? Pamela K. Xaverius, PhD & Joanne Salas, M.P.H.

Spina Bifida and Fertility Amy Houtrow, MD, PhD, MPH Associate Professor of Physical Medicine & Rehabilitation and Pediatrics University of Pittsburgh.

Melissa VonderBrink, MPH Ohio Department of Health Center for Public Health Statistics and Informatics.

Highlights from the HIV Surveillance Report, 2008 Minnesota Department of Health HIV/AIDS Surveillance System Minnesota Department of Health HIV/AIDS Surveillance.

Dental Care During Pregnancy Oregon 2000 Kathy R. Phipps, DrPH (1) Kenneth D. Rosenberg, MD, MPH (2) Alfredo P. Sandoval, MS, MBA (2) (1) Association of.

CityMatCH / NACCHO Emerging Issues in Maternal and Child Health Conference Call Impact of Healthy Weight in Mothers on Birth Outcomes August 19, 2004 Siobhan.

Women’s Health in Massachusetts Highlights from the Massachusetts Behavioral Risk Factor Surveillance System (BRFSS): Health Survey Program Bureau.

Epidemiology of HIV Among Hispanics Reported in Florida, Through 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division of Disease Control.

Reduced Risks of Neural Tube Defects and Orofacial Clefts With Higher Diet Quality Carmichael SL, Yang W, Feldkamp ML, et al; National Birth Defects Prevention.

Prevention of Birth Defects: Periconceptional Multivitamins with Folic Acid (MVF) Jill Moore (1) Ken Rosenberg, MD, MPH (1,2) Al Sandoval, MS, MBA (2)

Preterm is less than 37 completed weeks gestation. Source: National Center for Health Statistics, final natality data. Retrieved August 10, 2015, from.

Lucina Suarez, PhD Kate Hendricks, MD Texas Department of Health

Racial Disparity in Correlates of Late Preterm Births: A Population-Based Study Shailja Jakhar, Christine Williams, Louis Flick, Jen Jen Chang, Qian Min,

HS499 Bachelor’s Capstone Week 6 Seminar Research Analysis on Community Health.

HIV/AIDS among Women in Texas Enhanced Perinatal Surveillance May 30, 2007 Nita Ngo, MPH.

Maternal Alcohol Consumption and Risk of Orofacial Clefts Lixian Sun Department of Epidemiology.

1 How Complete is California’s HIV Status Determination Among 2008 TB Cases? Darryl Kong, MPH TB Control Branch California Department of Public Health.

Epidemiology Applications Fran C. Wheeler, Ph.D School of Public Health University of South Carolina Columbia, SC (803)

1 PHSKC 4/01 Epidemiology of HIV/AIDS Seattle-King County, WA HIV/AIDS Epidemiology Program Public Health - Seattle & King Co. (206) On the web.

Racial and Ethnic Disparities in the Knowledge of Shaken Baby Syndrome among Recent Mothers Findings from the Rhode Island PRAMS Hanna Kim, Samara.

Aidsnet.org Miami-Dade County HIV/AIDS Epidemiological Data October 25, 2011 Data provided by the Florida Department of Health HIV/AIDS Surveillance Program.

Spina Bifida Association of America Mission: To promote the prevention of spina bifida and to enhance the lives of all affected Local Group Members 59.

Matthew Facer, PhD Epidemiologic Studies Section, Office of AIDS California Department of Public Health A Brief Profile of HIV/AIDS Among Latinos in California.

Alcohol Consumption and Diabetes Preventive Practices: Preliminary Findings from the U.S.-Mexico Border Patrice A.C. Vaeth, Dr.P.H. Raul Caetano, M.D.,

Preterm Birth, Infant Mortality and Birth Defects National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention.

Back to the Future: Perinatal Outcomes in Latinos Elena Fuentes-Afflick, MD, MPH San Francisco General Hospital University of California, San Francisco.

Epidemiology of HIV Among Hispanics Reported in Florida, Through 2013 Florida Department of Health HIV/AIDS Section Division of Disease Control and Health.

Preterm is less than 37 completed weeks gestation. Source: National Center for Health Statistics, final natality data. Retrieved October 15, 2015, from.

Massachusetts Births 2005 Center for Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology Registry of Vital Records.

AIDS Cases with TB Florida 2013 TB Created: 12/27/13 Revision: 10/16/14 To protect, promote and improve the health of all people in Florida through integrated.

Differing First Year Mortality Rates of Term Births to US-born and Foreign- born Mothers James W. Collins, Jr. 11/7/15.

CityMatCH / NACCHO Emerging Issues in Maternal and Child Health Conference Call Impact of Healthy Weight in Mothers on Birth Outcomes August 19, 2004 Siobhan.

Florida Department of Health HIV/AIDS and Hepatitis Section Division of Disease Control and Health Protection Annual data trends as of 12/31/2012 Living.

Florida Department of Health HIV/AIDS & Hepatitis Program Annual data trends as of 12/31/2011 Living (Prevalence) data as of 05/16/2012 Epidemiology of.

State-specific Prevalence of Obesity Among U.S. Adults, by Race/Ethnicity, Definitions: Obesity: Body mass index (BMI) of 30 or higher. Body.

Florida Department of Health HIV/AIDS Section Division of Disease Control and Health Protection Annual data trends as of 12/31/2013 Living (Prevalence)

STDs in Racial and Ethnic Minorities Sexually Transmitted Disease Surveillance 2010 Division of STD Prevention.

Preterm is less than 37 completed weeks gestation. Source: National Center for Health Statistics, final natality data. Retrieved October 15, 2015, from.

Epidemiology of HIV Among Asians and Pacific Islanders Reported in Florida, Through 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division.

TM Assessing the Impact of Fortification on the Epidemiology of Neural Tube Defects FDA Advisory Committee for Reproductive Health Drugs December 15, 2003.

Racial/Ethnic Disparities in Gestational Diabetes Mellitus in Oregon Monica Hunsberger, MPH, RD, PhD 1, Rebecca J. Donatelle, PhD 2, Kenneth D. Rosenberg,

Cervical cancer among Asian subgroups in California, Janet Bates, MD MPH California Cancer Registry NAACCR Annual Meeting Denver, Colorado June.

Impact of HIV Disease, Among the Caribbean-Born, Florida, 2014 Florida Department of Health HIV/AIDS Section Division of Disease Control and Health Protection.

Yolo County Obesity Data Yolo County Childhood Nutrition and Fitness Forum September 18, 2004 Samrina Marshall, MD, MPH Assistant Health Officer, Yolo.

Preconception: Who’s at Risk for Pregnancy

Preterm birth Colorado,

Preterm birth Tennessee,

Preterm birth Delaware,

Preterm birth Texas, Source: National Center for Health Statistics, final natality data. Retrieved October 15, 2015, from

Preterm birth New Mexico,

Robert H. Keefe, PhD, ACSW Sandra D. Lane, PhD, MPH

Adele Schwartz Benzaken

Presentation transcript:

Prevalence and Risk Factors for Spina Bifida in Latino Populations Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology and Surveillance Branch Texas DSHS

Association of Spina Bifida with Maternal Race/Ethnicity 1 Canfield et al Pediatr Perinatal Epidemiol. 2 Carmichael et al BDRA. 3 Canfield et al BDRA. Study LocationYearsNo. of Cases Relative Risk* (95% CI) Texas – (0.9–1.6) California – ( ) National – (1.0–1.4) *Compared to the referent category of non-Hispanic whites

Variable Whites cPR 1 Hispanics cPR 1 (95% CI) Blacks cPR 1 (95% CI) Subtype (N=923)(N=513)(N=316)(N=94) SB M 2 (N=790)Referent1.20 (1.03–1.40)0.89 (0.71–1.12) SB L 3 (N=133)Referent1.74 (1.23–2.46)0.25 (0.09–0.69) TotalReferent1.27 (1.11–1.46)0.80 (0.65–1.00) Case type SB M 2 (N= 790)(N=443)(N=257)(N=90) Isolated (N=683)Referent1.19 (1.01–1.40)0.79 (0.61–1.02) Multiple major defects (N=107)Referent1.26 (0.82–1.95)1.63 (0.97–2.72) Lesion level, isolated SB M 2 (N=657) (N=377)(N=215)(N=65) Cervical (N=5)Referent2.06 ( )2.20 ( ) Thoracic (N=55)Referent1.33 ( )1.41 ( ) Lumbar (N=525)Referent1.21 ( )0.67 ( ) Sacral (N=72)Referent0.83 ( )0.88 ( ) 1 PR = Prevalence ratio 2 SB M = Myelomeningocele, meningocele, and myelocele 3 SB L = Lipomyelomeningocele and lipomeningocele Agopian et al Am J Med Genet A. Association of Race/Ethnicity with Spina Bifida Stratified by Clinical Subtype,

Variable Whites (N=385) PR 1 Hispanics (N=221) PR 1 (95% CI) Blacks (N=70) PR 1 (95% CI) Sex, isolated SB M 2 (N=676) Male (N=340)Referent1.55 (1.23–1.95)1.12 (0.80–1.56) Female (N=336)Referent0.90 (0.70–1.14)0.55 (0.37–0.82) Agopian et al Am J Med Genet A. 1 PR=Prevalence ratio 2 SB M =Myelomeningocele, meningocele, and myelocele Association of Race/Ethnicity with Spina Bifida Stratified by Infant Sex,

CharacteristicCrude OR (95% CI) FatherWhiteReferent Hisp., US born1.30 (0.92–1.82) Hisp., MX/CA* born, 5+yrs in US1.95 (1.34–2.85) Hisp., MX/CA* born, <5yrs in US2.28 (1.13–4.58) MotherWhiteReferent Hisp., US born1.23 (0.92–1.63) Hisp., MX/CA* born, 5+yrs in US2.16 (1.56–3.00) Hisp., MX/CA* born, <5yrs in US1.92 (1.23–2.99) BothWhiteReferent Hisp., US born1.33 (0.88–2.02) Hisp., MX/CA* born, 5+yrs in US2.45 (1.49–4.03) Hisp., MX/CA* born, <5yrs in US3.28 (1.46–7.37) *MX/CA = Mexico/Central America Canfield et al BDRA. Association of Maternal and Paternal Hispanic Birthplace/Immigration Factors with Spina Bifida, 1997–2003

Decline in the Prevalence of Spina Bifida by Race/Ethnicity US, 1995 – 2002 Williams et al Pediatrics. Fortification

Prevalence of Spina Bifida in 10 US Regions, 2002 *Adjusted for maternal age Shin et al Pediatrics.

Association of Race/Ethnicity with Selected Self-reported Preconception Health Indicators– Texas Pregnancy Risk Assessment Monitoring System, 2002–2010 Maternal Factors White (n=5413) Hispanic (n=5758) PR (95% CI) Black (n=4215) PR (95% CI) SmokingReferent0.35* ( ).54* (0.49–0.60) No daily multivitaminReferent1.18* (1.14–1.21)1.18* (1.15–1.21) ObeseReferent1.29* ( )1.49* (1.36–1.64) CDC Publication pending. * Association is statistically significant in multivariate models that included age, race/ethnicity, education, insurance, Medicaid, and pregnancy intent.

Variable # Foreign-Born# U.S.-BornAdjusted OR*95% CI Smoking –0.37 Exposure to Passive Smoke –0.98 Periconceptional Folic Acid Supplements (daily v. none) –0.98 Obese (v. normal BMI) –0.66 *Odds ratio adjusted for maternal age, education, and pregnancy intention, referent group is U.S. born Ramadhani et al BDRA. The Association of Nativity with Selected Maternal Factors, Hispanic NBDPS Controls, 1997–2005

Folic Acid Awareness and Use Among Women with a History of an NTD-Affected Pregnancy Texas, 2000–2001 Canfield et al MMWR.

Texas Neural Tube Defect Project–Mexican Americans on TX-US Border, Cluster: Brownsville, Texas peer reviewed articles on risk factors NTD risk factors for folic acid deficient population: –Low serum B 12 –Periconceptional hyperthermia –Exposure to nitrosatable drugs with high nitrate/nitrite intake –Periconceptional diarrhea –Exposure to fumonisins –Hyperinsulinemia –Passive smoke exposure

Summary Relative to whites, Latinos are: –Only at modestly elevated risk of spina bifida, regardless of clinical phenotype or pattern –At greater risk if one/both parents foreign born –Less likely to be exposed to smoke (Foreign-born>US-born) –Less likely to supplement (Foreign-born>US-born) –More likely to be obese (US-born>Foreign-born)

Mark A Canfield, PhD, Manager Birth Defects Epidemiology and Surveillance Branch Texas Department of State Health Services Phone: (512) Web site: THANK YOU