Descriptive epidemiology of lipomyelomeningocele, Hawaii, 1986-2001. 2004

Mathias B Forrester, and Ruth D Merz
Hawaii Birth Defects Program, Honolulu, HI 96817, USA.

BACKGROUND The epidemiology of neural tube defects (NTDs) may depend on the type of the defect and its location. There is little epidemiologic information on lipomyelomeningocele, a type of NTD. The objective of this investigation was to describe the epidemiology of lipomyelomeningocele. METHODS Cases were obtained from a Hawaii birth defect registry and consisted of all infants delivered during 1986-2001 with lipomyelomeningocele. Lipomyelomeningocele rates per 10,000 births were calculated for various factors. RESULTS A total of 17 cases of lipomyelomeningocele were identified, for a total rate of 0.57. When the lipomyelomeningocele rate was examined with respect to the time period of folic acid fortification of cereal grains in the United States, the rate was 0.57 during 1986-1996 (prefortification), 0.57 during 1997-1998 (voluntary fortification), and 0.58 during 1999-2001 (mandatory fortification). A total of 11 (64.7%) of the cases were female. Lipomyelomeningocele rates were higher among infants born to mothers in younger and older age groups. The rate was highest among Pacific Islanders, followed by Filipinos and Far East Asians, and lowest among whites. Rates were greater with lower birth weight and gestational age and among multiple births. CONCLUSIONS Lipomyelomeningocele rates were not found to be affected by folic acid fortification. The majority of cases were female. Other demographic and clinical factors appear to be associated with lipomyelomeningocele risk. None of the differences in rates between the various subgroups were statistically significant, and due to the small number of cases, the 95% confidence interval (CI) ranges were wide. However, the findings suggest possible patterns of occurrence. Additional studies involving larger numbers of cases are recommended.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D008423 Maternal Age The age of the mother in PREGNANCY. Age, Maternal,Ages, Maternal,Maternal Ages
D008591 Meningomyelocele Congenital, or rarely acquired, herniation of meningeal and spinal cord tissue through a bony defect in the vertebral column. The majority of these defects occur in the lumbosacral region. Clinical features include PARAPLEGIA, loss of sensation in the lower body, and incontinence. This condition may be associated with the ARNOLD-CHIARI MALFORMATION and HYDROCEPHALUS. (From Joynt, Clinical Neurology, 1992, Ch55, pp35-6) Myelocele,Myelomeningocele,Acquired Meningomyelocele,Myelomeningocele, Acquired,Acquired Meningomyeloceles,Acquired Myelomeningocele,Acquired Myelomeningoceles,Meningomyelocele, Acquired,Meningomyeloceles,Meningomyeloceles, Acquired,Myeloceles,Myelomeningoceles,Myelomeningoceles, Acquired
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D005006 Ethnicity A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. Ethnic Groups,Nationality,Ethnic Group,Nationalities
D005260 Female Females
D005492 Folic Acid A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses (POACEAE). Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. Pteroylglutamic Acid,Vitamin M,Folacin,Folate,Folic Acid, (D)-Isomer,Folic Acid, (DL)-Isomer,Folic Acid, Calcium Salt (1:1),Folic Acid, Monopotassium Salt,Folic Acid, Monosodium Salt,Folic Acid, Potassium Salt,Folic Acid, Sodium Salt,Folvite,Vitamin B9,B9, Vitamin
D005527 Food, Fortified Any food that has been supplemented with essential NUTRIENTS either in quantities that are greater than those normally present, or which are not found in the food typically. Fortified food also includes food enriched by adding various nutrients to compensate for those removed by refinement or processing. (Modified from Segen, Dictionary of Modern Medicine, 1992). Enriched Food,Food, Supplemented,Enriched Foods,Food, Enriched,Foods, Enriched,Foods, Fortified,Foods, Supplemented,Fortified Food,Fortified Foods,Supplemented Food,Supplemented Foods

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