Nathan I N Henry,Balakrishnan Nair,Anna Ranta,Rita Krishnamurthi,Anjali Bhatia,Valery Feigin
{"title":"Insights from ARCOS-V's Transition to Remote Data Collection During the COVID-19 Pandemic: A Descriptive Study.","authors":"Nathan I N Henry,Balakrishnan Nair,Anna Ranta,Rita Krishnamurthi,Anjali Bhatia,Valery Feigin","doi":"10.1159/000541368","DOIUrl":"https://doi.org/10.1159/000541368","url":null,"abstract":"INTRODUCTIONThe ARCOS-V study, an epidemiological study on stroke and transient ischemic attack (TIA), faced the challenge of continuing data collection amidst the COVID-19 pandemic. This study aims to describe the methodological changes and challenges encountered during the transition from paper-based methods to digital data collection for the ARCOS-V study, and to provide insights into the potential of using digital tools to transform epidemiological research.METHODSThe study adapted to remote data collection using REDCap and Zoom, involving daily health record reviews, direct data entry by trained researchers, and remote follow-up assessments. The process was secured with encryption and role-based access controls. The transition period was analyzed to evaluate the effectiveness and challenges of the new approach.RESULTSThe digital transition allowed for uninterrupted monitoring of stroke and TIA cases during lockdowns. Using REDCap and Zoom improved data reach, accuracy, and security. However, it also revealed issues such as the potential for systematic data entry errors and the need for robust security measures to protect sensitive health information.CONCLUSIONThe ARCOS-V study's digital transformation exemplifies the resilience of epidemiological research in the face of a global crisis. The successful adaptation to digital data collection methods highlights the potential benefits of such tools, particularly as we enter a new age of Artificial Intelligence (AI).","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":"29 1","pages":"1-15"},"PeriodicalIF":5.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changing Epidemiology of Neurological Diseases in Africa.","authors":"G Logroscino,R Kalaria,P M Preux","doi":"10.1159/000539654","DOIUrl":"https://doi.org/10.1159/000539654","url":null,"abstract":"","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":"38 1","pages":"1-3"},"PeriodicalIF":5.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Su Liu, Jianfeng Luo, Zhenxu Xiao, Wanqing Wu, Xiaoniu Liang, Qianhua Zhao, Xianfeng Zhao, Yi Wang, Wenhuan Fu, Ding Ding
{"title":"Low Intake of Total Antioxidant Nutrients as a Risk Factor for Incident Dementia in Older Adults: The Shanghai Aging Study.","authors":"Su Liu, Jianfeng Luo, Zhenxu Xiao, Wanqing Wu, Xiaoniu Liang, Qianhua Zhao, Xianfeng Zhao, Yi Wang, Wenhuan Fu, Ding Ding","doi":"10.1159/000541231","DOIUrl":"10.1159/000541231","url":null,"abstract":"<p><strong>Introduction: </strong>Previous longitudinal studies reported the impact of antioxidant nutrients (ANs) on cognitive impairment in the older population, but the conclusions were inconsistent. This study aimed to verify the hypothesis that dietary intake of total AN was associated with incident dementia among older individuals.</p><p><strong>Methods: </strong>Community residents without dementia aged ≥60 years were prospectively followed up for an average of 5.2 years in the Shanghai Aging Study. At baseline, daily intakes of total dietary AN (the sum of carotene, vitamin C, vitamin E, lutein, and flavonoids) and energy were calculated based on an interviewer-administered food frequency questionnaire measuring the dietary intake over the past 1 year for each participant. A battery of neuropsychological tests was used to evaluate cognitive function, and a consensus diagnosis of dementia was made according to the DSM-IV criteria at baseline and follow-up.</p><p><strong>Results: </strong>Among 1,550 dementia-free participants, 135 (8.7%) incident dementia cases were identified during the average of 5.2 years of follow-up. Participants with low AN intake (<112 mg/day) had a significantly higher risk of incident dementia than those with high AN intake (≥112 mg/day) (hazard ratio 1.87, 95% confidence interval 1.26-2.77) after adjusting for age, gender, education, obesity, APOE-ε4, hypertension, diabetes, depression, baseline Mini-Mental State Examination score, and total energy intake. The significant association of total AN intake with incident dementia was only found in individuals ≥70 years.</p><p><strong>Conclusion: </strong>Low total AN intake may be a risk factor for incident dementia among older adults. Maintaining sufficient AN intake may be beneficial against age-related cognitive decline.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of Traumatic Brain Injury in the General Adult Population of the USA: A Meta-Analysis.","authors":"Armin Karamian, Brandon Lucke-Wold, Ali Seifi","doi":"10.1159/000540676","DOIUrl":"10.1159/000540676","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. It has been estimated that 64-74 million individuals experience TBI from all causes each year. Due to these variations in reporting TBI prevalence in the general population, we decided to perform a meta-analysis of published studies to better understand the prevalence of TBI in the general adult population of the USA which can help health decision-makers in determining general policies to reduce TBI cases and their costs and burden on the healthcare system.</p><p><strong>Methods: </strong>Our meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The study protocol was registered with PROSPERO (CRD42024534598). A comprehensive literature search of PubMed from the National Library of Medicine and Google Scholar was performed from database inception to April 2024. Sixteen studies that evaluated the US general population met our inclusion criteria. A meta-analysis using a random-effects model was performed to estimate the prevalence of TBI in the general adult population of the USA.</p><p><strong>Results: </strong>The total sample consisted of 27,491 individuals, of whom 4,453 reported a lifetime history of TBI with loss of consciousness (LOC) (18.2%, 95% CI 14.4-22.7%). Some studies did not report relevant information based on gender, but based on available data, among males, 1,843 individuals out of 8,854 reported a lifetime history of TBI with LOC (20.8%). Among females, 1,363 individuals out of 11,943 reported a lifetime history of TBI with LOC (11.4%). The odds of sustaining TBI in males were higher than in females with moderate heterogeneity between studies (OR = 2.09, 95% CI 1.85-2.36, p < 0.01, I2 = 40%).</p><p><strong>Conclusion: </strong>The prevalence of TBI in the US general population is 18.2%, making it a major public health concern. In addition, males were more than twice as likely as females to sustain TBI with LOC. Considering the irreparable long-term adverse effects of TBI on survivors, their families, and the healthcare system, prevention strategies can facilitate substantial reductions in TBI-related permanent disabilities and medical care costs.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alon Gorenshtein, Liron Leibovitch, Tom Liba, Shai Stern, Yael Stern
{"title":"Gender Disparities in Neurological Symptoms of Long COVID: A Systematic Review and Meta-Analysis.","authors":"Alon Gorenshtein, Liron Leibovitch, Tom Liba, Shai Stern, Yael Stern","doi":"10.1159/000540919","DOIUrl":"10.1159/000540919","url":null,"abstract":"<p><strong>Background: </strong>Female gender is a known risk factor for long COVID. With the increasing number of COVID-19 cases, the corresponding number of survivors is also expected to rise. To the best of our knowledge, no systematic review has specifically addressed the gender differences in neurological symptoms of long COVID.</p><p><strong>Methods: </strong>We included studies on female individuals who presented with specific neurological symptoms at least 12 weeks after confirmed COVID-19 diagnosis from PubMed, Central, Scopus, and Web of Science. The search limit was put for after January 2020 until June 15, 2024. We excluded studies that did not provide sex-specific outcome data, those not in English, case reports, case series, and review articles Results: A total of 5,632 eligible articles were identified. This article provides relevant information from 12 studies involving 6,849 patients, of which 3,414 were female. The sample size ranged from 70 to 2,856, with a maximum follow-up period of 18 months. The earliest publication date was September 16, 2021, while the latest was June 11, 2024. The following neurological symptoms had a significant difference in the risk ratio (RR) for female gender: fatigue RR 1.40 (95% confidence interval [CI]: 1.22-1.60, p < 0.001), headache RR 1.37 (95% CI: 1.12-1.67, p = 0.002), brain-fog RR 1.38 (95% CI 1.08-1.76, p = 0.011) depression RR 1.49 (95% CI: 1.2-1.86, p < 0.001), and anosmia RR 1.61 (95% CI: 1.36-1.90, p < 0.001). High heterogenicity was found for fatigue, brain fog, and anxiety due to the diverse methodologies employed in the studies.</p><p><strong>Conclusion: </strong>Our findings suggest that women are at a higher risk for long-COVID neurological symptoms, including fatigue, headaches, brain fog, depression, and anosmia, compared to men. The prevalence of these symptoms decreases after 1 year, based on limited data from the small number of studies available beyond this period.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-15"},"PeriodicalIF":3.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between Constipation and the Risk of Parkinson's Disease among Participants in the UK Biobank.","authors":"Jing Zhang, Mengyao Shi, Qilu Zhang, Yi Chen, Xiangyan Yin, Xiaoxiao Wang, Yonghong Zhang","doi":"10.1159/000540955","DOIUrl":"10.1159/000540955","url":null,"abstract":"<p><strong>Introduction: </strong>Constipation is common in patients with Parkinson's disease (PD), but its impact on incident PD remains uncertain. We aimed to prospectively investigate constipation symptoms and the risk of PD.</p><p><strong>Methods: </strong>Participants without PD at baseline from the UK Biobank were included in the study. Information on the regular use of laxatives, bowel movement frequency, and the frequency of hard or lumpy stools was collected. Incident PD was defined by the ICD-10 code. Cox proportional hazards models were used to assess the association between constipation symptoms and incident PD.</p><p><strong>Results: </strong>In the analysis of regular laxative use and PD, 490,797 participants were included and 2,735 incident PD were detected. The multivariable adjusted HR of PD in participants who regularly used laxatives was 1.99 (95% confidence interval [CI], 1.70-2.33) compared with those who did not. In the analysis of bowel movement frequency and hard or lumpy stools and PD, 170,017 participants were included and 519 incident PD were detected. The multivariable adjusted HRs were 2.16 (95% CI, 1.74-2.68) and 2.57 (95% CI, 2.00-3.31) for participants with a bowel movement frequency of 3-6 times/week and <3 times/week, respectively, compared with those with a bowel movement frequency of ≥7 times/week; compared with participants who never had hard or lumpy stools, multivariable adjusted HRs were 1.31 (95% CI, 1.07-1.60), 2.32 (95% CI, 1.77-3.05), and 2.94 (95% CI, 2.14-4.05) for those who sometimes had hard or lumpy stools, often had hard or lumpy stools, and most of time/always had hard or lumpy stools, respectively.</p><p><strong>Conclusions: </strong>Constipation measured by the regular use of laxatives, bowel movement frequency, and the frequency of hard or lumpy stools was significantly associated with an increased risk of incident PD.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yue-Yang Zhang, Xin Yang, Ying Miu, Bing-Xue Chen, Qin Wan
{"title":"Associations of Diet and Lifestyle with Mortality and Stroke: The China Cardiometabolic Disease and Cancer Cohort (4C) Study.","authors":"Yue-Yang Zhang, Xin Yang, Ying Miu, Bing-Xue Chen, Qin Wan","doi":"10.1159/000540922","DOIUrl":"https://doi.org/10.1159/000540922","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the individual and combined associations between dietary habits and lifestyle factors concerning all-cause mortality and stroke in Chinese adults.</p><p><strong>Method: </strong>We conducted a nationwide, multicenter, prospective cohort study involving 10,008 participants, gathering baseline data on lifestyle, metabolic status, dietary habits, and living behaviors. Subsequently, a 10-year follow-up was performed, resulting in the inclusion of 7,612 participants in this study. We employed Spearman correlation analysis, restricted cubic spline regression, and Cox regression analysis to evaluate the connections between outcome events, dietary habits, and lifestyle.</p><p><strong>Result: </strong>For each additional serving of pulses consumed per week, there was a slight decrease in the risk of all-cause mortality (HR: 0.91, 95% CI: 0.83-0.99). The hazard ratios for stroke were 2.24 (1.48, 3.37) for current smokers, in comparison to individuals who had never smoked. Appropriate intake of specific dietary factors and certain lifestyle habits were associated with reduced stroke: fruit drinks at 0.51 (0.34, 0.87), and animal viscera at 0.58 (0.32, 1.04). Weekly consumption of at least 21 servings of vegetables (0.72, 0.53-0.98), 0-1 serving of fried food (0.58, 0.38-0.90), and at least 1 serving of carbonated beverages (0.51, 0.28-0.92) was associated with a reduced risk of stroke.</p><p><strong>Conclusion: </strong>Smoking was found to be linked to an increased risk of stroke. A higher intake of fruit drinks and animal viscera was associated with a reduced risk of stroke. In contrast, a higher intake of beans was associated with a decreased risk of overall mortality. Consuming an appropriate amount of vegetables, fried foods, and carbonated drinks was found to potentially lower the risk of stroke. Collectively, these findings underscore the importance of developing tailored dietary interventions conducive to the Chinese populace's health.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlotta Josefson, Tiina Rekand, Åsa Lundgren-Nilsson, Katharina S Sunnerhagen
{"title":"Epidemiology of Spinal Cord Injury in Adults in Sweden, 2016-2020: A Retrospective Registry-Based Study.","authors":"Charlotta Josefson, Tiina Rekand, Åsa Lundgren-Nilsson, Katharina S Sunnerhagen","doi":"10.1159/000540818","DOIUrl":"10.1159/000540818","url":null,"abstract":"<p><strong>Study design: </strong>We conducted a retrospective, descriptive register study.</p><p><strong>Objective: </strong>The aim of the study was to present the epidemiological and demographic characteristics of the Swedish spinal cord injury (SCI) population.</p><p><strong>Setting: </strong>Rehabilitation units in Sweden were connected to the National Quality Register for Rehabilitation Medicine (Svenskt Register för Rehabiliteringsmedicin: SveReh). The registry includes data from 26 units around the country.</p><p><strong>Methods: </strong>Information was extracted from SveReh for patients who underwent rehabilitation for a new onset SCI between January 1, 2016, and December 31, 2020. Data regarding gender, age, aetiology, level of injury, neurogenic bowel and/or bladder dysfunction, complications during the primary rehabilitation, and the need for bi-level positive airway pressure, continuous positive airway pressure, or ventilator were analysed.</p><p><strong>Results: </strong>Mean age at onset was 56 years, and men were overrepresented (66%). Tetraplegia was more common among traumatic SCI (TSCI) than non-traumatic SCI (NTSCI). The incidence was 11.9-14.8 per million for TSCI and 8.9-11.8 per million for NTSCI. At discharge, 8% of patients needed a breathing aid. Of those who were ventilator-dependent at discharge, 75% had a TSCI. Disturbed bowel and bladder functioning was noted in 58% of patients at discharge. The median time spent at the unit was 40 days, but it was approximately 2 weeks longer for those with a TSCI.</p><p><strong>Conclusions: </strong>Systematic and updated data on the Swedish SCI population show a pattern similar to Scandinavian countries with high age at onset and falls being the main cause of TSCI. The TSCI incidence was lower than in previous studies, and the results for NTSCI were novel.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bo Lei, Shuang Yang, Ling Tian, Simin Zhou, Thanh N Nguyen, Mohamad K Abdalkader, Xing Liu, Yingbin Sun, Ning Zhao, Qin Han, An Mao, Zhaojun Tao, Yan Wang, Wenfeng Cao, Shiquan Yang, Jun Zhang, Fuqiang Guo, Hongbin Wen, Jinhua Zhang, Chengsong Yue, Jie Yang, Hongfei Sang, Zhongming Qiu, Ying Jin, Weidong Luo
{"title":"Rates and Impact of Serious Adverse Events after Endovascular Thrombectomy among Large Vessel Occlusion Stroke Patients.","authors":"Bo Lei, Shuang Yang, Ling Tian, Simin Zhou, Thanh N Nguyen, Mohamad K Abdalkader, Xing Liu, Yingbin Sun, Ning Zhao, Qin Han, An Mao, Zhaojun Tao, Yan Wang, Wenfeng Cao, Shiquan Yang, Jun Zhang, Fuqiang Guo, Hongbin Wen, Jinhua Zhang, Chengsong Yue, Jie Yang, Hongfei Sang, Zhongming Qiu, Ying Jin, Weidong Luo","doi":"10.1159/000540555","DOIUrl":"10.1159/000540555","url":null,"abstract":"<p><strong>Objective: </strong>Complications or serious adverse events (SAEs) are common in the treatment of patients with large vessel occlusion stroke. There has been limited study of the impact of SAEs for patients after endovascular thrombectomy (EVT). The goal of this study was to characterize the rates and clinical impact of SAEs following EVT.</p><p><strong>Methods: </strong>A post hoc analysis was performed using pooled databases of the \"DEVT\" and \"RESCUE BT\" trials. SAEs were designated as symptomatic intracranial hemorrhage, brain herniation or craniectomy, respiratory failure, circulatory failure, pneumonia, deep venous thrombosis, and systemic bleeding. The primary endpoint was functional independence (modified Rankin scale score 0-2 within 90 days). Logistic regression analysis was used to determine the predictors and associations between SAEs and outcomes.</p><p><strong>Results: </strong>Of 1,182 enrolled patients, 402 (34%) had a procedural complication and 745 (63%) had 1,404 SAE occurrences with 4.65% in-hospital mortality. The three most frequent SAEs were pneumonia (620, 52.5%), systemic bleeding (174, 14.7%), and respiratory failure (173, 14.6%). Pneumonia, systemic bleeding, or deep venous thrombosis was less life-threatening. Patients with advanced age (adjusted odds ratio, 1.28 [95% confidence interval, 1.14-1.43]), higher NIHSS (1.09 [1.06-1.11]), occlusion site (middle cerebral artery-M1 vs. internal carotid artery [ICA]: 0.75 [0.53-1.04]; M2 vs. ICA: 1.30 [0.80-2.12]), longer procedure time (1.01 [1.00-1.01]), and unsuccessful vessel recanalization (1.79 [1.06-2.94]) were more likely to experience SAEs. Compared with no SAE, patients with SAEs had lower odds of functional independence (0.46 [0.40-0.54]).</p><p><strong>Conclusions: </strong>Overall, SAEs diagnosed following thrombectomy in patients with stroke were common (more than 60%) and associated with functional dependence. Patients with advanced age, higher NIHSS, longer procedure time, and failed recanalization were more likely to experience SAEs. There was no statistical difference in the risk of SAEs among patients with M1 and M2 occluded compared with those ICA occluded. An understanding of the prevalence and predictors of SAEs could alert clinicians to the estimated risk of an SAE for a patient after EVT.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-12"},"PeriodicalIF":3.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preconception Folic Acid and Multivitamin Supplementation for the Prevention of Neural Tube Defect: An Umbrella Review of Systematic Review and Meta-analysis.","authors":"Biruk Beletew Abate, Henok Kumsa, Gebremeskel Abebe Kibret, Tilahun Wodaynew, Tesfaye Engdaw Habtie, Muluemebet Kassa, Melesse Abiye Munie, Dessie Temesgen, Befkad Derese Tilahun, Abebe Merchaw, Addis Wondimagegn Alamaw, Alemu Birara Zemariam, Tegene Atamenta Kitaw, Amare Kassaw, Ayelign Mengesha Kassie, Gizachew Yilak, Mulat Awoke Kassa, Fasikaw Kebede, Solomon Moges, Molalign Aligaz Adisu, Molla Azmeraw","doi":"10.1159/000539803","DOIUrl":"10.1159/000539803","url":null,"abstract":"<p><strong>Background: </strong>Previous reviews explored the association between maternal use of folic acid and multivitamin supplements and risk of neural tube defect (NTD) in children, with no definitive conclusion. These reviews had produced contradictory results, and there had been no umbrella review. Therefore, the objective of this umbrella review is to combine the inconsistent data on the effect of prenatal folic acid and/or multivitamin supplementation for the prevention of NTD in offspring.</p><p><strong>Methods: </strong>Using the PRISMA guideline, PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar reported that the effects of folic acid and/or multivitamin supplementation for the prevention of NTD in offspring were searched. The quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed.</p><p><strong>Result: </strong>Ten SRM with 296,816 study participants were included. The random-effects model analysis from 10 included systematic review and meta-analysis revealed that the pooled effect of either folic acid or multivitamin supplementation for the prevention of NTD globally is found to be 0.43 (95% CI: 0.29, 0.58) (I2 = 93.50%; p ≤0.001). In the subgroup analysis, the pooled effect was found to be 0.23 (0.09, 0.37) in folic acid group, while this estimate is 0.63 (0.53, 0.72) and 0.61 (0.46, 0.75) in groups who took multivitamin. The pooled effect of prevention of NTD was found to be 0.50 (0.34, 0.66) in SRMs aimed at occurrence prevention (primary prevention) group, while this estimate is 0.20 (-0.01, 0.41) among SRMs, which aimed at reoccurrence (secondary) prevention, and 0.61 (0.46, 0.75) among those SRMs aimed to assess the effect folic acid or multivitamin for the prevention of both occurrence and reoccurrence. The pooled effect of either folic acid or multivitamin supplementation for the prevention of NTD was found to be 0.45 (0.03, 0.87) in SRMs of observational studies, while this estimate is 0.43 (0.32, 0.54) among SRMs of randomized controlled trials.</p><p><strong>Conclusion: </strong>This umbrella review of systematic review and meta-analysis found that prenatal folic acid and/or multivitamin supplementation was associated with a 57% reduction in NTD. Participants who took folic acid supplementation were associated with a slightly higher (77%) percentage of reduction in NTD compared with those who took multivitamin (37%). Reductions of 80% and 50% were observed for reoccurrence and occurrence prevention of NTD. Reductions of 57% and 55% of NTD have been found in SRM of RCTs and observational studies. This umbrella review revealed that both folic acid and multivitamin were associated with significantly lower levels of NTD in children.","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-14"},"PeriodicalIF":3.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}