Arick Wang, Lauren H Zauche, Krista S Crider, Cara T Mai, Yan Ping Qi, Lorraine F Yeung, Jennifer L Williams
{"title":"美国育龄妇女出生缺陷可改变风险因素的趋势和流行:2007年至2020年3月的国家健康和营养检查调查","authors":"Arick Wang, Lauren H Zauche, Krista S Crider, Cara T Mai, Yan Ping Qi, Lorraine F Yeung, Jennifer L Williams","doi":"10.1016/j.amepre.2025.107947","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Congenital heart defects, orofacial clefts, and neural tube defects share similar modifiable risk factors. The prevalence and trends of risk factors for these selected birth defects were assessed among nonpregnant, nonlactating women of reproductive age (aged 12-49 years) in the U.S.</p><p><strong>Methods: </strong>Cross-sectional data from the National Health and Nutrition Examination Survey 2007-March 2020 were analyzed in fall 2024. Demographics, BMI, household food security, folic acid supplement use, usual intake of dietary folate and vitamin B12, concentrations for serum and red blood cell folate, serum vitamin B12, serum cotinine (smoking exposure), and diabetes status were reported. Weighted percentages of prevalence of risk factors with 95% CIs were calculated using the survey package in R to account for clustered sampling.</p><p><strong>Results: </strong>Among 5,374 women of reproductive age, approximately 66.4% (95% CI=64.3, 68.4) had at least 1 known modifiable risk factor: 6.7% (95% CI=5.7, 7.6) reported very low food security, 33.8% (95% CI=32.2, 35.4) had obesity, 4.8% (95% CI=4.0, 5.5) had diabetes, 18.8% (95% CI=17.2, 20.4) had smoking exposure, and 19.5% (95% CI=17.8, 21.1) had red blood cell folate concentrations below the threshold (748 nmol/L) for optimal neural tube defect prevention. Over the time studied, the percentage of women of reproductive age with at least 1 risk factor rose from 65.3% (95% CI=62.1, 68.4) to 69.5% (95% CI=65.4, 73.9; p=0.08).</p><p><strong>Conclusions: </strong>Approximately 2 of 3 women of reproductive age in the U.S. have pre-existing modifiable risk factors for birth defects. Implementation of preconception health care could help reduce the prevalence of known risk factors and improve birth outcomes.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107947"},"PeriodicalIF":4.5000,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trends and Prevalence of Modifiable Risk Factors for Birth Defects Among U.S. Women of Reproductive Age: National Health and Nutrition Examination Survey 2007 to March 2020.\",\"authors\":\"Arick Wang, Lauren H Zauche, Krista S Crider, Cara T Mai, Yan Ping Qi, Lorraine F Yeung, Jennifer L Williams\",\"doi\":\"10.1016/j.amepre.2025.107947\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Congenital heart defects, orofacial clefts, and neural tube defects share similar modifiable risk factors. The prevalence and trends of risk factors for these selected birth defects were assessed among nonpregnant, nonlactating women of reproductive age (aged 12-49 years) in the U.S.</p><p><strong>Methods: </strong>Cross-sectional data from the National Health and Nutrition Examination Survey 2007-March 2020 were analyzed in fall 2024. Demographics, BMI, household food security, folic acid supplement use, usual intake of dietary folate and vitamin B12, concentrations for serum and red blood cell folate, serum vitamin B12, serum cotinine (smoking exposure), and diabetes status were reported. Weighted percentages of prevalence of risk factors with 95% CIs were calculated using the survey package in R to account for clustered sampling.</p><p><strong>Results: </strong>Among 5,374 women of reproductive age, approximately 66.4% (95% CI=64.3, 68.4) had at least 1 known modifiable risk factor: 6.7% (95% CI=5.7, 7.6) reported very low food security, 33.8% (95% CI=32.2, 35.4) had obesity, 4.8% (95% CI=4.0, 5.5) had diabetes, 18.8% (95% CI=17.2, 20.4) had smoking exposure, and 19.5% (95% CI=17.8, 21.1) had red blood cell folate concentrations below the threshold (748 nmol/L) for optimal neural tube defect prevention. Over the time studied, the percentage of women of reproductive age with at least 1 risk factor rose from 65.3% (95% CI=62.1, 68.4) to 69.5% (95% CI=65.4, 73.9; p=0.08).</p><p><strong>Conclusions: </strong>Approximately 2 of 3 women of reproductive age in the U.S. have pre-existing modifiable risk factors for birth defects. Implementation of preconception health care could help reduce the prevalence of known risk factors and improve birth outcomes.</p>\",\"PeriodicalId\":50805,\"journal\":{\"name\":\"American Journal of Preventive Medicine\",\"volume\":\" \",\"pages\":\"107947\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Preventive Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amepre.2025.107947\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.107947","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Trends and Prevalence of Modifiable Risk Factors for Birth Defects Among U.S. Women of Reproductive Age: National Health and Nutrition Examination Survey 2007 to March 2020.
Introduction: Congenital heart defects, orofacial clefts, and neural tube defects share similar modifiable risk factors. The prevalence and trends of risk factors for these selected birth defects were assessed among nonpregnant, nonlactating women of reproductive age (aged 12-49 years) in the U.S.
Methods: Cross-sectional data from the National Health and Nutrition Examination Survey 2007-March 2020 were analyzed in fall 2024. Demographics, BMI, household food security, folic acid supplement use, usual intake of dietary folate and vitamin B12, concentrations for serum and red blood cell folate, serum vitamin B12, serum cotinine (smoking exposure), and diabetes status were reported. Weighted percentages of prevalence of risk factors with 95% CIs were calculated using the survey package in R to account for clustered sampling.
Results: Among 5,374 women of reproductive age, approximately 66.4% (95% CI=64.3, 68.4) had at least 1 known modifiable risk factor: 6.7% (95% CI=5.7, 7.6) reported very low food security, 33.8% (95% CI=32.2, 35.4) had obesity, 4.8% (95% CI=4.0, 5.5) had diabetes, 18.8% (95% CI=17.2, 20.4) had smoking exposure, and 19.5% (95% CI=17.8, 21.1) had red blood cell folate concentrations below the threshold (748 nmol/L) for optimal neural tube defect prevention. Over the time studied, the percentage of women of reproductive age with at least 1 risk factor rose from 65.3% (95% CI=62.1, 68.4) to 69.5% (95% CI=65.4, 73.9; p=0.08).
Conclusions: Approximately 2 of 3 women of reproductive age in the U.S. have pre-existing modifiable risk factors for birth defects. Implementation of preconception health care could help reduce the prevalence of known risk factors and improve birth outcomes.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.