(1010) Maternal Ethnicity and the Risk of Fetal Myelomeningocele: Population Based Study

Friday, February 10, 2023

3:30 PM – 5:00 PM

Objective: To investigate the association between ethnicity and occurrence of isolated fetal meningomyelocele (MMC) and the trend over the past 5 years.

Study Design: Population-based study using CDC birth data from 2016-2020. Non-isolated MMC cases were excluded. Ethnicities were divided in Non-Hispanic White (reference population), Non-Hispanic Black, Non-Hispanic Asian, Hispanic, American Indian/Alaskan Native (AIAN) and Pacific Islanders (NHOPI). A Chi-square test of independence was performed to identify significant factors. These factors were then stratified into three clusters/levels. At the first level, the models were unadjusted. At the second level, the models were adjusted for socioeconomic, demographics, and metabolic profiles separately. And at the final level, they were adjusted for all the variables.

Results: Total of 18,999,808 live births including 2,430 isolated MMC were investigated during the study period. Isolated MMC prevalence varied among ethnicities with the highest being among AIAN and the lowest among Asian. Following the three level adjustment models, ethnicity was still significantly associated with MMC; adjusted odds ratio (aOR) 0.73 (95% CI .65-.82), p< 0.001 in Hispanic, aOR 0.34 (95% CI .26-.46), p< 0.001 in Asian, and aOR 0.51 (95% CI .45-.58), p< 0.001 in Black population. Although there was some increase and decrease of prevalence over the past 5 years, test of trend was not significant. Subgroup analysis of association between the significant variables and each ethnicity in cases with MMC showed significant variations in prevalence of obesity, diabetes, hypertension, and education among different ethnicities.

Conclusion: Isolated MMC prevalence varied by ethnicity. This could be explained by the significant differences of occurrence of obesity, diabetes, hypertension, and education that we demonstrated among different ethnicities with fetal MMC. Future studies are needed to seek etiological explanations for the ethnicity differences and to develop improved methods for primary prevention.

Primary & Presenting Author(s)

Hiba J. Mustafa, MD
Assistant Professor of Fetal Surgery and Maternal-Fetal Medicine
Indiana University Riley Children's Hospital Fetal Center
Carmel, Indiana, United States

Coauthor(s)

MH
Mohammad-Hossein Heydari, N/A
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences
Tehran, Tehran, Iran
Ali Javinani, MD (he/him/his)
Post-doctoral Research Fellow
Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School
Boston, Massachusetts, United States
AB
Aurelian Bidulescu, MD, MPH, PhD
Associate Professor, Director of Graduate Studies
Indiana University School of Public Health Bloomi
Indianapolis, Indiana, United States
CB
Catherine T. Burns, N/A
Indiana University School of Medicine
Indianapolis, Indiana, United States
Asma Khalil, MD, MSc (she/her/hers)
Professor of Maternal Fetal Medicine
St George's Hospital, University of London
London, England, United Kingdom
MH
Mounira Habli, MD
Maternal-Fetal Medicine, Good Samaritan Hospital, Cincinnati, Ohio.
Cincinnati, Ohio, United States
Magda Sanz Cortes, MD, PhD (she/her/hers)
Associate Professor in the Department of Obstetrics and Gynecology, Baylor College of Medicine
Baylor College of Medicine
Houston, Texas, United States