Factores de riesgo maternos y defectos de tubo neural en la descendencia, en dos hospitales de Nicaragua, 2016-2020. Un estudio de casos y controles.
DOI:
https://doi.org/10.5377/universitas.v14i1.16471Palabras clave:
defectos del tubo neural, factor de riesgo, ácido fólico, planificación del embarazo.Resumen
Los defectos del tubo neural (DTN) son las segundas malformaciones congénitas más comunes que afectan el desarrollo del sistema nervioso central, con alta prevalencia en la región occidental de Nicaragua.Este estudio analiza la asociación entre los factores de riesgos maternos y ambientales y DTN en la descendencia. Método: Se realizó un estudio de casos y controles en los hospitales universitarios de León y Chinandega entre enero 2016 y diciembre de 2020. Los casos (76) se definieron como nacidos vivos o mortinatos con DTN. Los controles (146) recién nacidos sin defectos del tubo neural con una proporción (2:1) se emparejaron por fecha y hospital de nacimiento.Se utilizó un modelo de regresión multivariado para estudiar la asociación entre las características maternas y ambientales con el riesgo de desarrollar defectos del tubo neural. Resultados: 73 casos con DTN y 146 controles sanos fueron incluidos en este estudio. El no tomar suplementos con ácido fólico durante el primer trimestre del embarazo (ORA= 16.0, IC95%: 5.9-43.3), la procedencia rural (ORA= 2.7, IC95% : 1.23-6.21) y el bajo peso al nacer (ORA= 9.9, IC 95%: 3.12-31.60), se determinaron como factores de riesgo con significancia estadística.Conclusión: La falta de consumo de suplementos con ácido fólico durante etapas tempranas del embarazo es un factor de riesgo consistente de defectos de tubo neural, en la región noroccidental de Nicaragua. Fortalecer los planes de información, educación y comunicación sobre consumo de ácido fólico a las mujeres en edad reproductiva deben ser considerados para incrementar el consumo de este micronutriente y disminuir los DTN.
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