Abstract
We previously reported that among neural tube defects (NTDs) with no known causes the ones that occur alone (singles) have different epidemiologic characteristics from those that occur in combination with other defects (multiples), suggesting an underlying causal heterogeneity. In this study, we compared family histories of 223 single NTD cases and 66 multiple cases ascertained through the Metropolitan Atlanta Congenital Defects Program (MACDP) between 1970 and 1979. Compared with siblings of multiples, siblings of singles had a higher precurrence rate for NTDs (2.0% vs. 0.0%) and for birth defects in general (10.9% vs. 3.0%). Furthermore, siblings of singles that were born within 2 years before the birth of the index case had a higher precurrence rate for NTDs (8.0% vs. 1.1%) and for major birth defects (20.0% vs. 2.9%) than had those born earlier. These results further suggest that NTDs are etiologically heterogeneous, depending on the presence of associated defects, and point to important environmental influences in the increased risk for birth defects among siblings of singles. Larger studies are needed to confirm these data and show that single and multiple NTDs have different recurrence rates, not only for NTDs but also for other birth defects.
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- Carter C. O., David P. A., Laurence K. M. A family study of major central nervous system malformations in South Wales. J Med Genet. 1968 Jun;5(2):81–106. doi: 10.1136/jmg.5.2.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carter C. O., Evans K. Spina bifida and anencephalus in greater London. J Med Genet. 1973 Sep;10(3):209–234. doi: 10.1136/jmg.10.3.209. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carter C. O. Genetics of common disorders. Br Med Bull. 1969 Jan;25(1):52–57. doi: 10.1093/oxfordjournals.bmb.a070671. [DOI] [PubMed] [Google Scholar]
- David T. J., O'Callaghan S. E. Oesophageal atresia in the South West of England. J Med Genet. 1975 Mar;12(1):1–11. doi: 10.1136/jmg.12.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Edmonds L. D., Layde P. M., James L. M., Flynt J. W., Erickson J. D., Oakley G. P., Jr Congenital malformations surveillance: two American systems. Int J Epidemiol. 1981 Sep;10(3):247–252. doi: 10.1093/ije/10.3.247. [DOI] [PubMed] [Google Scholar]
- Embury S., Seller M. J., Adinolfi M., Polani P. E. Neural tube defects in curly-tail mice. I. Incidence, expression and similarity to the human condition. Proc R Soc Lond B Biol Sci. 1979 Nov 30;206(1162):85–94. doi: 10.1098/rspb.1979.0092. [DOI] [PubMed] [Google Scholar]
- Erickson J. D. Racial variations in the incidence of congenital malformations. Ann Hum Genet. 1976 Jan;39(3):315–320. doi: 10.1111/j.1469-1809.1976.tb00135.x. [DOI] [PubMed] [Google Scholar]
- Fraser F. C., Nussbaum E. Neural tube defects in sibs of children with tracheo-oesophageal dysraphism. Lancet. 1980 Oct 11;2(8198):807–807. doi: 10.1016/s0140-6736(80)90427-4. [DOI] [PubMed] [Google Scholar]
- Harris H. Nature and nurture. N Engl J Med. 1977 Dec 22;297(25):1399–1400. doi: 10.1056/NEJM197712222972510. [DOI] [PubMed] [Google Scholar]
- Holmes L. B., Driscoll S. G., Atkins L. Etiologic heterogeneity of neural-tube defects. N Engl J Med. 1976 Feb 12;294(7):365–369. doi: 10.1056/NEJM197602122940704. [DOI] [PubMed] [Google Scholar]
- Janerich D. T., Piper J. Shifting genetic patterns in anencephaly and spina bifida. J Med Genet. 1978 Apr;15(2):101–105. doi: 10.1136/jmg.15.2.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Khoury M. J., Erickson J. D., James L. M. Etiologic heterogeneity of neural tube defects: clues from epidemiology. Am J Epidemiol. 1982 Apr;115(4):538–548. doi: 10.1093/oxfordjournals.aje.a113335. [DOI] [PubMed] [Google Scholar]
- McBride M. L. Sib risk of anencephaly and spina bifida in British Columbia. Am J Med Genet. 1979;3(4):377–387. doi: 10.1002/ajmg.1320030409. [DOI] [PubMed] [Google Scholar]
- Nevin N. C., Johnston W. P. A family study of spina bifida and anencephalus in Belfast, Northern Ireland (1964 to 1968). J Med Genet. 1980 Jun;17(3):203–211. doi: 10.1136/jmg.17.3.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Seller M. J., Embury S., Polani P. E., Adinolfi M. Neural tube defects in curly-tail mice. II. Effect of maternal administration of vitamin A. Proc R Soc Lond B Biol Sci. 1979 Nov 30;206(1162):95–107. doi: 10.1098/rspb.1979.0093. [DOI] [PubMed] [Google Scholar]
- Yen S., MacMahon B. Genetics of anencephaly and spina bifida? Lancet. 1968 Sep 14;2(7568):623–626. doi: 10.1016/s0140-6736(68)90709-5. [DOI] [PubMed] [Google Scholar]