Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Erickson JD[original query] |
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Perspectives from the founding CDC leadership of the National Birth Defects Prevention study
Moore CA , Yoon PW , Edmonds LD , Erickson JD . Birth Defects Res A Clin Mol Teratol 2015 103 (8) 649-51 The Centers for Disease Control and Prevention (CDC) conducted its first formal case-control study to better understand the causes of major birth defects in the early 1980s (Erickson et al., 1984). The primary purpose of the study was to evaluate the possible causal contribution of paternal experiences during military service in Vietnam, with particular emphasis on exposures to the herbicide known as “Agent Orange.” The cases and controls were drawn from births that occurred in the Atlanta, Georgia area, where CDC has operated a birth defects surveillance program since 1967. The case-control design permitted evaluation of a wide array of potential maternal exposures that might cause birth defects, as well as additional paternal influences (Erickson, 1991). For example, the study identified a neural tube defect preventive benefit of periconceptional multivitamin use which paved the way for folic acid intervention to prevent neural tube defects (Mulinare et al., 1988). | Building on this experience, the CDC launched the multicenter National Birth Defects Prevention Study (NBDPS) in 1997 to advance understanding of the causes of birth defects. Because the causes of most birth defects are unknown and might be preventable if risk factors are identified, the NBDPS focused on birth defects of unknown etiology (Holmes, 1989). These included neural tube defects, congenital heart defects, orofacial clefts, limb deficiencies, abdominal wall defects, intestinal atresias, and other major birth defects that can be reliably ascertained in early infancy. One unique aspect of the NBDPS addressed the variability of birth defects classification across previous epidemiologic studies. In an effort to increase homogeneity within analytic groups of defects, clinical geneticists collaborated to develop classification guidelines that were applied across the study sites (Rasmussen et al., 2003). This and other efforts to coordinate work and maintain consistent methodology across participating Centers in multiple states, improved the power of NBDPS to identify potential causes of specific birth defects despite the relatively low prevalence of each individual defect type. This is particularly important for studying the epidemiology of birth defects because to date, exposures identified as causing birth defects have a relatively specific impact on one or a few types of birth defects rather than increasing the risk of all birth defects (Tinker, Gilboa, et al., 2015). The NBDPS methods and final counts of data collected are summarized by Reefhuis et al. in this issue (Reefhuis et al., 2015), and the strengths and weaknesses of the NBDPS have been assessed (Dolk, 2015). |
Folic acid use and nonsyndromic orofacial clefts in China: a prospective cohort study
Li S , Chao A , Li Z , Moore CA , Liu Y , Zhu J , Erickson JD , Hao L , Berry RJ . Epidemiology 2012 23 (3) 423-32 BACKGROUND: Questions remain about the effectiveness, dose, and timing of folic acid in preventing orofacial clefts. Case-control studies report conflicting results. There have been no cohort studies of orofacial clefts and the use of folic acid without other vitamins. METHODS: In a prospective cohort of 240,244 women enrolled between 1993 and 1995 in 1 northern and 2 southern provinces in China, we examined the risk of nonsyndromic cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP) in relation to maternal use of 400 mcg of folic acid without other vitamins. RESULTS: Daily use of 400 mcg of folic acid without other vitamins, started before the last menstrual period (LMP), was associated with reduced risk of CL/P with adjusted rate ratio (aRR) of 0.69 (95% confidence interval = 0.55-0.87). The greatest reduction in risk was observed in the north among daily users who began taking folic acid pills before LMP (aRR = 0.21 [0.10-0.44]); in the south there was marginal reduction in risk (aRR = 0.81 [0.63-1.05]). No evidence of reduced CL/P risk was observed among women who started folic acid pills on or after their LMP. No persuasive evidence for reduction in CP risk was seen with folic acid pill use at any time. CONCLUSION: Daily maternal consumption of 400 mcg of folic acid without other vitamins, started before mother's LMP, was associated with a reduced risk of CL/P in babies born in a high-prevalence region of China. |
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