ABSTRACTS:

TITLE: DOUBLING THE NUMBER OF WOMEN CONSUMING VITAMIN SUPPLEMENT PILLS CONTAINING
FOLIC ACID: AN URGENTLY NEEDED BIRTH DEFECT PREVENTION COMPLEMENT TO THE FOLIC ACID FORTIFICATION OF CEREAL GRAINS
AUTHOR: G. P. OAKLEY JR
JOURNAL: REPRODUCTIVE TOXICOLOGY 1997 Jul-Aug;11(4):579-81
ABSTRACT: The major known environmental causes of birth defects are ancient agents that have been in the environment for centuries but have been only recently discovered. Rubella, alcohol, and folic acid deficiency are examples of such agents. In the United States, we have made great progress in preventing congenital rubella syndrome. We also have a great opportunity to prevent spina bifida and anencephaly (SBA)(Malformations of the spinal column and brain) by increasing the number of women who daily consume vitamin supplements containing folic acid. Even with the recently announced grain fortification regulations, there are 45 million women unprotected from an SBA-affected pregnancy. This article suggests that a substantial educational campaign could, over a 5-year period, double the number of women consuming folic acid supplement pills and make a substantial contribution toward preventing SBA.

KEY WORDS/PHRASES
ANENCEPHALY
BIRTH DEFECTS
FOLIC ACID
SPINA BIFIDA

TITLE: ASSOCIATION BETWEEN CENTRAL NERVOUS SYSTEM INFECTIONS DURING CHILDHOOD AND ADULT ONSET SCHIZOPHRENIA AND OTHER PSYCHOSES: A 28-YEAR FOLLOW-UP
AUTHOR: P. RANTAKALLIO
JOURNAL: INT'L JOURNAL OF EPIDEMIOLOGY 1997 Aug;26(4):837-43
ABSTRACT: Maternal exposure to influenza epidemics during pregnancy may increase the risk of schizophrenia in the offspring. We investigated the association between central nervous system (CNS) infections defined prospectively up to the age of 14, and later onset of schizophrenia and other psychoses in the 1966 birth cohort in Northern Finland, which covers 96% of all births in the area during that year.

METHODS: Data regarding CNS infections were collected 1966-1980. Registered diagnoses of psychoses in 1982-1993 were validated on DSM-III-R criteria.

RESULTS: Out of 11,017 subjects, 145 had suffered a CNS infection during childhood, 102 of them a viral infection, 76 had DSM-III-R schizophrenia and 53 some other psychosis. Four cases of schizophrenia had suffered viral CNS infection and two cases of other psychosis bacterial infection. When neurological abnormalities and father's social class were adjusted, an odds ratio (OR) of schizophrenia after viral CNS infection was 4.8; the other significant risk factors being intelligence quotient (IQ) < 85, perinatal brain damage and male sex but not epilepsy. Similarly adjusted OR of other psychoses was 6.9 after bacterial CNS infection; the other significant risk factors being IQ < 85 and severe hearing defect. Two of the live viral infections were caused by Coxsackie B5 during an epidemic in which 16 neonates were infected together.

CONCLUSIONS: Central nervous system infections during childhood clearly carried an increased risk of adult onset schizophrenia or other psychoses, viral infections being important for schizophrenia, particularly Coxsackie B5 during the newborn period.

KEY WORDS/PHRASES
EPIDEMICS
PSYCHOSES
SCHIZOPHRENIA

TITLE: BIRTH OUTCOMES FOLLOWING ZIDOVUDINE EXPOSURE IN PREGNANT WOMEN: THE ANTIRETROVIRAL PREGNANCY REGISTRY
AUTHOR: A. WHITE, R.ELDRIDGE, E. ANDREWS
JOURNAL: ACTA PAEDIATRICS SUPPL 1997 Jun;421:86-8
ABSTRACT: Potential risk of adverse birth outcomes associated with the use of antiretrovirals in human immunodeficiency virus (HIV)-infected women during pregnancy must be assessed. Data through June 1995 are reported from the worldwide Antiretroviral Pregnancy Registry on the incidence of structural birth defects following prenatal exposure to zidovudine. Healthcare professionals register pregnant women anonymously. Follow-up is at time of delivery. Results are reviewed semi-annually by an advisory committee, which follows the Centers for Disease Control and Prevention (CDC) guidelines for definitions of birth defects. From 1989 through to 30 June, 1995, 198 births involving exposure to zidovudine were reported. Of 73 first-trimester exposures, outcomes included one infant with a birth defect. Of 125 exposures in the second and third trimesters, six infants were reported with birth defects. Data on other antiretrovirals are insufficient for analysis. The Registry findings to date do not show an increase in the number of birth defects (1/63 in the first trimester following prenatal zidovudine exposure when compared with that expected in the general population; however, the number of outcomes to date represents a sample of insufficient size for developing precise estimates regarding the teratogenic risk of zidovudine.

KEY WORDS/PHRASES
ADVERSE BIRTH OUTCOMES
ANTIRETROVIRALS
HIV
TERATOGENIC
ZIDOVUDINE