SEX-DIFFERENCES IN PREVALENCE OF CONGENITAL NEURAL DEFECTS AFTER PERICONCEPTIONAL FAMINE EXPOSURE

The purpose of this investigation was to examine the sex distribution of deaths from spina bifida in birth cohorts exposed and unexposed to severe periconceptional famine. For this purpose, we compared the risk of deaths from spina bifida between birth cohorts exposed and unexpos ed to the Dutch Hunger Winter of 1944-1946, In males, the relative ris k of death from spina bifida was 2.62 [95% confidence interval (CI) = 1.14-6.01]. In females, the relative risk for spina bifida was 0.59 (9 5% CI = 0.14-2.37). The sex ratio (male:female) for deaths from spina bifida in the exposed birth cohort was 2.74; a male predominance was n ot seen in any other birth cohort. Deaths from anencephaly and other c entral nervous system disorders did not exhibit this male predominance in the exposed birth cohort. These findings indicate that severe peri conceptional nutrient deficiency may have a greater effect on the occu rrence of spina bifida in males vs females. Other potential explanatio ns include sex-specific effects of prenatal famine on prenatal or post natal survival rates of cases.