Systematic review of clinician awareness of mycotoxin impact in neural tube defects and best practices for pediatric neurosurgeons: implications for public health and policy

Rebecca Y. Du*, Melissa A. LoPresti, Caroline C. Hadley, Sandi Lam

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Purpose: In lower-income populations, high rates of neural tube defects (NTDs) are a concern. Nutritional folate deficiencies and mycotoxins in contaminated food supplies increase risk of NTDs. As physicians in public health and involved in the care of children with NTDs, pediatric neurosurgeons have an interest in the treatment and prevention of NTDs. We aimed to evaluate the literature to assess the awareness and the existence of best practices/educational materials on this issue to better guide management. Methods: A systematic review using the National Library of Medicine PubMed database was conducted to find articles related to mycotoxins in foods causing neural tube defects. Additional citation searches of key publications and personal collections were used. Two reviewers evaluated the resulting studies for subject area analysis. Best practice recommendations were drawn from articles selected for full-text review. Results: Seventy-three articles were identified. Most articles were found in “nutritional sciences” (18), “teratology” (14), and “toxicology” (13). No articles were found in neurosurgery. Thirty-two additional articles were identified through other sources to screen best practice recommendations. Of the 105 articles, 34 journal articles were included in best practice recommendation guidelines. Key recommendations included education of proper food storage, hygienic agricultural practices, decontamination techniques, diet diversification, folate supplementation, risk assessment, and food safety policy and public health initiatives. Conclusion: There is an absence of neurosurgical literature–related mycotoxins and NTDs. We suggest a set of best practices/educational materials on this topic and advocate pediatric neurosurgery engagement in public health initiatives targeted towards populations most affected by mycotoxins.

Original languageEnglish (US)
Pages (from-to)637-644
Number of pages8
JournalChild's Nervous System
Volume35
Issue number4
DOIs
StatePublished - Apr 5 2019
Externally publishedYes

Keywords

  • Folate
  • Fumonisin
  • Global neurosurgery
  • Mycotoxin
  • Neural tube defect
  • Public health
  • Public policy
  • Spina bifida

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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