Neural tube defects incidence, Risk factors and Perinatal outcome

Abstract

Background :- Neural tube defects are congenital malformation resulting from complete or partial of the neural tube to close in developing embryo, anencephaly and spina bifida, comprising the vast majority of NTDs. NTDs substantially are contributing to morbidity and mortality, particularly in infancy and childhood.

Aims:- to explore the incidence of NTDs among Yemeni women attending Al-Thawra hospital Sanaa as well as to determine the risk factors and perinatal outcome.

Methods: this was a prospective descriptive study of NTDs in Al-Thawra general hospital in Sanaa -Yemen, conducted over a period of one year from 1st January to 31th December. 66 women who delivered a baby with NTDs. The data were collected by using a questionnaire, interviewing all women who were pregnant with a fetus with NTDs and those who diagnosed after delivery to have a baby with NTDs, all data were check it, the most information collected, summarized and analyzed.

Results: - there were 11986 deliveries of which 66 women were delivered a baby with NTDs. The overall incidence was 0.55%. The age of patients ranged from 17-45 years, the highest percentage of NTDs was found among the age 20-29 years. There were 56 patients (84.8%) delivered a baby with NTDs were from urban area, whereas 10 (15.2%) were from rural area. The lowest parity was primigravida (22.7%) and the highest was 5 and above. Most of the patient 52(78.8%) delivered a baby with NTDs at gestational age <37 weeks, whereas 14(21.2%) were delivered at 37 weeks or more. All women who delivered a baby with NTDs did not receive folic acid supplementation before pregnancy. Consanguineous marriage found in 5(7.6%) .

Conclusions and Recommendations: The incidence of NTDs was not very high, this mostly due to improve maternity services, anencephaly was the most common type. In most cases of NTDs no risk factor was identified. First trimester folic acid supplementation can decrease the prevalence. Women who had medical disease such as diabetes or epilepsy, the disease should be controlled, and drugs should be reassessed before pregnancy.