Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 15808372

Neural tube defects: is a decreasing prevalence associated with a decrease in severity?

Amanda M Cotter·Sean F Daly
View original source ↗Export metadata ↓

Abstract

OBJECTIVE: Severe neural tube defects (NTDs) tend to occur with disproportionate frequency in areas of high prevalence. The objective of our study was to determine the birth prevalence of NTDs during a 25-year period at a single institution based in an area of high prevalence for NTDs and to investigate if a decreasing prevalence resulted in a change in the type of NTDs. STUDY DESIGN: All cases of NTD affected births born at the Coombe Women's Hospital during the interval 1975-1999 were reviewed. There were 171,260 births at the Coombe Women's Hospital between 1975 and 1999. During this interval, there were 522 NTD affected births. RESULTS: From 1975 until 1999 the prevalence of NTDs significantly decreased (P < 0.0001). This transition from high to low prevalence was associated with a significant decrease in severe forms of NTDs (P < 0.0001). This decreasing trend in rate and severity of NTD affected births was most dramatic prior to either food fortification or periconceptual folic acid supplementation. CONCLUSIONS: Our transition from high to low prevalence for NTDs has been associated with a significant decrease in severe forms of NTDs.

Explore related subjects

AnencephalyDietary SupplementsEncephaloceleFolic AcidHumansInfant, NewbornIrelandNeural Tube DefectsSpinal DysraphismJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Amanda M Cotter, Sean F Daly. 2005-04-01. Neural tube defects: is a decreasing prevalence associated with a decrease in severity?. https://doi.org/10.1016/j.ejogrb.2004.06.028

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Non-initiation and discontinuation of resuscitation.

Whereas certain aspects of neonatal resuscitation may benefit from evidence evaluation using standard evaluation techniques, the ethical aspects of non-initiation and discontinuation of resuscitative efforts are more subjective and might certainly be influenced by the biases of the reviewers. The outcome data are relatively straightforward, although survival and morbidity data differ significantly by region and even among hospitals classified at similar levels in the same region. However, the interpretation of that data is necessarily somewhat subjective. Whereas certain aspects of neonatal resuscitation may benefit from evidence evaluation using standard evaluation techniques, the ethical aspects of non-initiation and discontinuation of resuscitative efforts are more subjective and might certainly be influenced by the biases of the reviewers. The outcome data are relatively straightforward, although survival and morbidity data differ significantly by region and even among hospitals classified at similar levels in the same region. However, the interpretation of that data is necessarily somewhat subjective. Does a survival rate of 1% of patients at a certain weight or gestational age warrant full resuscitative efforts? What about 20% or 49%? Similar questions could be posed regarding significant morbidity. However, as the science of neonatal resuscitation advances, it is important to review objective evidence-based outcome data in certain situations in which non-initiation or discontinuation of resuscitative efforts may be appropriate to determine if certain common themes can be elicited.

Anencephaly↗
PubMed2006

Neural tube defects and associated anomalies in a fetal and perinatal autopsy series.

Neural tube defects (NTDs) are congenital malformations of the central nervous system (CNS) secondary to abnormal closure of the neural tube during embryonic development. This study provides information on NTD rate, distribution, associated morphologic anomalies and organ weights in a Danish fetal and perinatal autopsy series during a 16 year period. The data were extracted from the autopsy reports of a consecutive series of 1984 fetal and perinatal autopsies from the Copenhagen area performed in the period 1989-2004. Registered parameters included: The location and morphology of the NTD, associated morphological anomalies, and organ weights. Organ weights were evaluated according to new fetal autopsy standards and grouped as low, normal or high. Ninety-seven NTD cases were found (4.9%): Spina bifida (38 cases), cephalocele (17 cases) and anencephaly (42 cases). 63% of NTD cases had associated morphologic anomalies. Among the most common were hydrocephalus, NTD in another region, and anomalies in the urogenital system. 58% of the NTD cases had abnormal weight of one or more organs. Most notable was low adrenal weight not only in anencephalic fetuses but also in cases with cephalocele, suggesting a possible association.

Anencephaly↗