Background Neural tube defects (NTDs) are a group of birth defects that result from a partial or complete failure of the neural tube to close during embryogenesis. Their prevalence varies between 0.5 to 2 per 1000 births in countries without folic acid supplementation. The aim of our study is to assess the NTDs incidence and describe the risk factors within Moroccan newborn infants. Method This is a descriptive study over a period of 5 and a half years including all births at “Les Orangers” Maternity and Reproductive Health Hospital of Rabat with notification of NTD cases, whether isolated or combined with other anomalies. Data were reported on pre-established sheets and on the teratovigilance registry. Statistical analysis was performed with SPSS version 18 statistical software. Results During the study period, 43,923 births were recorded including 44 cases of neural tube defects, an incidence rate of 1 per 1000 births, with a female predominance; sex ratio = 0.8. These defects included anencephaly (50%), spina bifida (38.6%) and encephalocele (11.4%). The risk factors detected during this study include consanguinity (34%), consumption of fenugreek or other plants (36%), diabetes (4.5%) and medication (2.2%). A family history of malformation was reported in 6.8% of cases and among siblings in 4.5% of cases. The average maternal age was 30.38 ± 6.88 and the average gestational age was 36.80 ± 5.11. A quarter of mothers did not benefit from any medical monitoring during pregnancy while 59% did not take folic acid supplementation during the first trimester of pregnancy and none of them took B9 vitamin during the periconceptional period. The antenatal diagnosis was performed in 63% of cases. The mortality rate was 3.8 per 10,000 and 16% of cases evolved positively. Conclusion NTDs require high intensity and multidisciplinary care which stresses the importance, in our context, of strengthening and optimizing acid folic supplementation strategies during the periconceptional period.

Background: Congenital malformations are described in about 3% of live births and 20% of stillbirths in the industrialized countries. The prevalence of congenital anomalies in developing countries, including Morocco, is not well known at the national level. The aim of our study is to conduct a descriptive exploratory analysis of congenital malformations cases diagnosed at the "Les Orangers" Maternity and Reproductive Health Hospital in Rabat. Methods: We collected all the cases of congenital malformations diagnosed at the "Les Orangers" Maternity and Reproductive Health Hospital in Rabat, from January 1st, 2011 to June 31st, 2016. Data were reported on pre-established sheets and on a registry of malformations. Total and specific prevalences were calculated for each malformation. A principal component analysis (PCA) was then conducted followed by a Varimax rotation in order to identify the different associations of malformations in our series. Results: We registred 245 cases of congenital malformations out of a total of 43,923 recorded births; a prevalence of 5.58 per thousand births of which 19.2% were FDIU (fetal deaths in utero). A polymalformative syndrome was found in 26.5% of cases which makes a total number of 470 anomalies. The musculoskeletal anomalies predominate with a rate of 33%, followed by neurological abnormalities 18%, of whom 31% were hydrocephalus, 26.2% anencephaly, and 20.24% spina bifida. Malformations of the eye, ear, face and neck were described in 12% of the cases, while genetic abnormalities were observed in 8,5% of which 87.5% represented Down syndrome. The antenatal diagnosis of congenital malformations was performed in 28.6% of cases. Conclusions: Our study provides a general overview of the epidemiological situation related to different types of congenital anomalies for a specific area in Morocco. It represents a database that should be complemented by other multicenter studies and the implementation of a

Congenital malformations are described in about 3% of live births and 20% of stillbirths. In the industrialized countries, they represent one of the main causes of infant mortality, morbidity and handicap. In our country, as in all developing countries, the prevalence of congenital anomalies is not well known at the national level, besides, causes and risk factors are not always identified. The aim of our work is to conducta the first large descriptive exploratory analysis of congenital malformations cases diagnosed at the "Les Orangers" maternity and reproductive health hospital in Rabat. METHODS We have collected all the cases of congenital malformations diagnosed at the "Les Orangers" maternity and reproductive health hospital in Rabat for a period of five and a half years from January 1st, 2011 to June 30th, 2016. Data were collected on pre-established sheets and on a registry of malformations. Total and specific prevalences were calculated for each malformation then a principal component analysis was conducted followed by a Varimax rotation in order to identify the different associations of malformations in our series. RESULTS During the study period, a total of 43923 births were recorded. We have registred 245 cases of congenital malformations with a prevalence of 5.58 per thousand births of which 19.2% were fetal deaths in utero. The most representative anomalies were malformations of the osteoarticular system and muscles with a rate of 33%, followed by neurological abnormalities representing 18%, of whom 31% were hydrocephalus, 26.2% anencephaly, and 20.24% spina bifida. Malformations of the eye, ear, face and neck were described in 12% of the cases, while genetic abnormalities were observed in 8,5% of which 87.5% represented Trisomy 21. The antenatal diagnosis of congenital malformations was performed in 28.6% of cases. We observed a slight male predominance with a sex ratio of 1.19. CONCLUSIONS Congenital malformations are a real public health problem as they represent a major cause of stillbirth and neonatal mortality. Identifying and studying the causes and risk factors is a priorityin order to adapt a primary prevention strategy, especially folic acid supplementation to prevent neural tube closure defects.

Background: The aim of the study is to describe the teratogenic risk factors of congenital malformations in a large sample from the Moroccan population.Methods: It is a descriptive epidemiological study conducted between January 1st, 2011 and June 31th, 2016 at the "Les Orangers" maternity and reproductive health hospital in Rabat, Morocco.The data were collected on pre-established sheets and on the hospital’s malformations register.Results: A total of 245 cases of congenital malformations were recorded out of a total of 43923 births with a prevalence of 5.58 per thousand.Women over 35 years represent 24.1% of all cases. Consanguinity was found in 22.4% of cases, maternal diabetes in 7%, Fenugreek and herbs intake in 28.6%, and medication in 2.8%. Almost all of women (97.5%) are of low to moderate socio-economic level. Antenatal diagnosis was performed in only 28.6% of cases.Conclusion: Causes and risk factors of congenital malformations are diverse, which requires the application of large preventive and therapeutic approaches. However, the identification of risk factors specific to each country is necessary to establish specific preventive measures.

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