Incidence of neural tube defects and their risk factors within a cohort of Moroccan newborn infants

Abstract

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.

Trend and burden of neural tube defects among cohort of pregnant women in Ethiopia: Where are we in the prevention and what is the way forward?

“…Our research also found that all mothers did not received folic acid supplementation throughout their pregnancy. This finding is consistent with studies conducted in Addis Ababa, Ethiopia, and Morocco [10,13,23]. This could be due to is lack of preconception care in the country as well as a lack of media coverage on promotion of preconception of folic acid supplementation.…”

“…Anencephaly was found to be the most common type of NTD (48.1%), followed by spina bifida (22.6 percent), which is consistent with findings from a study conducted at three teaching hospitals in Addis Ababa, Ethiopia [13], in Tigray region, Ethiopia [11], Amhara region, Ethiopia [19], Bale zone Oromia, Ethiopia [20], Gujarat hospital, India (26%) [21], South west Iran (86.8%) [22], in Morocco [23], and in Nigeria [24]. These findings contradict the findings of studies conducted at Tikur Anbessa, Gandhi Memorial, and Ethio-Sewdish Hospitals in…”

Birth defects data from hospital-based birth defect surveillance in Guilin, China, 2018–2020

“…In our study, half of the NTD cases (three cases) had multiple malformations, one anencephaly associated with cleft lip and palate, one spina bifida associated with congenital atresia of the rectum and anus, and one encephalocele with craniotabes (Supplementary Table 3), which demonstrate the importance of improving the prenatal diagnosis to reduce fetal BDs. Together, this study suggest that the prevention and control strategies implemented by the Ministry of Health should be further strengthen by enforcing folic acid supplementation, increasing women's awareness of BDs, providing more adequate medical care for pregnancy women, such as prenatal diagnosis (22). Another highlight of this study was that we classified the common BDs according to their etiology.…”

“…Anencephaly, spina bifida and encephalocele, which are the three main types of neural tube defects (NTDs) ( 5 , 22 , 23 ). Mandatory folic acid supplementation is highly likely to be responsible for the NTDs being one of the least common BDs, which had also been observed in our study and other reports ( 3 , 22 ).…”

“…Anencephaly, spina bifida and encephalocele, which are the three main types of neural tube defects (NTDs) ( 5 , 22 , 23 ). Mandatory folic acid supplementation is highly likely to be responsible for the NTDs being one of the least common BDs, which had also been observed in our study and other reports ( 3 , 22 ). Forci K et al ( 22 ) reported that a prevalence rate of NTD in Moroccan (2011–2016) was 1.00 per 1,000 births, which was a lower rate than those reported by previous Moroccan studies (e.g.…”