Neural tube defects

Sarah Clements; Daniel Challis; Debra Kennedy

doi:10.1017/CBO9780511997778.032

Chapter 16.1 - Neural tube defects

Pathophysiology and prevention

from Section 2 - Fetal disease

Published online by Cambridge University Press: 05 February 2013

Daniel Challis and

Edited by

Anthony Johnson and

Mark D. Kilby: Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson: Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes: Affiliation:
Department of Obstetrics, Leiden University Medical Center

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Summary

Introduction

Neural tube defects (NTDs) are among the most common major congenital abnormalities worldwide, with birth incidence varying between 0.5 and 2 per 1000 births. The incidence is known to vary according to geography and race, with historically higher rates seen in China, Egypt, and India (greater than 8 per 1000 births). Worldwide rates however have been steadily declining. In England the rates peaked between 1954 and 1955 with a substantial decrease seen since, starting in the early 1970s. This decline predated widespread preventative strategies and is unlikely to be explained entirely by prenatal screening. Further reductions have been seen in recent years which have been attributed to the successful preventative strategy of folate supplementation. Current rates are as low as 0.6 per 1000 births in the United States and other countries that have folate food fortification strategies in place.

Open NTDs result from failure of the embryonic process of neural tube closure. This leaves brain or spinal cord neural tissue exposed to the extra-embryonic environment. The spectrum of malformations defined as NTDs include anencephaly, encephalocele, and spina bifida.

Keywords

neural tube defects folate genetic syndromes hyperthermia obesity twinning diabetes amniotic bands anti-folate medications

Type: Chapter
Information: Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
, pp. 301 - 310

DOI: https://doi.org/10.1017/CBO9780511997778.032 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2012

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Book contents

Chapter 16.1 - Neural tube defects

Summary

Keywords

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References

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