Incidence of neural tube defects in tertiary care university hospital in Bangladesh

Abstract

Background: Although national population-based birth defect prevalence estimates are unavailable for Bangladesh specifically, data extrapolated from the March Dimes Global Birth Defects Report indicate a prevalence of neural tube defects (NTDs) of 4.7 per 1,000 live births.

Purpose: This study aimed to determine the prevalence of NTD among infants born at a tertiary care multidisciplinary referral hospital in Bangladesh.

Methods: Live born infants with NTD were prospectively enrolled in 2015-2021. Each enrolled NTD case was examined for type, location, and associated anomalies. The overall and annual prevalence rates were then calculated.

Results: A total of 10,372 newborns were enrolled; of them, 68 had NTD (incidence, 6.4 [range, 4.59-11.2] per 1,000 live births). The mean maternal age was 27.49± 4.72 years. Three-quarters of the NTD cases were detected at birth, and 94% of the mothers reported not taking periconceptional folic acid supplements. The meningomyelocele complex was the most frequent location. Two peaks in incidence were noted in 2017 and 2021 (10.28 and 11.2 per 1,000 live births, respectively). The distribution of different NTD types included meningomyelocele at 53%, encephalocele at 26.6%, meningocele at 16%, and anencephaly at 4.4%. A male predominance was noted overall except for anencephaly. The most common location was the lumbosacrum (47%). The NTD was isolated in 20.59% (14 of 68) of cases and associated with other malformations in 80% (54 of 68) of cases.

Conclusion: The incidence of NTD was 6.4 per 1,000 live births at a leading tertiary care multidisciplinary referral center in Bangladesh. However, this figure might not reflect the incidence of NTD in the wider population.

Keywords: Anencephaly; Meningomyelocele; Neural tube defect.

Fig. 1.

Yearly incidence of neural tube defects per 1,000 live births overall and by subtype. NTD, neural tube defect.