Congenital Defects Research Team, Faculty of Medicine and Pharmacy, University Mohamed V Rabat, P.B: 174 Downtown Rabat, Rabat, Morocco.
Laboratory of Biostatistics, Clinical & Epidemiological Research, Faculty of Medicine and Pharmacy of Rabat, University Mohamed V Rabat, Rabat, Morocco.
BMC Pediatr. 2021 Mar 15;21(1):124. doi: 10.1186/s12887-021-02584-5.
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.
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.
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.
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.
神经管缺陷（NTDs）是一组出生缺陷，它们是由于胚胎发生过程中神经管部分或完全闭合失败而导致的。在没有叶酸补充的国家，其患病率在每 1000 例出生中为 0.5 至 2 例。我们研究的目的是评估摩洛哥新生儿神经管缺陷的发病率，并描述其危险因素。
这是一项为期 5 年半的描述性研究，包括拉巴特“Les Orangers”产科和生殖健康医院的所有分娩病例，并报告了 NTD 病例，无论是孤立的还是与其他异常合并的病例。数据记录在预先制定的表格和致畸监测登记册上。使用 SPSS 18 统计软件进行统计分析。
在研究期间，记录了 43923 例分娩病例，包括 44 例神经管缺陷病例，发病率为每 1000 例出生 1 例，以女性为主；性别比例为 0.8。这些缺陷包括无脑畸形（50%）、脊柱裂（38.6%）和脑膨出（11.4%）。在这项研究中发现的危险因素包括近亲结婚（34%）、食用葫芦巴或其他植物（36%）、糖尿病（4.5%）和药物治疗（2.2%）。6.8%的病例有畸形家族史，4.5%的病例有兄弟姐妹畸形史。母亲的平均年龄为 30.38±6.88 岁，平均妊娠龄为 36.80±5.11 周。四分之一的母亲在怀孕期间没有接受任何医疗监测，而 59%的母亲在妊娠早期没有服用叶酸补充剂，也没有在围孕期服用 B9 维生素。63%的病例进行了产前诊断。死亡率为每 10000 例 3.8 例，16%的病例病情好转。
神经管缺陷需要高强度和多学科的护理，这强调了在我们的背景下，加强和优化围孕期叶酸补充策略的重要性。
