Arynchyna-Smith Anastasia, Kancherla Vijaya, Aban Inmaculada, Arynchyn Alexander, Maleknia Pedram, Becker David, Kulczycki Andrzej, Blount Jeffrey P
University of Alabama at Birmingham, Birmingham, AL, USA.
Emory University, Atlanta, GA, USA.
Childs Nerv Syst. 2025 Jul 18;41(1):237. doi: 10.1007/s00381-025-06894-2.
Assess the global neurosurgeon workforce's awareness of neural tube defect (NTD) prevalence, prevention strategies, and clinical time spent on spina bifida (SB) care.
An online survey was administered to neurosurgeons worldwide between 2021-2022. Categorical responses were analyzed using descriptive analysis. Adjusted and unadjusted logistic regression analyses were conducted to examine the association between the clinical time spent on SB care and NTD prevalence awareness, controlling for sex, income region, pediatric training, and practice years, estimating odds ratios (ORs) and 95% confidence intervals (CIs).
Overall, 234 neurosurgeons (71% participation rate) responded from 64 countries. Respondents included 166 (77%) non-US residents practicing in non-high-income-country (non-HIC) (49%). Most were male (78%), 31-60 years old (80%), and urban-based (76%). Approximately quarter were unaware of the NTD prevalence at the national (28%) or global (24%) level, or the effectiveness of folic acid fortification (FAF) (27%). About 17% reported NTD rates ≥ 20/10,000 live births in their country. Neurosurgeons most often cited supplementation pills (46%) and flour FAF (36%) as the most common strategies to prevent NTD pregnancies. They were more likely to prefer strategies based on flour FAF (48%) and salt FAF (35%). There was a significant positive association between practicing in non-HIC and spending ≥ 20% of clinical time caring for SB (aOR = 6.42, 95% CI = 2.66-15.46, p < 0.001).
This study highlights the need to improve awareness of NTD prevalence and preventive strategies among the neurosurgical community. There is a significant disparity in time spent on SB care between HIC and non-HIC countries. Neurosurgeons can serve as key advocates for global and local SB prevention efforts, with particular emphasis on FAF.
评估全球神经外科医生群体对神经管缺陷（NTD）患病率、预防策略以及脊柱裂（SB）护理临床时间的认知情况。
2021年至2022年期间，对全球神经外科医生进行了一项在线调查。使用描述性分析对分类回答进行分析。进行了调整和未调整的逻辑回归分析，以检验SB护理临床时间与NTD患病率认知之间的关联，同时控制性别、收入地区、儿科培训和执业年限，估计比值比（OR）和95%置信区间（CI）。
总体而言，来自64个国家的234名神经外科医生（参与率71%）做出了回应。受访者包括166名（77%）在非高收入国家（非HIC）（49%）执业的非美国居民。大多数为男性（78%），年龄在31至60岁之间（80%），且位于城市地区（76%）。约四分之一的人不知道国家（28%）或全球（24%）层面的NTD患病率，也不知道叶酸强化（FAF）的有效性（27%）。约17%的人报告其所在国家的NTD发生率≥20/10000活产。神经外科医生最常提到的预防NTD妊娠的策略是补充剂（46%）和面粉FAF（36%）。他们更倾向于基于面粉FAF（48%）和盐FAF（35%）的策略。在非HIC国家执业与将≥20%的临床时间用于SB护理之间存在显著正相关（调整后OR = 6.42，95% CI = 2.66 - 15.46，p < 0.001）。
本研究强调了提高神经外科界对NTD患病率和预防策略认知的必要性。HIC国家和非HIC国家在SB护理上花费的时间存在显著差异。神经外科医生可以成为全球和地方SB预防工作的关键倡导者，尤其要强调FAF。
