The Prevalence and Distribution of Spina Bifida in a Single Major Referral Center in Malaysia

Abstract

BackgroundThe aim of this study is to review the medical history of patients with spina bifida, encompassing both aperta and occulta types born between the years 2003 until 2016, spanning a 13-year time period. We assessed each patient and maternal parent information, details of the defects, and conditions associated with the primary defect. We also include information on patients’ ambulation and education level (where available).MethodsData from the Department of Patient Information University of Malaya Medical Centre (UMMC), Malaysia was captured from spina bifida patients (ICD10: Q05 spina bifida). Data involved patients referred to UMMC between 2003 and 2016 and/or born in UMMC within that particular time frame. We filtered and extracted the information according to the data of clinical examination, medical review, and social history provided in the medical records.ResultsA total of 86 patient records with spina bifida were analyzed. Spina bifida prevalence rate in this study ranged from 1.87 to 8.9 per 1,000 live births depending on weightage. We note that ethnicity was a factor whereby the highest numbers of spina bifida were from Malays (n = 36, 41.86%), followed by equal numbers of Chinese and Indians (n = 24, 27.91%). The highest number of diagnoses reported was myelomeningocele type-spina bifida (n = 39, 45.35%). The most common site of the spina bifida lesion was located at the lumbar region irrespective of aperta or occulta types (n = 23, 26.74%). Data on other associated phenotypes of spina bifida such as hydrocephalus and encephalocele was also captured at 37.21% (n = 32) and 1.16% (n = 1), respectively. In terms of mobility, 32.84% (n = 22/67) of patients between the ages 4 and 16 years old were found to be mobile. As many as 36.07% of patients ranging from 5 to 16 years of age (n = 22/61) received formal education ranging from preschool to secondary school.ConclusionThe prevalence of spina bifida in UMMC is as according to international statistics which is in the range of 0.5–10 per 1,000 live births. Majority of the reported cases were males, Malays, full term babies, and of the myelomeningocele phenotype located at the lumbar region.

Clinical Manifestation and Initial Management of Newborn with Spina Bifida Aperta: a case report.

“…The proportion of spina bifida as part of the syndrome is less than 10% of all NTDs. 3,4 Before the 1970s, the mortality rate for patients with spina bifida was almost 40%, but now it has decreased due to advances in health care and medical equipment support. The survival rate for spina bifida patients is now close to 75%.…”

“…Among all of the congenital abnormalities mentioned, spina bifida is the most common type of NTDs with a higher chance of survival and compatible with postnatal life. 1,3 There are two forms of spina bifida, spina bifida occulta and spina bifida aperta. In the spina bifida occulta, the defect is still covered with skin, and the spinal cord is not exposed.…”

Eph and Ephrin Variants in Malaysian Neural Tube Defect Families

“…In particular, the Malaysian population seems biased towards the closed type of Neural Tube Defect seen in preliminary datasets ([ 41 ], unpublished data from the Invertebrate and Vertebrate Neurobiology Laboratory, Universiti Malaya). In the preliminary datasets, based on MRI and surgical reports [ 4 ], lipomyelomeningocele, lipomeningocele, and meningocele were classified as spina bifida occulta (closed type NTD) whilst myelomeningocele and meningocele were classified as spina bifida aperta (open type NTD).…”

Etiology and Pathophysiology of the Spina Bifida

“…The indirect lifetime cost in these patients is even higher due to great impact of their increased overall morbidity. The results from the economic evaluations demonstrate that folic acid fortification in food and pre-conception folic acid consumption are cost-effective ways to reduce the incidence of neural tube defects [5,6]. Considering all possible medical and economic consequences of the issue of diagnosis of spina bifida, there is an emerging need for clarification of exact etiology and pathophysiological mechanisms with emphasis on possible primary prevention, as well as early and effective treatment of spina bifida and also all upcoming complications.…”