The Prevalence of Neural Tube Defects in Sétif University Maternity Hospital, Algeria-3 Years Review (2004-2006)

Abstract

Neural tube defects (NTDs) including spina bifida, anencephaly and encephalocele are among the most common birth defects, with high associated mortality and morbidity. There are no data concerning the incidence, associated anomalies, treatment and outcome of NTDs in Algeria. The objective of this study is to analyse data on NTD cases from 2004-2006 at Sétif Hospital, a hospital with 8,000-10,000 deliveries annually. A retrospective chart review of patients with NTDs was performed, who were born at Sétif Hospital 2004-2006. During the 3 year period we examined, there were 215 patients with NTDs treated in the Sétif Hospital. The incidence of NTD is 7.5 per 1,000 births. The sex distribution was not equal among NTD cases, 126 (58.6%) females, 88 (40.9%) males and one (0.5%) unidentified sex. Among all NTD cases, there where 122 (56.7%) with spina bifida, 69 (32.1%) with anencephaly, 1 (0.5%) with encephalocele and 23 (10.7%) with anencephaly and spina bifida. Hundred and seventeen (54.4%) cases died in utero and 4 cases (1.9%) unknown. The rate of consanguinity among all NTD cases was 13% (28/215). The rate of affected newborns was highest in mothers aged 31-35 years (21.9%). The peak prevalence was in June (15.8%). A half of NTDs were spina bifida and there was a high rate of mortality. This study demonstrates that NTD represents a significant public health problem in Algeria. In Algeria there were no population-wide educational campaigns about folic acid or its association with the prevention of birth defects. Public health interventions aimed at increasing the periconceptional consumption of folic acid should be implemented or enhanced to reduce the incidence of NTDs in Algeria.

Maternal factors and associated anomalies in NTD fetuses from Tunisia

“…From the research conducted in Algeria for a period of three years (2004)(2005)(2006), it has been concluded that consanguinity is a factor in fetuses with NTDs in 13% of the cases (28/215 cases), which is twice less than our results [18].…”

“…In Algeria, the established NTD rate is 0.75 per 1000 births where, in 13% of the cases, incest was found [18]. The influence of the seasons of conception for the presence of NTDs has been the subject of numerous studies with varying results [19,20].…”

Neural Tube Defects in Algeria

“…Our research is the first in Algeria, which studied NTD patients in order to determine the association of the T allele with NTD in the region of Sétif, where NTD are highly prevalent (Houcher et al, 2008). The MTHFR C677T gene polymorphism was neutral in our population.…”

“…Thus, the MTHFR genotype of the father also contributes to the risk of NTD (Blom, 1998) The thermolabile MTHFR C677T variant is a risk factor for NTD in some but not all populations (Botto and Yang, 2000) and is associated with low folate and elevated www.intechopen.com homocysteine levels. The high prevalence of the MTHFR 677T allele (17%) (Bourouba et al, 2009), the higher risk of NTD (7.5 per 1,000 births) (Houcher et al, 2008) and lower daily folate intake (69%) of less than the reference nutrient intake for folate (Houcher et al, 2003), i.e. a combination of genetic and nutritional factors, may therefore play a role in the NTD rate in this region of Algeria, although the mechanism, by which the genotype or folate status increases the risk of NTD is not clear.…”

Prevalence of Spina Bifida among Newborns in Africa: A Systematic Review and Meta-Analysis

“…Spina bifida with myeloschisis may result from a defect that is caused by a local overgrowth of the neural plate. As a result, the caudal neuropore fails to close at the end of the fourth week [ 1 , 6 ]. Due to the tethering of the spinal cord, the incidence of hydrocephaly is expected to be very high in each case of spina bifida cystica [ 2 , 3 ].…”