Impact of Prenatal Diagnosis on the Birth Prevalence of Neural Tube Defects, Atlanta, 1990-4991

Objective. To determine the impact of prenatal diagnosis on the birth prevalence of neural tube defects (NTDs) in Atlanta during 1990 through 1991. Methods. Live-born and stillborn infants with NTDs who were at least 20 weeks' gestation were ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based birth defects registry. Prenatally diagnosed NTD-affected pregnancies were ascertained from the four perinatal centers and the three genetic laboratories operating in Atlanta during 1990 through 1991. Fetal death certificates were also reviewed for potential cases. Results. During 1990 through 1991, MACDP ascertained 59 NTD cases, for a birth prevalence of 0.77/1000 live births. During this period, an additional 28 NTD-affected pregnancies were detected prenatally and terminated before 20 weeks' gestation. The adjusted NTD rate during 1990 through 1991, which includes prenatally diagnosed cases, was 1.13/1000 live births. Conclusions. Prenatal diagnosis is making a substantial impact on the birth prevalence of NTDs in Atlanta. However, since NTD rates in Atlanta were 2 to 2.5 per 1000 live births in 1970, prenatal diagnosis and termination of pregnancy does not completely account for the declining rate of NTDs.

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Prevalence of Neural Tube Defects and the Impact of Prenatal Diagnosis in Three Districts of Beijing, China

Paediatric and Perinatal Epidemiology ◽

10.1111/ppe.12354 ◽

2017 ◽

Vol 31 (4) ◽

pp. 293-300 ◽

Cited By ~ 8

Author(s):

Lei Jin ◽

Jingru Yu ◽

Yanjun Xu ◽

Hui Liu ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Neural Tube ◽

Neural Tube Defects ◽

The Impact ◽

Beijing China

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Birth prevalence of neural tube defects: a population-based study in South-Eastern Hungary

Child s Nervous System ◽

10.1007/s00381-012-1951-1 ◽

2012 ◽

Vol 29 (4) ◽

pp. 621-627 ◽

Cited By ~ 2

Author(s):

Nóra Szabó ◽

Gyurgyinka Gergev ◽

Andrea Valek ◽

József Eller ◽

László Kaizer ◽

...

Keyword(s):

Neural Tube ◽

Neural Tube Defects ◽

Population Based ◽

Population Based Study ◽

Birth Prevalence ◽

South Eastern

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Prevalence of neural tube defects in 20 regions of Europe and the impact of prenatal diagnosis, 1980-1986. EUROCAT Working Group.

Journal of Epidemiology & Community Health ◽

10.1136/jech.45.1.52 ◽

1991 ◽

Vol 45 (1) ◽

pp. 52-58 ◽

Cited By ~ 90

Keyword(s):

Prenatal Diagnosis ◽

Neural Tube ◽

Neural Tube Defects ◽

Working Group ◽

The Impact

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Neural Tube Defects: The Experience of the Registry of Congenital Malformations of Alsace, France, 1995-2009

Fetal Diagnosis and Therapy ◽

10.1159/000362663 ◽

2014 ◽

Vol 37 (1) ◽

pp. 6-17 ◽

Cited By ~ 7

Author(s):

Dana Timbolschi ◽

Elise Schaefer ◽

Bondo Monga ◽

Delphine Fattori ◽

Béatrice Dott ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Spina Bifida ◽

Neural Tube ◽

Neural Tube Defects ◽

Congenital Malformations ◽

Epidemiological Data ◽

Population Based ◽

Folic Acid Supplementation ◽

Total Prevalence ◽

Global Rate

Context and Objective: Considering the lack of accurate and up-to-date information available about neural tube defects (NTDs) in France, the purpose of this study was to review clinical and epidemiological data of NTDs and to evaluate the current efficiency of prenatal diagnosis in Alsace (northeastern France). Methods: A population-based retrospective study was performed from data of the Registry of Congenital Malformations of Alsace between 1995 and 2009. Data were analyzed as a whole and according to the anatomical type of the malformation (anencephaly, cephalocele and spina bifida). Statistical analyses were carried out using the Statistical Package for the Social Sciences. Results: 272 NTDs were recorded divided in 113 cases of anencephaly (42%), 35 cases of cephalocele (13%) and 124 cases of spina bifida (45%). The total prevalence at birth of 14/10,000 (95% CI 13-16) was stable throughout the reporting period. A chromosome abnormality was identified in 27 cases (12% of all karyotyped cases). NTDs were prenatally diagnosed by ultrasound in 88% of the cases. The mean age upon prenatal diagnosis slightly declined during the 15-year period, significantly for spina bifida only. The global rate of terminations of pregnancy following prenatal diagnosis was 97% (230/238). Conclusion: This work constitutes a unique population-based study providing accurate and specific up-to-date data from a unique center over a longer period (1995-2009). The most important information concerns the high and stable prevalence, which calls into question the efficiency of the primary prevention by folic acid supplementation and the efficiency of prenatal diagnosis.

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Current Trends in the Incidence of Neural Tube Defects

PEDIATRICS ◽

10.1542/peds.70.3.333 ◽

1982 ◽

Vol 70 (3) ◽

pp. 333-337

Author(s):

Gayle C. Windham ◽

Larry D. Edmonds

Keyword(s):

Neural Tube ◽

Neural Tube Defects ◽

Monitoring Program ◽

The United States ◽

Congenital Defects ◽

Live Births ◽

Current Trends ◽

The Difference ◽

Rate Of Decline ◽

Different Sources

To verify and investigate the reported decline of neural tube defects (NTDs) in the last decade, data from three different sources were examined: the Birth Defects Monitoring Program (BDMP), composed of newborn discharge diagnoses; the population-base Metropolitan Atlanta Congenital Defects Program (MACDP); and the National Center for Health Statistics (NCHS), whose data include only live births. Although the three systems use different methods of ascertaining cases, all data bases showed a decreasing trend in NTD rates, with annual percent decreases of 3.1% for NCHS, 5.7% for BDMP, and 7.7% for MACDP. The decrease was noted in all variables examined: race, sex, and birth status for each defect. NTD rates appear to be declining more rapidly in females than in males. Further, the rate among stillborn infants decreased more than the rate among liveborn infants. The exclusion of stillbirths in the NCHS data may contribute to its low rate of decline for female anencephalics. Data from England showed a larger average annual decrease (10.6%) than did data from the United States. Although reasons for the overall decline are not verifiable, a variety of explanations are suggested for this decline and for the difference in NTD rate decline noted between live births and stillbirths. The overall decline in NTD rates should be investigated with respect to etiology; recognition of the decline is useful for planning and evaluating health care programs.

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Impact of pre-pregnancy diabetes mellitus on congenital anomalies, Canada, 2002–2012

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.35.5.01 ◽

2015 ◽

Vol 35 (5) ◽

pp. 79-84 ◽

Cited By ~ 18

Author(s):

S Liu ◽

J Rouleau ◽

JA León ◽

R Sauve ◽

KS Joseph ◽

...

Keyword(s):

Diabetes Mellitus ◽

Congenital Anomaly ◽

Congenital Anomalies ◽

Population Attributable Risk ◽

Population Based ◽

Birth Prevalence ◽

Live Births ◽

Diagnostic Codes ◽

Cardiovascular Defects ◽

The Impact

Objective To examine the impact of pre-pregnancy diabetes mellitus (DM) on the population birth prevalence of congenital anomalies in Canada. Methods We carried out a population-based study of all women who delivered in Canadian hospitals (except those in the province of Quebec) between April 2002 and March 2013 and their live-born infants with a birth weight of 500 grams or more and/or a gestational age of 22 weeks or more. Pre-pregnancy type 1 or type 2 DM was identified using ICD-10 diagnostic codes. The association between DM and all congenital anomalies as well as specific congenital anomaly categories was estimated using adjusted odds ratios; the impact was calculated as a population attributable risk percent (PAR%). Results There were 118 892 infants with a congenital anomaly among 2 839 680 live births (41.9 per 1000). While the prevalence of any congenital anomaly declined from 50.7 per 1000 live births in 2002/03 to 41.5 per 1000 in 2012/13, the corresponding PAR% for a congenital anomaly related to pre-pregnancy DM rose from 0.6% (95% confidence interval [CI]: 0.4–0.8) to 1.2% (95% CI: 0.9–1.4). Specifically, the PAR% for congenital cardiovascular defects increased from 2.3% (95% CI: 1.7–2.9) to 4.2% (95% CI: 3.5–4.9) and for gastrointestinal defects from 0.8% (95% CI: 0.2–1.9) to 1.4% (95% CI: 0.7–2.6) over the study period. Conclusion Although there has been a relative decline in the prevalence of congenital anomalies in Canada, the proportion of congenital anomalies due to maternal prepregnancy DM has increased. Enhancement of preconception care initiatives for women with DM is recommended.

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