Neural tube defects in a university teaching hospital in southern Nigeria: trends and outcome.
BACKGROUND
There has been some increase in the proportion of Neural Tube Defects (NTD) admitted in the University of Port Harcourt Teaching Hospital recently. Fora largely preventable birth defect, this increase is both unnecessary and unacceptable. This study was undertaken to describe the admission patterns and outcome of neural tube defects in University of Port Harcourt Teaching Hospital.


METHODS
A retrospective study of babies with neural tube defects who were admitted into Special Care Baby Unit (SCBU) of the University of Port Harcourt Teaching Hospital from 1st May 2002 to 30th April 2005 was carried out. Their case notes were retrieved and information on the sex, maternal drugs during pregnancy, type of defect and associated malformations, prenatal diagnosis, management and outcome were obtained. The admission rate and the incidence were then calculated.


RESULTS
There were 2891 total admissions (1691 males and 1200 females) during the study period of which 37 (1.3%) were neonates with NTD. Of those with NTD, 25 were males and 12 female giving a male to female ratio of 2:1 (statistically not significant p = 0.242.) The total hospital delivery at the study period was 7,388 of which 7 had NTD giving an incidence of 0.95/1000 deliveries. The commonest type of NTD was myelomeningocoele in 31 (83.8%), and the commonest site was the thoracolumbar region (93.5%). Frontal encephalocoele was seen in 6 (16.2%). All the babies with myelomeningocoele presented with flaccid paraparesis and were incontinent of both urine and faeces. Seventeen of the babies had only spina bifida while 14 had additional defects including talipes equinovarus (8), hydrocephalus (2), frontal encephalocoele (1), and multiple malformations (3). Ten babies (27%) died, three of them after surgery. All the mothers received folic acid from the second trimester of pregnancy, but none did before pregnancy.


CONCLUSIONS
The Incidence of NTD is on the increase in our environment. There is need to formulate/implement the policy of preconceptional folic acid therapy for all woman of childbearing age as a preventive measure
Ugwu
R O
RO
Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt. rossaire2003@yahoo.com
Eneh
A U
AU
Oruamabo
R S
RS
D002490:Central Nervous System / Q000187:drug effects; D005260:Female; D005492:Folic Acid; D006784:Hospitals, Teaching; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D005492:Folic Acid