Neural tube defects: the experience of the registry of congenital malformations of Alsace, France, 1995-2009.
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).


CONCLUSIONS
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.
Service de Génétique Médicale, CMCO-SIHCUS, Hôpital de Hautepierre, Strasbourg, France.
Dana
D
Timbolschi
Elise
E
Schaefer
Bondo
B
Monga
Delphine
D
Fattori
Béatrice
B
Dott
Romain
R
Favre
Monique
M
Kohler
Israël
I
Nisand
Brigitte
B
Viville
Dominique
D
Astruc
Pierre
P
Kehrli
Bernard
B
Gasser
Véronique
V
Lindner
Luc
L
Marcellin
Elisabeth
E
Flori
Françoise
F
Girard-Lemaire
Hélène
H
Dollfus
Bérénice
B
Doray
D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000175:diagnosis* / Q000453:epidemiology*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies