Incidence and Risk Factors for Neural Tube Defects in Peshawar

Background: Neural tube defects are common and major birth defects. Their incidence varies according to the geographic conditions, race, sex of the baby and certain maternal conditions. This study was conducted to determine the incidence of neural tube defects and its risk factors in Peshawar. Material and Methods: It was retrospective study of deliveries at Gynae A unit of Lady Reading Hospital Peshawar, from January 2004 to December 2004. Pregnant women with babies having neural tube defects were taken as subjects and those having normal babies as controls. They were interviewed and information recorded in a proforma. Results: During the study period 3310 deliveries occurred, among which 46 were having neural tube defects. Twenty-one had hydrocephalus, 8 spina bifida with meningocoele, 6 fetuses were anencephalic where as 11 had multiple neural tube defects. During pregnancy the majority of neural tube defects were diagnosed by ultrasonography 17 (15.21%). Twelve (26.08%) of these ladies had spontaneous vaginal delivery, 16 (34.7%) vaginal delivery after encephalocentesis and 5 (10.8%) had caesarean section. Uterine rupture occurred in 6.5% cases after prolonged obstructed labour. Of 46 women with affected babies, all had not taken folic acid in their first trimester. Conclusion: Neural tube defects are not uncommon congenital anomalies in our set up. These can be prevented by intake of folic acid supplements periconceptionally.