Short-term clinical outcomes of newborns who have neural tube defects

Abstract

INTRODUCTION: Neural tube defects (NTD) are one of the most common congenital anomalies of the newborns. The incidence of NTD in Turkey is 3/1000. Various types of NTD appear depending on the part affected by the closure of the neural tube. The etiology of NTD is multifactorial, and a significant portion of them can be prevented by folic acid supplementation. Patients with NTD need long-term medical, surgical and care support.METHODS: In this study, antenatal, natal and postnatal characteristics of NTD patients who were admitted to the NICU between 2013-2017 were examined retrospectively.RESULTS: Twenty-nine NTD patients were included in this study. Sixteen (55%) of the patients were male and 13 (45%) were female. Mean gestational age was 37.5 +/- 1.97 weeks, mean birth weight was 3050 +/- 703.29 grams. Six patients had the following maternal risk factors for NTD development: diabetes, obesity, smoking, and the use of valproic acid. None of the patients used preconceptional folic acid. Of the NTD, 23 were meningomyelocele, 1 was meningocele, 3 were encephalomyelocele, 1 was encephalocele, and 1 was acrania. NTD was the most common at the lumbosacral region (n=10) and the other regions were lomber (n=8), thoracic (n=5), occipital (n=4) and cervical (n=1). While the complete loss of leg movements was seen in eleven of the patients, partial loss was seen in nine of them. The lesion level was higher than L4 in all of those with complete motor dysfunction and in 4 (44%) with partial motor dysfunction. Meningomyelocele sacs were ruptured in seven patients. Shunt procedures were required in 18 of 19 patients with hydrocephalus. Shunt placement and meningomyelocele operations were performed simultaneously in 11 patients.DISCUSSION and CONCLUSION: The preventable etiologic risk factors of NTDs should be known especially by the parents who are considering having a child.