Perinatal Outcomes in Patients With Neural Tube Defects in a Middle-Income Setting

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY Birth Defects Research Pub Date : 2025-02-19 DOI:10.1002/bdr2.2455

Berenice Velazquez-Torres, Sandra I. Pacheco-Ruiz, Sandra Acevedo-Gallegos, Mario I. Lumbreras-Marquez, Rolando Jimenez-Guerra, Jose A. Ramirez-Calvo, Maria J. Rodriguez-Sibaja, Yubia Amaya-Guel

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Abstract

Background

Neural tube defects (NTDs) are the second most common congenital malformation. Periconceptional, prenatal, and perinatal interventions have been implemented to reduce their incidence and improve those affected's survival and quality of life. The study aims to describe this population's prevalence, interventions performed, clinical management, and perinatal outcomes.

Methods

A retrospective review of all prenatally diagnosed neural tube defect cases from January 2018 to April 2024 at a perinatal referral center in Mexico City was conducted.

Results

One hundred seventy-two cases were identified with a prevalence of 9.8/1000 births, including anencephaly (17.26%), myeloschisis (8.63%), myelomeningocele (56.83%), encephalocele (12.94%), meningocele (4.31%) and lipomyelomeningocele (0.71%), with a median gestational age at diagnosis of 28.4 weeks; 39.57% had normal pregestational weight. Maternal characteristics in the sample included epilepsy (4.32%), diabetes (15.83%), history of a child with NTD (1.43%), exposure to teratogens (4.32%), and folic acid intake after 8 weeks gestation (21.58%). Myelomeningocele had a higher survival rate to discharge of 93.40%, as well as associated defects (53.1%), with bilateral clubfoot being the highest (29.1%); Nine patients (6.47%) received palliative care. The median in-hospital length of stay was 21.5 days. Post-surgical complications were reported in 10.9% of patients with myelomeningocele. 25.8% received pediatric rehabilitation assessment, 5.7% presented with neurogenic bladder, and 3rd-level hospitals were the highest referral units.

Conclusion

Managing NTDs involves preconception strategies, prenatal diagnosis, postnatal care, timely surgical interventions, and early pediatric rehabilitation. Likewise, proper referral to complex tertiary care to manage complications and additional morbidity in these cases could improve short- and long-term patient outcomes.

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.