To estimate the incidence of Neural Tube Defects(NTDs) in Saudi Arabia and the degree of disability caused by this common birth disorder.  Risk factors and other causes particular to Saudi Arabia need to be identified. 
Neural tube defects are common causes of disability which involve multiple systems.  Hence, they require a multidisciplinary care.  This care constitutes a tremendous burden on health resources and forms an important aspect in health planning.  The causes and risk factors are multi-factorial and differ according to the different social and nutritional variables.  Some might be preventable. The aims of this study are to estimate the incidence of neural tube defects and degree of disability in a cohort of Saudi population.  It will also detect any preventable risk factors.  These results will help in future planning for the reduction of this major handicapping illness in Saudi Arabia.

M. A. M Salih, J. S. Jarallah

At that stage only 5 cases were detected in King Khalid University Hospital.  Twenty-five controls were recruited from the same hospital.  The mean age for mothers of cases was 27.4 + 2.83 years compared to 28.96 + 5.73 for controls.  Father’s age mean was 36.5+8.68 for cases and 34.7 +  9.1 for controls.  Three cases were Saudi in origin compared to 18 controls.  None of the demographic characteristics including mother age, father age, years of formal education, mother work and country of origin was statistically different among cases and controls.
Among the household microenvironment of cases and controls there was no statistical significant variation among cases and controls regarding the type of the home, presence of air-conditioning and room density index (1.7+0.84  versus 1.53+ 1.05 for cases and controls respectively).
Regarding reproduction history of mothers of cases and controls, although both gravida and parity were higher in controls than cases (the medians were 4 versus 2 and 2 versus 1, respectively; there was no statistical significant difference in gravida, parity abortion and still birth.
Concerning genetic factors and consanguinity parameters, family history of hydrocephalus was reported more among cases (40%) than controls (4%).  The difference was statistically significant (P<0.005).  Other variables including blood related parents and family history of congenital anomalies were not statistically different among cases and controls.
Supplementation by folic acid and presence of anemia or mothers affected by diabetes or hypertension during gestation were not statistically different among cases and controls.  Neither cases nor control mothers, however, exposed to X-ray irradiation during gestation.
Studying events during gestation and labour of cases and controls showed that there were no statistical differences among cases and control regarding method of labour.  The duration of gestation was longer in controls compared to cases (37.6 +  7.9 versus 29.2 +  7.3 respectively) with statistically significant difference (P=0.03) .
The neonatal characteristics of cases and controls: Head circumference was much higher in controls compared to cases (median 335mm vs 205mm, respectively).  The difference was statistically significant (p=0.003).  Also the weight was significantly heavier in controls than cases (Median 3020g vs. 1750g respectively; P=0.03).  Forty percent of cases and 36% of controls were males.  No statistical differences were found among cases and controls regarding gender, medical status, Apgar score or neonatal adverse events.

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King Saud University

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