PREVALENCE OF NEURAL-TUBE DEFECTS IN NORTHEASTERN FRANCE, 1979-1992 IMPACT OF PRENATAL-DIAGNOSIS

The objective of this study was to determine in total prevalence of ne ural tub defects (NTD) in northeastern France during 1979-1992 inclusi ve, the impact of prenatal diagnosis on birth prevalence. All births a nd termination of pregnancy affected by NTD were ascertained from mult iple sources thank to our registry of congenital anomalies. In our reg ion maternal serum alpha-fetoprotein screening is not available wherea s routine ultrasonographic screening of congenital anomalies is perfor med in all pregnant women. Total prevalence of NTD during 1979-1992 wa s 10.94 per 10,000 with no upward or downward trend. The total prevale nce of NTD in our region remained stable. However birth prevalence fel l significantly. The fall was 100 per cent for anencephaly and 60 and 50 per cent for spina bifida and encephalocele, respectively. This dec rease was obtained by routine ultrasonographic examination only and te rmination of pregnancy. Comparison with similar studies in other count ries demonstrated that screening by maternal serum alpha-fetoprotein i s needed in our region.