PREVALENCE OF NEURAL-TUBE DEFECTS IN NORTHEASTERN FRANCE, 1979-1994 IMPACT OF PRENATAL-DIAGNOSIS

The objective of this study was to determine in total prevalence of ne ural tube defects (NTD) in northeastern France during 1979-1994 inclus ive, the impact of prenatal diagnosis on birth prevalence. All births and termination of pregnancy affected by NTD were ascertained from mul tiple sources thank to our registry of congenital anomalies. In our re gion maternal serum alpha-fetoprotein screening is not available where as routine ultrasonographic screening of congenital anomalies is perfo rmed in all pregnant women. Total prevalence of NTD during 1979-1994 w as 10.73 per 10,000 with no upward or downward trend. The total preval ence of NTD in our region remained stable. However birth prevalence fe ll significantly. The fall was 100 per cent for anencephaly and 60 per cent for spina bifida. This birth prevalence was unchanged for enceph alocele. This decrease for anencephaly and spina bifida was obtained b y routine ultrasonographic examination only and termination of pregnan cy. Comparison with similar studies in other countries demonstrated th at screening by maternal serum alpha-fetoprotein is needed in our regi on.