Neural tube defects in the middle belt of Nigeria

Forty-two babies were found to have neural tube defects during a 3-year prospective study in a large cosmopolitan West African city. An incidence of 7/1000 deliveries was noted. The commonest defect was meningomyelocele, in 45 per cent of cases. Other defects comprised anencephaly (5 per cent), Arnold-Chiari malformation (7 per cent), encephalocele (19 per cent), occipital meningocele (14 per cent) and spina bifida occulta (10 per cent). No case of consanguinity was encountered. More defects were found among females and low birth weight infants among those whose mothers were aged between 20 and 30 years, and in mothers with parity of four and above. The commonest associated defect was talipes equinus in 15/42 (36 per cent) infants. Developmental assessments (neurological follow-up status) done at the age of 18 months on five surviving cases of meningomyelocele showed very poor development.