“Prevalence and secular trend of neural tube defects in fetal deaths in Argentina, 1994–2019”

BRONBERG, RUBEN; JORGE, MARTINEZ; LEONARDO, MORALES; ANAHI, RUDERMAN; DAMIAN, TAIRE; VIRGINIA, RAMALLO; JOSE, DIPIERRI

Birth Defects Research

Wiley Periodicals, LLC

Año: 2023

2472-1727

Background: Fetal deaths are a major source of information on the epidemiologyof neural tube defects (NTDs; anencephaly and myelomeningocele). Weanalyzed NTDs prevalence and secular trend using fetal death records between1994 and 2019 in Argentina.Materials and Methods: Data were obtained from the Department of Statisticsand Information of the Ministry of Health (DEIS). Using the number offetal deaths due to anencephaly and myelomeningocele, we estimated the proportionof all fetal deaths due to anencephaly, myelomeningocele, and NTDs(anencephaly + myelomeningocele) during pre- and post-fortification periodin Argentina. We also estimated the ratio of fetal deaths due to anencephaly,myelomeningocele, and NTDs (anencephaly + myelomeningocele) to 10,000live births. Secular trend in the outcomes was analyzed using a Poisson modeland Joinpoint regression analysis.Results: In the entire period analyzed, the NTD proportion on fetal deathswas 1.32. In 1994, NTDs accounted for 34.7% of congenital malformations fetaldeaths (CM) and 1.7% of all fetal deaths, whereas in 2019, these percentageswere 9.4% and 0.5%, respectively. NTDs present a negative secular trend(p < .05). The risk of fetal death due to anencephaly and myelomeningoceledecreases between 2005 and 2019 by 67% and 51% respectively (p < .05) incomparison to the period between 1994 and 2004 before the effective fortificationof wheat flour used in the food industry destined for the domestic market.Discussion and Conclusion: We found a significant decrease in the risk ofall fetal deaths due to NTDs, particularly anencephaly, in Argentina over thestudy period, with most reduction observed during the mandatory flour fortificationera (introduced in Argentina in 2002). The inclusion of fetal deaths inNTD surveillance, coupled or uncoupled with other pregnancy outcomes, isessential for monitoring preventive supplementation measures.