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Real prevalence of neural tube defects in Japan: How many of such pregnancies have been terminated?
Authors:Atsuo Kondo  Shinobu Akada  Kunihisa Akiyama  Masato Arakawa  Shunsuke Ichi  Yutaka Inamoto  Tomohiko Ishida  Hiroshi Ishikawa  Tomonori Itoh  Akio Izumi  Fuminori Kimura  Atsuya S Kondo  Ryu Matsuoka  Akito Miyauchi  Junko Mochizuki  Yoshihito Momohara  Shigehiko Morikawa  Miki Morioka  Nobuhito Morota  Ken Nakabe  Satoshi Obayashi  Masataka Oku  Osamu Samura  Jun Sasahara  Masakatsu Sase  Kumi Shimamoto  Katsunori Shimamura  Seiji Sumigama  Katsuhiko Tada  Hiroyuki Takahashi  Akihiro Tani  Seiji Wada  Osamu Wada‐HIraike  Tomoyuki Watanabe  Masatoshi Yamaguchi  Tomoyo Yasui  Masato Yokomine
Abstract:The vital role of folic acid is to reduce the risk of having a neonate afflicted with neural tube defects. The prevalence of neural tube defects (myelomeningocele and anencephaly) has been reported in an incomplete form over the last 40 years in Japan. We aimed to evaluate the total number of neural tube defects including those delivered or terminated, to clarify the proportion of those terminated, and to internationally compare their prevalence. Through information on >311 000 deliveries obtained from 262 hospitals/clinics for 2 years of 2014 and 2015, we identified that the rate of total neural tube defects (termination of pregnancy, live births and stillbirths) was 8.29 per 10 000 deliveries for the year 2014 and was 8.72 for 2015, which were 1.5 and 1.6 times higher than the respective values (live births and stillbirths) reported. It is also observed that the ratio of the total number of myelomeningocele (termination of pregnancy, live births, and stillbirths) to that of anencephaly was approximately 1:1.2, that a half of pregnancies afflicted with neural tube defects were terminated, and that the proportion of termination of pregnancy due to myelomeningocele and due to anencephaly was 20% and 80%, respectively. Internationally, the real prevalence of neural tube defects in Japan was comparatively high, ranking fifth among the seven developed countries. In conclusion, the real prevalence of total neural tube defects was approximately 1.5 times higher than that currently reported by the Japan Association of Obstetricians and Gynecologists.
Keywords:live births  neural tube defects  prevalence  stillbirths  termination of pregnancies
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