NEURAL TUBE DEFECTS: ETIOLOGY, RISK FACTORS, AND THE IMPACT OF FOOD FORTIFICATION PROGRAM

Abstract

Neural tube defects (NTDs) are a group of congenital malformations that result from incomplete closure of the neural tube during embryonic development. Neural tube forms the brain and spinal cord, while its failure to close properly can result in severe defects, such as spina bifida and anencephaly. This review article provides a logical classification of various defects as well as an overview of the causes, regional incidences, disease severity and outcomes. It further discusses risk factors such as family history, genetic disorders and maternal factors including folic acid deficiency, obesity and exposure to certain drugs during pregnancy. Initial research on NTDs generated 3,397 publications but following our inclusion criteria, we selected 186 papers to review. Our findings indicate that the incidences vary by ethonogeographic perspective, but on average, global prevalence is 1 in 1,000 live births. The effects of NTD range from mild to severe, while some individuals requiring life-long medical care and others having limited mobility or intellectual disability. The major cause of NTD is mineral deficiency of various vitamins particularly diatery folate. Over 123 countries as participants of the food fortification programs (FFP), under the world food program (WFP) have aimed to reduce mineral deficiencies but many vulnerable populations still remain beyond reach. We explain how NTDs continue to affect vulnerable populations and thus build a case for further strengthening the FFP.