Neural tube defects : is it a growing health problem in Iraq?

Abstract EN

Objective : Neural tube defects (NTDs) are the most common severely disabling birth defects with a prevalence of 1 / 1.000 live births worldwide.

There are increasing concerns about the rise in the prevalence of NTDs in various localities in Iraq over the past years.

The aim of present work was to address the magnitude of NTDs in various localities in Iraq and discuss factors contributing to it.

Methods : A systematic review of the research literature on NTDs in Iraq covering the period 2000-2010 inclusive, using Medline, PubMed, Cochrane Library, Science Citation Index, Embase, and conference proceedings.

It was also supplemented by manual searching in locally published journals.

A comparative study was carried out between the reported prevalence of NTDs and their rate of increase in various localities in Iraq and that reported worldwide.

Results : In the order of descending frequency, Fallujah ranked the first (95 / 1.000 live births ; 95 folds), followed by Najaf (27 / 1.000 live births ; 27 folds), Diwaniah live births ; 8 folds), Baghdad (7.4 / 1.000 live), (Births ; 7 folds), Basr 4.3 / 1.000 live births ; 4 folds), and Ramadi (3.3 / 1.000 live births ; 3 folds).

Conclusions : NTDs represented a significant and growing health problem in Iraq.

The cumulative effects of exposure to toxicants, including depleted uranium, maternal malnutrition, gestational folate deficiency, absent national programs on dietary folate fortification, and psycho-social stress are thought to be contributory to the rise in the prevalence of NTDs in Iraq.