Prenatal Screening for Neural Tube Defects

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Abstract
NEURAL tube defects, including anencephaly and spina bifida, are among the commonest major congenital malformations in the United States.1 A study in selected Massachusetts hospitals disclosed a combined prevalence rate of 2.24 per 1,000 births during the years 1930 to 1965.2 Between 1972 and 1975, twenty-six neural tube defects were found among 18,155 consecutive deliveries at the Boston Hospital for Women (1.43 per 1,000).3 The Center for Disease Control in Atlanta reported an incidence of 2.35 per 1,000 for the white population and 0.9 per 1,000 for the black population.4 Among the first 6,031 pregnancies screened in Nassau County, NY, ten neural tube defects were prospectively identified. Women who have been delivered of a conceptus with one of these lesions are at approximately 2% risk of having another similarly affected offspring in each succeeding pregnancy.3 In a given year, however, more than 90% of all

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