• Ari Sami Hussain Nadhim Department of Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani, Kurdistan Region, Iraq.
  • Nasih Othman Sulaimani Polytechnic University, Sulaimani, Kurdistan Region, Iraq.
  • Nabaz Mohammed Mustafa Shaheed Dr Aso Hospital, Sulaimani, Kurdistan Region, Iraq.



Neural tube defect, spina bifida, Sulaimaniyah, Iraqi Kurdistan, Case series



Very little is known about neural tube defects (NTDs) in Iraqi Kurdistan. This study was undertaken in Sulaymaniyah province in order to describe these defects in the area and report on the outcome of patients.


This descriptive study involved a case series of 50 patients admitted with NTD to the department of neurosurgery at Sulaimaniyah Teaching Hospital during 2006-2010.


Ninety eight patients were admitted to the centre of whom 50 patients were included in the study. The estimated incidence at birth was 3.5 per 10,000, 56% of the patients were females and 44% were males with a female to male ratio of 1.27. The median age at first visit was 9 days (Interquartile range 1, 36). The maternal age ranged from 17-42 years with a mean age of 28 years (SD 6 years). Eight percent of the children had siblings with NTDs, 6% had other anomalies and 12% of their parents were relatives in blood. The majority of lesions (76%) were myelomeningocele, 14% were meningocele and 10% were myeloschisis. Only half of the patients were diagnosed during pregnancy and 30% of all patients had hydrocephalus at time of diagnosis. There was no significant association between sex and site of lesion (P=0.3) and between sex and type of the lesion (P=0.5).


Establishment of prenatal screening is essential in order to help parents to be prepared and make an informed decision about pregnancy. Antenatal care must be strengthened for all pregnant women and folic acid supplementation should be emphasized.


Detrait ER, George TM, Etchevers HC, Gilbert JR, Vekemans M, Speer MC. Human neural tube defects: developmental biology, epidemiology, and genetics. Neurotoxicol Teratol 2005;27:515-524. DOI:

Au KS, Ashley-Koch A, Northrup H. Epidemiologic and genetic aspects of spina bifida and other neural tube defects. Developmental disabilities research reviews 2010;16:6-15. DOI:

McDonnell RJ, Johnson Z, Delaney V, Dack P. East Ireland 1980-1994: epidemiology of neural tube defects. J Epidemiol Community Health 1999;53:782-788. DOI:

Mandiracioglu A, Ulman I, Luleci E, Ulman C. The incidence and risk factors of neural tube defects in Izmir, Turkey: a nested case-control study. Turk J Pediatr 2004;46:214-220.

Golalipour M, Mansourian R, Keshtkar A. Serum Copper concentration in newborns with neural tube defects in Northern Iran; A case control study. Iran J Ped 2009;19:5.

Greenberg MS. Handbook of Neurosurgery. New York: Thieme, 2006.

Humphreys R, Rengachary S. Spinal Dysraphysm. In: Humphreys R, ed. Neurosurgery. New York: McGraw-Hill, 1996.

Nili F, Jahangiri M. Risk factors for neural tube defects: a study at university-affiliated hospitals in Tehran. Arch Iran Med 2006;9:20-25.

Kumar A. Neural tube defects: a neglected problem. Indian pediatrics 2009;46:665-667.

van der Linden IJ, Afman LA, Heil SG, Blom HJ. Genetic variation in genes of folate metabolism and neural-tube defect risk. The Proceedings of the Nutrition Society 2006;65:204-215. DOI:

Lupo PJ, Symanski E, Waller DK, Chan W, Langlois PH, Canfield MA, Mitchell LE. Maternal exposure to ambient levels of benzene and neural tube defects among offspring: Texas, 1999-2004. Environ Health Perspect 2011;119:397-402. DOI:

Shiota K. Neural tube defects and maternal hyperthermia in early pregnancy: epidemiology in a human embryo population. Am J Med Genet 1982;12:281-288. DOI:

Blatter BM, van der Star M, Roeleveld N. Review of neural tube defects: risk factors in parental occupation and the environment. Environ Health Perspect 1994;102:140-145. DOI:

Li Z, Ren A, Zhang L, Guo Z, Li Z. A population-based case-control study of risk factors for neural tube defects in four high-prevalence areas of Shanxi province, China. Paediatr Perinat Epidemiol 2006;20:43-53. DOI:

Rashid BR. Risk factors of neural tube defects in Sulaimania Governorate Baghdad: Iraqi Board for Medical specialization, 2008.

Gos M, Jr., Szpecht-Potocka A. Genetic basis of neural tube defects. II. Genes correlated with folate and methionine metabolism. Journal of applied genetics 2002;43:511-524.

Statacorp. Stata statistical software version 9.2. College station, Texas: Statacorp, 2006.

World Bank. Crude birth rate World Bank, 2008.

Yen IH, Khoury MJ, Erickson JD, James LM, Waters GD, Berry RJ. The changing epidemiology of neural tube defects. United States, 1968-1989. Am J Dis Child 1992;146:857-861. DOI:

Tuncbilek E, Boduroglu K, Alikasifoglu M. Neural tube defects in Turkey: prevalence, distribution and risk factors. Turk J Pediatr 1999;41:299-305.

Shin M, Besser LM, Siffel C, Kucik JE, Shaw GM, Lu C, Correa A. Prevalence of spina bifida among children and adolescents in 10 regions in the United States. Pediatrics 2010;126:274-279. DOI:

Whiteman D, Murphy M, Hey K, O’Donnell M, Goldacre M. Reproductive factors, subfertility, and risk of neural tube defects: a case-control study based on the Oxford Record Linkage Study Register. Am J

Epidemiol 2000;152:823-828. DOI:

Danzer E, Gerdes M, Bebbington MW, Koh J, Adzick NS, Johnson MP. Preschool neurobehavioral outcome following fetal myelomeningocele surgery. Fetal diagnosis and therapy 2011;30:174-179. DOI:

Boyd PA, Devigan C, Khoshnood B, Loane M, Garne E, Dolk H. Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome. BJOG : an international journal of obstetrics and gynaecology 2008;115:689-696. DOI:






How to Cite

Hussain Nadhim A, Othman N, Mustafa N. NEURAL TUBE DEFECTS IN SULAIMANIYAH, IRAQI KURDISTAN: A DESCRIPTIVE STUDY OF 50 CASES. JSMC [Internet]. 2014 Dec. 1 [cited 2024 May 28];4(2):105-13. Available from:

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