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|b Background: \ Neural tube defects are one of the most prevalent congenital anomalies. Data on the total irth prevalence, live birth and stillbirth prevalence of neural tube defects in Libya are lacking. The objective of this study is to conduct a systematic review of birth prevalence of neural tube defects in misrata hospital and compare it with existing estimates \ Methods: \ Study design: A cross sectional descriptive study based on hospital records. \ Study population and Study setting: \ The study was conducted retrospectively from 1.7.2010 till 1.7. 2013. Out of 18956 deliveries in the study period, 66 had neural tube defects, This retrospective study was done in Special Care Baby Unit, Misurata central hospital. Data were collected from hospital records. \ Results: \ The study was carried out for three years. During this period 18,956 babies were born, of which 66 deliveries had neural tube defect. Data were taken directly from the mothers or sometimes from hospital files because we admit all cases of NTD and entered into a programmed form. The female to male ratio was 2:1. Myelomeningocele where the most common 29 (44%) type of neural tube defects in our study, the second most type of this lesion was Anencephaly 16 (24%), the others were Meningocele 14 (21%), Encephalocele 5 (7.5%), combined lesion of anencephaly and myelomeningocele 2 (3. %). Among the 29 deliveries with myelomeningocele, the most common affected sites were lumbosacral 20 (68%) and thoracolumbar 5 (18%) then lumbar 3 (11%), sacral 1 (4.3%). In our study hydrocephalus was present in 28 (42%),Talpes equino varus seen in 31 babies, Undescended testes in 6 babies and Imperforated anus in 4 babies. 33 (50%) of babies their weight between 2.5-3.5 kgs and 15 (22%) less than 2.5kg. 18 (28%) of the offspring were a product of consanguineous marriages and the parents were not related in (73%). Vaginal delivery was the case in 38 deliveries (57%), while caesarean section was in 28 (43%) deliveries. Prevalence of (NTD) was highest in maternal age group between (30-35). Out of 66 deliveries 20 (30%) were found in primigravida mothers. \ The previous history of NTD found in 5 cases. 2 belonged to family and 3 belonged to other family and the later mother she was on folic acid before conception and would further evaluations shows the mother had defect in folic acid metabolism. Most of mothers free of any chronic illness during pregnancy and not receiving any drug apart from 5 diabetic mothers were on insulin. Most of mothers start to take folic acid after the intrauterine diagnosis of NTD. One (1.5%) mothers were on folic acid supplementation before the onset of pregnancy. 22 babies were died in the first week of life, 16 (73%) of them were anencephaly, 5 were myelomeningocele and 1 encephalocele. \ Conclusion: \ The systematic review suggests that neural tube defects contribute to a significant number of live births, suggesting that preconception folic acid supplementation should be an essential element of reproductive health services. and this urges improving maternity services, education of women of child bearing age about the importance of folic acid and the increase in the consumption of folic acid rich food, education of health staffs that the folic acid should be given before or immediately after conception to have its desired effects. And this needs availability of free antenatal care in government center because most of antenatal visit done in private clinic and it is costly.
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