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Neural Tube Defects Chairwoman: Professor Judith Hall 1994 Neural tube defects are major human congenital malformations. They are the second most common cause of perinatal death owing to birth defect in the UK and lead to considerable childhood morbidity. This book contains descriptions of normal neurulation in birds, amphibians and mammals, including humans. The anatomy of neural tube defects is discussed, with emphasis on the underlying molecular genetics, particularly in mouse strains with heritable neural tube defects. There is evidence for both genetic and environmental factors in the development of neural tube defects. Possible risk factors include anticonvulsant agents, diabetes and alcohol: the current status of epidemiological studies on these is assessed and the relative contributions of potential causative elements are critically reviewed. Clinical trials in humans have shown that folic acid consumption before and immediately after conception significantly reduces the risk of having a child with a neural tube defect. The book contains a detailed description of folic acid metabolism and discussion of how it may act during neural tube closure. The book describes methods for antenatal detection and diagnosis of neural tube defects. The feasibility of treatment, both in utero and after birth, is considered. Finally, the book presents the case for implementing a programme to ensure adequate consumption of folic acid by all women of child-bearing age. Possible objections to, or disadvantages of, such a programme are discussed fully and solutions to such problems are proposed. Related Ciba Foundation Symposia: No. 156 The childhood environment and adult disease Chairman: David Barker 1991 ISBN 0 471 92957 3 No. 165 Postimplantation development in the mouse Chairwoman: Anne McLaren 1992 ISBN 0 471 93384 8 No. 182 Germline development Chairwoman: Anne McLaren 1994 ISBN 0 471 94264 2

Neural Tube Defects. --- Neural tube --- -Embryology --- Nervous system --- Acrania --- Developmental Neural Tube Defects --- Iniencephaly --- Neural Tube Developmental Defects --- Neuroenteric Cyst --- Occult Spinal Dysraphism --- Occult Spinal Dysraphism Sequence --- Tethered Spinal Cord Syndrome --- Craniorachischisis --- Developmental Defects, Neural Tube --- Diastematomyelia --- Exencephaly --- Neurenteric Cyst --- Spinal Cord Myelodysplasia --- Tethered Cord Syndrome --- Acranias --- Craniorachischises --- Cyst, Neurenteric --- Cyst, Neuroenteric --- Cysts, Neurenteric --- Cysts, Neuroenteric --- Defect, Neural Tube --- Defects, Neural Tube --- Diastematomyelias --- Dysraphism, Occult Spinal --- Dysraphisms, Occult Spinal --- Exencephalies --- Iniencephalies --- Myelodysplasia, Spinal Cord --- Myelodysplasias, Spinal Cord --- Neural Tube Defect --- Neurenteric Cysts --- Neuroenteric Cysts --- Occult Spinal Dysraphisms --- Spinal Cord Myelodysplasias --- Spinal Dysraphism, Occult --- Spinal Dysraphisms, Occult --- Tethered Cord Syndromes --- Abnormalities --- -Congresses --- Neural Tube Defects --- -Abnormalities --- Neural tube defects