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Ronald J. Lemire, MD

JAMA. 1988;259(4):558-562.

Abstract
Neural tube defects (NTDs) are a group of malformations of the brain and spinal cord that originate at various times during gestation. The most common NTDs are anencephaly and meningomyelocele, which arise during the process of neurulation, a well-defined period between the 17th and 30th day after ovulation. These NTDs are clinically apparent by being open, ie, leaving nervous tissue exposed, in contrast to postneurulation NTDs that are skin covered. The incidence of NTDs is declining in several areas of the world, including the United States. While the reasons for this are unclear, there seems to be some effect from prenatal diagnosis, genetic counseling, and possibly nutritional supplementation.

(JAMA 1988;259:558-562)

Author Affiliations
From the Department of Pediatrics, University of Washington School of Medicine, and Children's Hospital and Medical Center, Seattle.

Footnotes
Reprint requests to Children's Hospital and Medical Center, 4800 Sand Point Way NE, PO Box C-5371, Seattle, WA 98105 (Dr Lemire).

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