Neural tube defects in Wales: changing demographics from 1998 to 2009.

OBJECTIVE: To establish if there is evidence for the perceived increase in the number of live births with a Neural tube defect (NTD) in South Wales from 1998 to 2009. METHODS: Data was obtained from the Congenital Abnormalities Register Information Services (CARIS), which recorded 305 cases of pregnancies involving neural tube defects. Descriptive analysis was carried out for each year in this period to obtain the number of live births, the proportion of live births compared to NTD pregnancies, plus the number and the percentage terminated each year. RESULTS: From the 305 cases, 66 resulted in live births, 230 in terminations. There was an increase in live births from 13.8% in 1998 to 33.3% in 2009, and a decrease in terminations from 82.76% in 1998 to 62.50% in 2009. The data also showed that this increase occurred mainly in the South of Wales. Discussion. Over this time period, there has been a decrease in the number of pregnancies affected by a neural tube defect and a decline in the proportion of pregnancies with neural tube defects resulting in terminations. Consequently, there has been an increase in the number of live births. The reasons for this change in trend is unclear, it may be that prospective parents are more willing to proceed with the pregnancy due to better support and services and the improved prognosis for children with neural tube defects. CONCLUSION: This data clearly shows that the number of children born with a NTD is increasing, and if this trend persists, services will have to expand and adapt to the change in the demographic of this population.

Ischaemic stroke among young people aged 15 to 50 years in Adelaide, South Australia.

OBJECTIVES: To report risk factors, aetiology and neuroimaging features among a large series of young Australian patients who were admitted to hospital for a first-ever occurrence of ischaemic stroke; to analyse the effect of age, sex and ethnicity on the presence of risk factors; and to compare Australian and overseas data. DESIGN, SETTING AND PATIENTS: Retrospective evaluation of data for all patients aged from 15 to 50 years who were admitted to a public hospital in Adelaide, South Australia, from January 2006 to June 2010 with a primary diagnosis of ischaemic stroke. RESULTS: Among 326 patients (184 males), the most frequent stroke risk factors overall were dyslipidaemia (187), smoking (161), hypertension (105) and obesity (92). Fifty-one patients used illicit drugs, mostly comprising marijuana and amphetamines. The most frequent stroke aetiologies overall were cardioembolism (85), arterial dissection (49), and small-vessel occlusion (31). Cardioembolism was highly prevalent among our study population compared with patients in other countries. Neuroimaging showed that more patients in our study had strokes that involved both vascular territories concurrently (9%) compared with patients in other countries. CONCLUSIONS: Risk factors, aetiology and features of ischaemic stroke among young people in Adelaide differ significantly from published data for young patients around the world. Patients in Adelaide are more likely to be obese, to be misusing marijuana and amphetamines, to suffer a cardioembolic event and to have a stroke that concurrently affects both the anterior and posterior cerebral circulation.