March 1981

Epidemiology of Anencephalus and Spina Bifida,

Author Affiliations

Child Development Center, Box 340
Child Development Center, Box 300 Tufts-New England Medical Center 20 Ash St Boston, MA 02111


by J. Mark Elwood and J. Harold Elwood, 405 pp, $69.50, New York, Oxford University Press, 1980.

Am J Dis Child. 1981;135(3):281. doi:10.1001/archpedi.1981.02130270073030

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This book provides an extensive summary of the epidemiologic information presently available concerning neural tube defects. In addition, prenatal diagnosis, screening, and legal and ethical questions are discussed.

The discussion of the embryology of neural tube defects does not adequately stress the lack of unanimity among investigators in the field. The authors accept the failure of closure theory; however, others believe the primary defect is rupture of the neural tube after closure has been completed.

The chapters on epidemiologic methods are too basic to be of interest to an epidemiologist, but they do provide a good review of the principles and problems of epidemiologic studies for those in other disciplines with less knowledge of epidemiology. (Appendix 2, on the other hand, is a sophisticated discussion of methodologic problems relative to the authors' own epidemiologic work in Canada.)

In the middle part of the book, the authors review a large number

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