Contrasting effects of maternal fertility and birth rank on the occurrence of neural tube defects.

The relationships between the occurrence of anencephalus and spina bifida, sibship size and birth rank were examined, using linked records for births in British Columbia. Comparison of 414 sibships in which at least one infant had a neural tube defect with 1362 randomly chosen unaffected sibships showed that the affected sibships were larger. There were both more births than expected after the affected birth, and shorter intervals between births before the affected birth. Within sibships, the risk of anencephalus or spina bifida decreased strongly with increasing birth rank. No associations were seen with maternal age at first birth.