Pilot Study to Assess the AntenatalPoint Prevalence of Neural Tube Defects and Associated Factors in Pregnant Woman Attending ANC in Ghandi Memorial Hospital in Addis Ababa Ethiopia, August 26- September 10of 2017
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Date
2017-09
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Addis Ababa Universty
Abstract
Introduction:NTDs are a heterogeneous group of CNS malformation resulting
from faulty development of neural tube during one the three embryonic periods.
NTD is the second most common congenital malformation following CHD and the
most common form of CNS malformation. It encompasses a broad spectrum of
CNS malformation spanning from anencephaly which is incompatible with life to
minor occult malformation.
NTDs have a global average incidence of 1.6 per 1000 live births, the highest
incidence reported in Mexico and England. There is no adequate data on its
incidence in Ethiopia but its frequency ranges from 0.77-6.1 per 1000 live births in
South Africa 1, 2, 3, 4&5.
NTD is a multifactorial process resulting from interplay between genetic and
environmental factors. There is an increased risk of NTD after affected siblings
and in siblings of affected parents1. There is also an increased risk in infants of
mothers with low serum folic acid level, poorly controlled insulin dependent
diabetes millets, obesity and maternal intake of anti-epileptic and folic acid
antagonist drug especially in the first trimester1, 11 & 12.
Objective: to assess the point prevalence and the frequency of different types of
NTD using routine obstetric anatomic ultrasound scan as well as factors
associated with NTD
Methods: A hospital based trans cross sectional study was conducted in Ghandi
memorial hospital on 84 pregnant women attending ANC from August 26 to
September 10 of 2017. The study has included all pregnant women with a
gestational age of 18 weeks and above and live pregnancy.
Result: The study has included 84 pregnant women all of whom was singleton
intra uterine pregnancies. The study participants had an average age of 27.5 years
and literacy rate of 99% .The reported monthly average income was 3300 birr.
None of them took preconception folic acid supplementation while 71.4% took
during first trimester. Thirty six point four percent took medically prescribed
medication during first trimester. Two of the fetuses had ananencephaly type of
NTD giving point prevalence of 23.8 NTD per 1000 pregnancies.
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Conclusion: The literacy rate and participants living above the poverty line is
much higher than both urban and national average. First trimester; especially,
preconception folic acid supplement intake is low in this study but the finding is
comparable to similar studies. The point prevalence of NTD is significantly higher
than the global and regional averages. All of the studies calculated their incidence
as a ratio of live births and did not consider all forms of pregnancy losses and still
births. But it is difficult to generalize based on this study findings due to small
study population size and facility based study design. Further study is
recommended to assess knowledge, attitude and practice of reproductive age
women towards folic acid supplement intake. Large population based study is
recommended to assess the prevalence and the frequency of different types of NTD.
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Keywords
Pregnant Woman,Ghandi Memorial Hospital,Radiology