Prevalence of Neural Tube Defect and Associated Risk Factors at Debre Berhan Referral Hospital, North Shewa, Ethiopia, 2019. Hospital based Case Control study
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Date
2019-01
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Addis Ababa University
Abstract
Background: - Neural tube defect (NTD) is a structural defect of the central nervous system that affects the brain, spine and spinal column of the developing embryo during the first month of developmental process and most common congenital malformations, are potentially preventable cause of perinatal morbidity and mortality. Worldwide, around 10% of infant mortalities are due to nervous system defects. It is estimated that approximately 300,000 babies are born each year with NTDs worldwide. In Ethiopia there is very limited published data regarding the prevalence and associated risk factors as well as established preventive strategy of NTDs. Therefore, the purpose of this study was to assess the associated risk factor and prevalence of NTDs among pregnant outcome in Debreberhan Referral Hospital.
Objective:- To assess the prevalence and risk factors of NTDs among pregnant outcome at DBRH, North Shewa, Ethiopia, 2019.
Methods:- Hospital based unmatched case control study was conducted among 50 cases (neonate born with NTDs) and 100 controls (neonate born without NTDs) for associated risk factors and retrospective cross sectional, descriptive study of registration of all birth outcome for prevalence of NTDs were revised. The study was carried out at DBRH from August30/2017 to August 30/2019.
The data was checked for completeness and consistencies, and cleaned, coded and entered using Epi data version 4.2 and was exported to statistical package for social sciences (SPSS) software version 20 for analysis. Variables having P<0.05 was consided as statistically significant
Results:- The total prevalence of NTDs was 10.9 per 1000 pregnancy and the prevalence of each NTD type was Anencephaly 5.6 per 1000 pregnancies, spina bifida 3.5 per 1000 pregnancies, encephalocele 0.9 per 1000 pregnancies and both spina bifida and anencephaly 0.7 per 1000 pregnancies. Logistic regression analysis showed that maternal age, < 20 (P=0.046), maternal age 31-35 (P =0.028), no education (P=0.014), Family history of NTDs (P=0.034), history of multiparous (P=0.002), history of abortion (P=0.024) and still birth (P=0.009), No ANC follow up, un planned pregnancy (P=0.000), history of medical illness (P=0.001), Hyperthermia (P=0.000), used antipyretics drugs (P=0.002), pericoceptional folic acid and Oral contraceptive use (P=0.001), maternal exposure to smoking (P=0.001) and pesticides (P=0.000), and use of local alcohol “Arki” (P=0.000) had significant association with NTDs.
Conclusion:- the prevalence of neural tube defects in this study is among the highest globally reported and family history of NTDs, coffee and alcohol consumption, maternal no education, maternal hyperthermia and disease, maternal antipyretic use, maternal age <20 and 31-35, exposure to pesticides and smoking were associated with the increasing the risk of NTD. Comprehensive preventive strategies focused on the identified risk factors should be established and early preiconceptional maternal screening for genetic factors and medical illness as well as periconceptional folic acid supplementation are the effective possible approaches to bring about the required reduction in NTD
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Keywords
Neural tube defect, Folic acid, maternal factors, Central Nervous System