Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Biomed Res Int. 2018 Mar 11;2018:4829023. doi: 10.1155/2018/4829023. eCollection 2018.
There is scarcity of data on prevalence of neural tube defects (NTDs) in lower-income countries. Local data are important to understand the real burden of the problem and explore risk factors to design and implement preventive approaches. This study aimed to determine prevalence and risk factors of NTDs. A hospital-based cross-sectional and unmatched case-control study was conducted at three teaching hospitals of Addis Ababa University. NTDs were defined as cases of anencephaly, spina bifida, and encephalocele based on ICD-10 criteria. The prevalence of NTDs was calculated per 10,000 births for both birth and total prevalence. During seven months, we observed 55 cases of NTDs out of 8677 births after 28 weeks of gestation-birth prevalence of 63.4 per 10,000 births (95% confidence interval (CI), 51-77). A total of 115 cases were medically terminated after 12 weeks of gestation. Fifty-six of these terminations (48.7%) were due to NTDs. Thus, total prevalence of NTDs after 12 weeks' gestation is 126 per 10,000 births (95% CI, 100-150). Planned pregnancy (adjusted odds ratio (aOR), 0.47; 95% CI, 0.24-0.92), male sex (aOR, 0.56; 95% CI, 0.33-0.94), normal or underweight body mass index (aOR, 0.49; 95%, 0.29-0.95), and taking folic acid or multivitamins during first trimester (aOR, 0.47; 95%, 0.23-0.95) were protective of NTDs. However, annual cash family income less than $1,300 USD (aOR, 2.5; 95%, 1.2-5.5), $1,300-1,800 USD (aOR, 2.8; 95%, 1.3-5.8), and $1,801-2,700 USD (aOR, 2.6; 95%, 1.2-5.8) was found to be risk factors compared to income greater than $2,700 USD. The prevalence of NTDs was found to be high in this setting. Comprehensive preventive strategies focused on identified risk factors should be urgently established. More studies on prevention strategies, including folic acid supplementations, should be conducted in the setting.
神经管缺陷（NTDs）在低收入国家的流行数据稀缺。了解当地的实际负担和探索风险因素对于设计和实施预防措施非常重要。本研究旨在确定 NTDs 的患病率和风险因素。在亚的斯亚贝巴大学的三家教学医院进行了一项基于医院的横断面和非匹配病例对照研究。根据 ICD-10 标准，将无脑畸形、脊柱裂和脑膨出定义为 NTDs 病例。出生和总患病率均以每 10,000 例活产计算 NTDs 的患病率。在七个月的时间里，我们观察到 55 例 NTDs 病例，其中 8677 例是 28 周后出生的活产儿，出生时的患病率为 63.4/10,000 例（95%置信区间[CI]：51-77）。共有 115 例在妊娠 12 周后终止妊娠。其中 56 例（48.7%）是由于 NTDs。因此，妊娠 12 周后 NTDs 的总患病率为 126/10,000 例（95%CI：100-150）。计划妊娠（调整后的优势比[aOR]，0.47；95%CI：0.24-0.92）、男性（aOR，0.56；95%CI：0.33-0.94）、正常或低体重指数（aOR，0.49；95%CI：0.29-0.95）和孕早期服用叶酸或多种维生素（aOR，0.47；95%CI：0.23-0.95）是 NTDs 的保护因素。然而，年收入低于 1300 美元（aOR，2.5；95%CI：1.2-5.5）、1300-1800 美元（aOR，2.8；95%CI：1.3-5.8）和 1801-2700 美元（aOR，2.6；95%CI：1.2-5.8）的家庭年收入被认为是 NTDs 的风险因素，而收入高于 2700 美元则不是。在这种情况下，NTDs 的患病率被发现很高。应紧急制定以确定的风险因素为重点的综合预防策略。应在该环境中开展更多关于预防策略的研究，包括叶酸补充。
