非洲神经管缺陷的出生患病率及相关危险因素：系统评价和荟萃分析。
Birth prevalence of neural tube defects and associated risk factors in Africa: a systematic review and meta-analysis.
机构信息
Department of Human Anatomy, College of Medicine and Health Sciences, School of Medicine, University of Gondar, Gondar, Amhara, Ethiopia.
Department of Epidemiology, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Amhara, Ethiopia.
出版信息
BMC Pediatr. 2021 Apr 21;21(1):190. doi: 10.1186/s12887-021-02653-9.
BACKGROUND
Neural tube defects are common congenital anomalies that result from early malformation in the development of the spinal cord and brain. It is related to substantial mortality, morbidity, disability, and psychological and economic costs. The aim of this review is to determine the pooled birth prevalence of neural tube defects and associated risk factors in Africa.
METHODS
The first outcome of this review was the pooled birth prevalence of the neural tube defects and the second outcome was the pooled measure of association between neural tube defects and associated risk factors in Africa. We systematically searched PubMed, PubMed Central, Joanna Briggs Institute, Google Scopus, Cochrane Library, African Journals Online, Web of Science, Science Direct, Google Scholar, and Medline databases. The heterogeneity of studies was assessed using the Cochrane Q test statistic, I test statistic, and, visually, using Forest and Galbraith's plots. A random-effect model was applied to get the pooled birth prevalence of neural tube defects. Subgroup, sensitivity, meta-regression, time-trend, and meta-cumulative analyses were undertaken. The fixed-effect model was used to analyze the association between neural tube defects and associated risk factors.
RESULTS
Forty-three studies with a total of 6086,384 participants were included in this systematic review and meta-analysis. The pooled birth prevalence of the neural tube defects was 21.42 (95% CI (Confidence Interval): 19.29, 23.56) per 10,000 births. A high pooled birth prevalence of neural tube defects was detected in Algeria 75 (95% CI: 64.98, 85.02), Ethiopia 61.43 (95% CI: 46.70, 76.16), Eritrea 39 (95% CI: 32.88, 45.12), and Nigeria 32.77 (95% CI: 21.94, 43.59) per 10,000 births. The prevalence of neural tube defects has increased over time. Taking folic acid during early pregnancy, consanguineous marriage, male sex, and substance abuse during pregnancy were assessed and none of them was significant.
CONCLUSIONS
The pooled birth prevalence of neural tube defects in Africa was found to be high. The risk factors evaluated were not found significant.
背景
神经管缺陷是一种常见的先天畸形，是由脊髓和大脑发育早期畸形引起的。它与大量的死亡率、发病率、残疾以及心理和经济成本有关。本综述的目的是确定非洲神经管缺陷的合并出生患病率及其相关危险因素。
方法
本综述的第一个结果是神经管缺陷的合并出生患病率，第二个结果是非洲神经管缺陷与相关危险因素之间的合并关联度量。我们系统地检索了 PubMed、PubMed Central、Joanna Briggs 研究所、Google Scopus、Cochrane 图书馆、African Journals Online、Web of Science、Science Direct、Google Scholar 和 Medline 数据库。使用 Cochrane Q 检验统计量、I 检验统计量和视觉上的 Forest 和 Galbraith 图评估研究的异质性。应用随机效应模型得出神经管缺陷的合并出生患病率。进行了亚组分析、敏感性分析、meta 回归分析、时间趋势分析和 meta 累积分析。使用固定效应模型分析神经管缺陷与相关危险因素之间的关联。
结果
本系统评价和 meta 分析共纳入了 43 项研究，共计 6086384 名参与者。神经管缺陷的合并出生患病率为 21.42（95%置信区间（CI）：19.29，23.56）/10000 名活产儿。在阿尔及利亚，神经管缺陷的合并出生患病率很高，为 75（95%CI：64.98，85.02）；在埃塞俄比亚，为 61.43（95%CI：46.70，76.16）；在厄立特里亚，为 39（95%CI：32.88，45.12）；在尼日利亚，为 32.77（95%CI：21.94，43.59）。神经管缺陷的患病率随着时间的推移而增加。在妊娠早期服用叶酸、近亲结婚、男性性别和妊娠期间滥用药物等因素进行评估，均未发现显著相关性。
结论
非洲神经管缺陷的合并出生患病率较高。评估的危险因素没有发现显著相关性。
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