Sinha Anuvi, P Ponmani, Chakraborty Hirok, Barnwal Rajan Kumar, Sinha Ratnesh
Obstetrics and Gynecology Department, Sadar Hospital, Ranchi, Jharkhand, India.
Department of Pharmacology, Karpagam Faculty of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Childs Nerv Syst. 2024 Dec;40(12):4123-4135. doi: 10.1007/s00381-024-06627-x. Epub 2024 Oct 4.
One of the most common and serious congenital defects is neural tube defect (NTD) in India. The data about the NTDs in India is lacking. The objective of this meta-analysis is to provide an estimate of NTDs in India with regional variations.
This study was conducted by doing a literature search using PubMed (Medline) and Embase databases for studies published from their inception to 1 October 2023 by using relevant keywords. We have prepared our study protocol by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and our study is registered in PROSPERO. Pooled prevalence was calculated by using the Der Simonian-Liard method and random effect model to find out the burden of NTD in India. Additionally, subgroup and sensitivity analyses were also performed. NHLBI (National Heart, Lung, and Blood Institute) tool was used for assessing the study quality.
A total of 1129 articles were identified by using the predefined keywords in which 27 articles were selected which were fitting the selection criteria defined in our study. The prevalence of NTDs in our meta-analysis was found to be 9.46 per 1000 births with a 95% confidence interval of 8.01 to 10.91 per 1000 births with significant heterogeneity with I2 of 99.15%.
Our study highlights the increasing trend of NTDs over the past decades, with significant regional variation in India. There is an urgent need for comprehensive prevention strategies such as advocacy and awareness, antenatal screening for NTDs, folic acid supplementation, and food fortification. Future research is required for identification and implementation for a target-based approach for region specific.
神经管缺陷（NTD）是印度最常见且最严重的先天性缺陷之一。印度缺乏关于神经管缺陷的数据。本荟萃分析的目的是估计印度神经管缺陷的情况及其区域差异。
本研究通过使用PubMed（Medline）和Embase数据库进行文献检索，以查找从数据库建立至2023年10月1日发表的相关研究，检索词为相关关键词。我们按照系统评价和荟萃分析的首选报告项目（PRISMA）清单制定了研究方案，并且我们的研究已在国际前瞻性系统评价注册库（PROSPERO）登记。采用Der Simonian-Laird方法和随机效应模型计算合并患病率，以查明印度神经管缺陷的负担。此外，还进行了亚组分析和敏感性分析。使用美国国立心肺血液研究所（NHLBI）的工具评估研究质量。
使用预定义关键词共识别出1129篇文章，其中27篇文章符合我们研究中定义的选择标准。我们的荟萃分析中神经管缺陷的患病率为每1000例出生9.46例，95%置信区间为每1000例出生8.01至10.91例，存在显著异质性，I²为99.15%。
我们的研究突出了过去几十年神经管缺陷呈上升趋势，且在印度存在显著的区域差异。迫切需要采取全面的预防策略，如宣传与提高认识、神经管缺陷的产前筛查、补充叶酸和食品强化。未来需要开展研究以确定并实施针对特定区域的基于目标的方法。
