The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study

Dawit Estifanos; Elias Teages Adgoy; Dawit Sereke; Birhane Zekarias; Suzan Marzolf; Kifleyesus Tedla

doi:doi:10.11648/j.sjph.20170506.17

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The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study

Dawit Estifanos, Elias Teages Adgoy, Dawit Sereke, Birhane Zekarias, Suzan Marzolf, Kifleyesus Tedla

Published in Science Journal of Public Health (Volume 5, Issue 6)

Received: 5 October 2017 Accepted: 23 October 2017 Published: 17 November 2017

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Abstract

Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A four-year and eight months (January 1^st, 2007 to August 31^st, 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ² analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and well-documented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.

Published in	Science Journal of Public Health (Volume 5, Issue 6)
DOI	10.11648/j.sjph.20170506.17
Page(s)	452-456
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Neural Tube Defects, Deliveries, Neonate, Congenital Structural Abnormalities

References

[1]	ACOG. Neural Tube Defects; ACOG Practice Bulletin, Clinical Management Guidelines, number 44, 2000.
[2]	World Health Organization. Prevention of neural tube defects, Integrated Management of Pregnancy and Childbirth (IMPAC), Department of making pregnancy safer 2006.
[3]	Pilu, G. & Gabrielli, S., ClinicalObstetrics, 3^rd edition. Prenatal diagnosis of central nervous system malformations, Pages 347–358
[4]	Adeleye, AO. et al. Central Nervous System Congenital Malformations in a Developing Country: Issues and Challenges against their prevention. Childs Nerv Syst 26:919-924, 2010.
[5]	Yin, Zhihua et al. A Population-based Case-Control study of risk factors for Neural Tube Defects in Shenyang, China. Childs Nerv Syst. 2010.
[6]	Djientcheu, VP et. al. Management of Neural Tube Defects in a Sub-Saharan Country: The Situation in Yaounde, Cameroon. Journal of Neurological Sciences 275:29-32, 2008.
[7]	Khoshnood B, Loane M, De Walle H, Arriola L, Addor MC, Barisic I, Beres J, Bianchi F, Dias C, Draper E, Garne E. Long term trends in prevalence of neural tube defects in Europe: population based study. Bmj. 2015 Nov 24; 351: h5949.
[8]	Bestwick JP, Huttly WJ, Morris JK, Wald NJ. Prevention of neural tube defects: a cross-sectional study of the uptake of folic acid supplementation in nearly half a million women. PloS one. 2014 Feb 19; 9(2): e89354.
[9]	Sayed, Abdul-Rauf et al. Decline in the Prevalence of Neural Tube Defects Following Folic Acid Fortification and Its Cost-Benefit in South Africa. Birth Defects Research (Part A) 82:211-216, 2008.
[10]	Zaganjor I, Sekkarie A, Tsang BL, Williams J, Razzaghi H, Mulinare J, Sniezek JE, Cannon MJ, Rosenthal J. Describing the prevalence of neural tube defects worldwide: A systematic literature review. PloS one. 2016 Apr 11; 11(4): e0151586.
[11]	Greene ND, Copp AJ. Neural tube defects. Annual review of neuroscience. 2014 Jul 8; 37: 221-42.
[12]	Omer IM, Abdullah OM, Mohammed IN, Abbasher LA. Prevalence of neural tube defects Khartoum, Sudan August 2014–July 2015. BMC research notes. 2016 Nov 24; 9(1):495.
[13]	Mark A. Canfield et al. The prevalence and predictors of anencephaly and spina bifida in Texas. Peadiatric and perinatal epidemiology; 23: 41-50, 2009.
[14]	Ahmed Z. Obiedat Neural tube defects in the Jordan: Is there a seasonal variation? Journal of child neurology; 25(7) 864-866, 2010.

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Dawit Estifanos, Elias Teages Adgoy, Dawit Sereke, Birhane Zekarias, Suzan Marzolf, et al. (2017). The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study. Science Journal of Public Health, 5(6), 452-456. https://doi.org/10.11648/j.sjph.20170506.17

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ACS Style

Dawit Estifanos; Elias Teages Adgoy; Dawit Sereke; Birhane Zekarias; Suzan Marzolf, et al. The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study. Sci. J. Public Health 2017, 5(6), 452-456. doi: 10.11648/j.sjph.20170506.17

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AMA Style

Dawit Estifanos, Elias Teages Adgoy, Dawit Sereke, Birhane Zekarias, Suzan Marzolf, et al. The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study. Sci J Public Health. 2017;5(6):452-456. doi: 10.11648/j.sjph.20170506.17

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@article{10.11648/j.sjph.20170506.17,
  author = {Dawit Estifanos and Elias Teages Adgoy and Dawit Sereke and Birhane Zekarias and Suzan Marzolf and Kifleyesus Tedla},
  title = {The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study},
  journal = {Science Journal of Public Health},
  volume = {5},
  number = {6},
  pages = {452-456},
  doi = {10.11648/j.sjph.20170506.17},
  url = {https://doi.org/10.11648/j.sjph.20170506.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20170506.17},
  abstract = {Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A four-year and eight months (January 1st, 2007 to August 31st, 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and well-documented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.},
 year = {2017}
}

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TY  - JOUR
T1  - The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study
AU  - Dawit Estifanos
AU  - Elias Teages Adgoy
AU  - Dawit Sereke
AU  - Birhane Zekarias
AU  - Suzan Marzolf
AU  - Kifleyesus Tedla
Y1  - 2017/11/17
PY  - 2017
N1  - https://doi.org/10.11648/j.sjph.20170506.17
DO  - 10.11648/j.sjph.20170506.17
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 452
EP  - 456
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20170506.17
AB  - Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A four-year and eight months (January 1st, 2007 to August 31st, 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and well-documented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.
VL  - 5
IS  - 6
ER  -

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Author Information

Dawit Estifanos

Department of Obstetrics and Gynaecology, Ministry of Health, Asmara, Eritrea
Elias Teages Adgoy

Department of Community Medicine and Primary Health Care, Orotta School of Medicine and Dentistry, Asmara, Eritrea
Dawit Sereke

Department of Obstetrics and Gynaecology, Ministry of Health, Asmara, Eritrea
Birhane Zekarias

Department of Obstetrics and Gynaecology, Ministry of Health, Asmara, Eritrea
Suzan Marzolf

Department of Obstetrics and Gynaecology, Ministry of Health, Asmara, Eritrea
Kifleyesus Tedla

Department of Obstetrics and Gynaecology, Ministry of Health, Asmara, Eritrea

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APA Style

Dawit Estifanos, Elias Teages Adgoy, Dawit Sereke, Birhane Zekarias, Suzan Marzolf, et al. (2017). The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study. Science Journal of Public Health, 5(6), 452-456. https://doi.org/10.11648/j.sjph.20170506.17

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ACS Style

Dawit Estifanos; Elias Teages Adgoy; Dawit Sereke; Birhane Zekarias; Suzan Marzolf, et al. The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study. Sci. J. Public Health 2017, 5(6), 452-456. doi: 10.11648/j.sjph.20170506.17

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AMA Style

Dawit Estifanos, Elias Teages Adgoy, Dawit Sereke, Birhane Zekarias, Suzan Marzolf, et al. The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study. Sci J Public Health. 2017;5(6):452-456. doi: 10.11648/j.sjph.20170506.17

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@article{10.11648/j.sjph.20170506.17,
  author = {Dawit Estifanos and Elias Teages Adgoy and Dawit Sereke and Birhane Zekarias and Suzan Marzolf and Kifleyesus Tedla},
  title = {The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study},
  journal = {Science Journal of Public Health},
  volume = {5},
  number = {6},
  pages = {452-456},
  doi = {10.11648/j.sjph.20170506.17},
  url = {https://doi.org/10.11648/j.sjph.20170506.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20170506.17},
  abstract = {Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A four-year and eight months (January 1st, 2007 to August 31st, 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and well-documented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.},
 year = {2017}
}

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TY  - JOUR
T1  - The Prevalence, Trend, and Associated Demographic Factors of Neural Tube Defects at Orotta National Referral Maternity Hospital, Asmara: Retrospective Record Review Study
AU  - Dawit Estifanos
AU  - Elias Teages Adgoy
AU  - Dawit Sereke
AU  - Birhane Zekarias
AU  - Suzan Marzolf
AU  - Kifleyesus Tedla
Y1  - 2017/11/17
PY  - 2017
N1  - https://doi.org/10.11648/j.sjph.20170506.17
DO  - 10.11648/j.sjph.20170506.17
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 452
EP  - 456
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20170506.17
AB  - Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A four-year and eight months (January 1st, 2007 to August 31st, 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and well-documented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.
VL  - 5
IS  - 6
ER  -

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