Prevalence of neural tube defects at Debre Berhan Referral Hospital, North Shewa, Ethiopia. A hospital based retrospective cross-section study

BACKGROUND: Neural tube defect (NTD) is a structural defect of the central nervous system of the developing embryo during the first month of developmental process. Most congenital malformations are potentially preventable cause of perinatal morbidity and mortality. Worldwide, around 10% of infant mortalities are due to nervous system defects. In Ethiopia there are limited published data regarding the prevalence and established preventive strategy of NTDs. The purpose of this study was to assess the prevalence of NTDs among pregnancy outcomes in Debre Berhan Referral Hospital (DBRH), Ethiopia. METHODS: Hospital based retrospective cross sectional, descriptive study was conducted on registration of all pregnancy outcomes from August 30, 2017 to August 30, 2019 at DBRH, Ethiopia. The collected data were checked for completeness and consistencies, and cleaned, coded and entered using Epi data version 4.2 and exported to Statistical Package for Social Sciences (SPSS) software version 20 for analysis. Variables were interpreted per 1000 pregnancies and those variables having p<0.05 was considered as statistically significant. RESULTS: The total prevalence of NTDs was 10.9 (95% CI 8.9 to 13.3) per 1000 pregnancies and the prevalence of each NTD type was anencephaly 5.6 (95% CI 4.2 to 7.4) per 1000 pregnancies, spina bifida 3.5 (95% CI 2.4 to 4.9) per 1000 pregnancies, encephalocele 1.1 (95% CI 0.6 to 2.0) per 1000 pregnancies, and both spina bifida and anencephaly 0.7(95% CI 0.3 to 1.4) per 1000 pregnancies. Among livebirths, aborted, stillbirths and medically terminated pregnancies (n = 8862), there were 50 anencephaly cases, 31 spina bifida cases, 10 encephalocele cases, and 6 cases affected by both spina bifida and anencephaly. CONCLUSION: The prevalence of NTDs in this study was among the highest globally reported. The total prevalence was 10.9 per 1000 pregnancies. Increased periconceptional folic acid use, counseling for women with certain medical illnesses at higher risk for NTDs, and early maternal screening for genetic factors are possible approaches to reduce in NTDs in the population.