Risk factors associated to neural tube defects among mothers who gave birth in North Shoa Zone Hospitals, Amhara Region, Ethiopia 2020: Case control study

Abstract

Introduction Neural tube defects affect the brain and the spinal cord of the developing embryo. The defects occur due to incomplete or failure of closure of the neural tube. The condition eventually causes death and lifelong disability. Worldwide, more than 300,000 babies are born with neural tube defects each year. The highest burden is in low- and middle-income countries. Therefore, this study aims to identify the risk factors associated with neural tube defects among mothers who gave birth in North Shoa Zone Hospitals. Methods A hospital based unmatched case-control study was conducted among 243 (81 cases and 162 controls) study participants in North Shoa Zone Hospitals. The hospitals were selected using simple random sampling and all cases and randomly selected controls in the selected hospitals were included in the study. The data were collected by using pre-tested structured questionnaire. Results Different factors were identified to have association with neural tube defect. Family annual cash income less than 24000ETB (AOR: 3.73, 95%CI: 1.35, 10.26), history of still birth (AOR: 3.63, 95%CI: 1.03, 12.2), history of abortion (AOR: 6.15, 95%CI: 2.63, 18.56), preconception tea use (AOR: 2.36, 95%CI: 1.15, 4.86) and pesticides/chemical exposure (AOR: 5.34, 95%CI: 1.77, 16.05) were positively associated factors. In contrast, preconception care (AOR: 0.14, 95%CI: 0.05, 0.39) and taking iron/folic acid/multivitamin during the current pregnancy (AOR: 0.16, 95%CI: 0.07, 0.33) showed a protective effect. Conclusion Family annual income less than 24000ETB, history of still birth, history of abortion, preconception tea uses and pesticides/chemical exposure were associated factors of neural tube defects. Preconception counseling and screening should be recommended for women who plan for pregnancy.

Factors Associated With Neural Tube Defects Among Newborns Delivered at Debre Berhan Specialized Hospital, North Eastern Ethiopia, 2021. Case-Control Study

“…By reviewing maternal medical records, the study population consisted of all newborns delivered at Debre Berhan Comprehensive Specialized Hospital from June 1, 2019 to June 1, 2021. According to the ICD-10 criteria, NTDs cases include anencephaly, spinal bifida, myelomeningocele, and encephalocele occurring either separately or in combination with other congenital malformations ( 21 ), whereas the controls are newborn babies without NTDs ( 22 ).…”

A quest for genetic causes underlying signaling pathways associated with neural tube defects

“…Several studies demonstrated the negative medical side effects caused by an enhanced and indiscriminate use of pesticides ( 69 , 70 ). Several lines of evidence reported that pesticides contribute to significant developmental and reproductive disorders with carcinogenic and teratogenic capabilities ( 69 , 71 , 72 ). Several previous experimental and case reports indicated a connection between congenital disorders and pesticide exposure ( 69 – 71 , 73 , 74 ).…”

“…Several lines of evidence reported that pesticides contribute to significant developmental and reproductive disorders with carcinogenic and teratogenic capabilities ( 69 , 71 , 72 ). Several previous experimental and case reports indicated a connection between congenital disorders and pesticide exposure ( 69 – 71 , 73 , 74 ). A study performed in Washington, USA, showed the increased risk of development of neural tube defects post pesticide exposure ( 75 ).…”

“…A systematic review showed that, due to the heavy usage of pesticides, the occurrence of neural tube defects in neonates is more prominent in developing countries such as those in the African continent ( 72 ). A case report study based on a questionnaire as directed by the WHO found an increased incidence of neural tube defects post-maternal exposure to pesticides ( 71 ). A study conducted on agriculture workers observed a higher incidence of congenital deformities in neonates ( 77 ).…”

Factors Associated with Neural Tube Defects among Women Who Gave Birth at Adama Hospital Medical College, Adama, Ethiopia: A Case Control Study

“…Maternal obstetric factors associated with increased risk of NTDs mentioned in several studies include; unplanned pregnancy ( 19 , 21 , 22 ), previous history of abortion ( 20 ), previous history of stillbirth ( 15 , 19 , 20 , 23 ), gender of the fetus ( 19 , 21 , 22 ), previously affected child ( 23 - 25 ), family history of NTDs ( 17 ), and multivitamin or folic acid supplementation early in pregnancy ( 19 - 23 ). Smoking and indoor air pollution associated with inadequate housing conditions increase the risk of having a fetus with NTDs ( 18 , 26 ).…”