महिला स्वास्थ्य देखभाल जर्नल
खुला एक्सेस
आईएसएसएन: 2167-0420
आईएसएसएन: 2167-0420
Mohamed Abdiqadir Ahmed1*, Roda Adan Abdilahi1, Alemayehu Bayray Kahsay2
Introduction: Neural Tube Defects (NTDs) are structural defects of the central nervous system that affect the brain, spine, and spinal column of the developing embryo during the first month of the developmental process. It is one of the top five most serious birth defects in the world. In Somaliland, an accurate estimate of the burden of neural tube defects is still unknown.
Objective: The aim of this study is to determine the overall magnitude and associated factors of neural tube defects in public and private hospitals in Hargeisa, Somaliland.
Methods: We conducted this study in three comprehensive and referral hospitals in Somaliland. A three-year review of the charts of mothers who delivered in these hospitals between January 1, 2019 and December 31, 2022, was done. Moreover, in addition to the data extraction checklist, we developed a structured questionnaire and telephone interviewed 384 randomly selected mothers, including all the mothers with children with neural tube defects. The data were collected by BSc midwives who were trained for 3 days on the methods of data collection. Data were entered, edited, and coded using SPSS Version 23. Descriptive statistics and numerical summary measures were done. Moreover, bivariate and multivariable logistic regression analysis was done to determine factors associated with NTD. Findings were interpreted using the Odds Ratio (OR), with its corresponding 95% C.I. and, P-value <0.05 was considered statistically significant. Finally, results were presented using text, tables, and figures.
Results: A total of 58 NTD cases were identified out of 36,489 live births registered in the three hospitals in Hargeisa, making the overall prevalence of NTDs to be 15.9 per 10,000 births. The most common types of neural tube defects found in the area were hydrocephalus (3.8 cases per 10,000 births), spinal bifida (3.6 cases per 10,000 births) respectively. Mothers in the age groups 33–37 and 38–42 had higher proportions of neural tube defects. According to the multivariable analysis, those with a maternal age of 28–32 have an increased risk of NTD by 27% (AOR: 1.27, 95% CI: 3.32, 4.21), and for those whose ages are between 38 and 42 years, the risk is increased by 9.1 times (AOR: 9.1, 95% CI: 2.70, 30.57). However, gestational age at full term at labor and folic acid intake showed a protective association with neural tube defects (AOR: 0.35, 95% CI 0.16, 0.75) and (AOR: 0.43, 95% CI 0.25, 0.91), respectively. Medication intake increases the risk of developing NTD by 2 times (AOR: 2.05, 95% CI: 1.07, 3.94), while those who take unidentified drugs are 4.47 times more likely to develop NTD (AOR: 4.47, 95% CI: 0.75, 26.72). Caffeine consumption also increased the risk of NTDs by 2.78 times (AOR: 2.78, 95% CI: 1.26, 6.09). Metabolic diseases like gestational diabetes and gestational hypertension were also significantly associated with neural tube defects (AOR: 6.3, 95% CI: 2.01, 19.67) and (AOR: 4.1, 95% CI: 2.06, 8.15), respectively.
Conclusion: The overall prevalence of Neural Tube Defects (NTD) in Somaliland is relatively lower than in other countries in Africa. The most common types of neural tube defects found in the area were hydrocephalus and spinal bifida, respectively. The magnitude of NTDs increased with the mother's age. Maternal age, medication intake, consumption of caffeine, and metabolic diseases like gestational diabetes and gestational hypertension were positively associated with NTDs. However, delivery at full term and folic acid intake during pregnancy were found to have a protective association with NTDs. Hence, health care professionals should focus on maternal safe drug prescription and maternal folate intake and strengthen the existing system in terms of providing maternal health services before and during pregnancy.