A study on the magnitude of neural tube defects among newborns delivered at a tertiary care hospital

Abstract

Background: In a developing fetus during the stages of embryogenesis, various congenital malformations tend to occur, among which neural tube defects (NTDs) are one of the more serious conditions. They result due to the failure of the closure of the neural tube along its length, which may lead to cranial or spinal defects. This may present with the wastage of the pregnancy as a stillbirth or, in cases of live birth, with serious complications and associated disabilities such as varying degrees of paralysis, neurogenic bladder, and incontinence of urine and stools and hydrocephalus. Numerous risk factors have been linked with the occurrence of NTDs such as genetic susceptibility, low socioeconomic status, exposure to teratogens such as methotrexate, trimethoprim, aminopterin, and valproate and other antiepileptic drugs during pregnancy, deficiency of vitamins like folate and B12 in females and the risk of recurrence of NTDs in future pregnancies to a female with a past pregnancy having NTD. Aims and Objectives: The present study aims to determine the prevalence and types of NTDs among newborns and to study associated anomalies among them with NTDs. Materials and Methods: General Hospital Palanpur, a tertiary care hospital connected with Banas Medical College and Research Institute, Palanpur, was the site of the study. In the current study, the total number of births was recorded during a 3-year period from 2019 to 2021, and total NTDs data were gathered and analyzed to determine the prevalence of NTDs at the hospital, as well as the various types and related abnormalities. Results: The total number of deliveries in the span of 2019–2021 was 3437 of which 21 cases of NTDs were noted. Out of 21, twelve were male and nine were female, which makes it 57.14% male preponderance compared to females. Moreover, the prevalence of NTDs comes out to be 6.1/1000 births in the span of 3 years. Furthermore, this study suggested that among the NTDs, 61.90% were meningomyelocele which makes it more prevalent than encephalocele and spina bifida. It is also seen that NTDs were more common in multigravida females with gravida <3 and gravida ≥3 (28.57% and 47.61%, respectively) and in multipara females with parity <3 and ≥3 (80.95% and 19.04%, respectively). Conclusion: The prevalence of NTDs is not uncommon in our sector, which needs to be addressed by periconceptional folic acid supplementation for all women of childbearing age.