Abstract
BackgroundIn the last two decades, India has witnessed a substantial decrease in infant mortality attributed to infectious disease and malnutrition. However, the mortality attributed to birth defects remains constant. Studies on the prevalence of birth defects such as neural tube defects and orofacial clefts in India have reported inconsistent results. Therefore, we conducted a systematic review of observational studies to document the birth prevalence of neural tube defects and orofacial clefts.MethodsA comprehensive literature search for observational studies was conducted in MEDLINE and EMBASE databases using key MeSH terms (neural tube defects OR cleft lip OR cleft palate AND Prevalence AND India). Two reviewers independently reviewed the retrieved studies, and studies satisfying the eligibility were included. The quality of included studies was assessed using selected criteria from STROBE statement.ResultsThe overall pooled birth prevalence (random effect) of neural tube defects in India is 4.5 per 1000 total births (95% CI 4.2 to 4.9). The overall pooled birth prevalence (random effect) of orofacial clefts is 1.3 per 1000 total births (95% CI 1.1 to 1.5). Subgroup analyses were performed by region, time period, consanguinity, and gender of newborn.ConclusionThe overall prevalence of neural tube defects from India is high compared to other regions of the world, while that of orofacial clefts is similar to other countries. The majority of studies included in the review were hospital based. The quality of these studies ranged from low to moderate. Further well-designed, high quality community-based observational studies are needed to accurately estimate the burden of neural tube defects and orofacial clefts in India.
Highlights
The progress towards achieving the 4th Millennium Development goal of reducing child mortality by two thirds by 2015 in India is slow, compared to other countries in the South East Asia Region [1]
The overall pooled birth prevalence of neural tube defects in India is 4.5 per 1000 total births
The overall pooled birth prevalence of orofacial clefts is 1.3 per 1000 total births
Summary
The progress towards achieving the 4th Millennium Development goal of reducing child mortality by two thirds by 2015 in India is slow, compared to other countries in the South East Asia Region [1]. There has been a decline in the number of deaths in children under five years of age in India from 2.5 million in 2001 to 1.5 million in 2012. Despite this decline India tops the list of countries with the largest number of under five deaths in the world [2]. There has been a decline in the number of deaths in infant and under-5 children attributed to infectious diseases and malnutrition in low and middle income countries; the mortality attributed to birth defects remains constant [1]. Studies on the prevalence of birth defects such as neural tube defects and orofacial clefts in India have reported inconsistent results. We conducted a systematic review of observational studies to document the birth prevalence of neural tube defects and orofacial clefts
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