Factors Associated with Neural Tube Defects of Neonates in Al-Najaf Government

Abstract

Objective: To identify the association of neural tube defects with some possible risk factors in Iraqi neonates. Methodology: This is a hospital based case control study carried out in two major hospitals in AL Najaf province during the period (first of February through the end of May 2014). All the available fifty responded cases of neonates with gross Neural Tube Defects (NTDs) who were diagnosed and confirmed as neural tubes defects by specialist pediatrician were studied as cases and compared with (100) randomly selected sex and age matched control group neonates ( Free of neural tube defects). Data collection were done through a structured questionnaire by interviewing mothers of both groups single handy by the researcher ,Odds Ratios (OR)were calculated to identify the probable risk factors of neural tube defects. Results: The proportions of types of neural tubes defects in this study were; spina bifida (52%), encephalocele (36%) and anencephaly (12%). the factors that significantly associated with increased risk for NTDs were a lack of folic acid supplementation (OR=12.55, (95% confidence interval CI 5.59-28.17); poor ante natal care OR=3.67(95% CI 1.80-7.48), abortions OR=5.52(95% 2.64-11-54) ,previous still birth OR=2.02( CI 95% 0.79-5.14), number of parity OR=1.10( CI 95% 0.48-2.30), maternal smoking OR=2.25( CI 95% 0.87-5.83) maternal age 0R=1.95 (0.88-4.31), maternal family history OR=1.36(0.37-5.1), maternal educational level [low educational level] was OR=4.86[2.2-10.9], while paternal factors were father family history of neural tube defect OR=21.7[2.67-53.42] ,father smoking OR=3.8 [1.77-8.34] father age OR=4.04 [1.55-10.55]. Residence OR=3.78[1.85-7.72], consanguinity OR=3.84[1.77-8.34] ,while the association between neonates factors and anomalies were age of neonates OR=2.125[1.10-4.30], birth weight OR=1.52[0.72-3.30]. Conclusion: The main factors that associated positively with neural tube defects among others factors were ( father family history of neural tube defects, lack of folic acid supplementations ,mothers with low education and consanguinity marriages) which highly significant and strongly effects in neural tubes defects among others factors ,while mothers with higher education was protected them siblings of this anomaly and found the number of parity had no relation on neural tube defects formation. Recommendation: Confirmation to avoid internal marriages and especially for families that have birth defects and an emphasis on taking the tab of folic acid before and during pregnancy in dose (400-500 micrograms) for women with children deformed previously or frequent abortion or who take drugs interferon Folic acid, parents should avoid smoking and urge the supplement level of science education due to increasing awareness of the health help them avoid all the factors causing neural tube defects