Neural Tube Defects: Pattern, Incidence and short-term outcome in Omdurman Maternity Hospital, Sudan

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Eltahir, Ghada
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In the developed countries, great improvement had occurred in the management of childhood illnesses which made the congenital diseases a major cause of infant morbidity and mortality, neural tube defects(NTDs) being one of them. In the last two decades a great effort has been done on NTDs leading to reduction in their incidence. The objectives of this prospective hospital based study were to: 1) determine the incidence of NTDs in Omdurman Maternity Hospital 2) describe the spectrum of NTDs, 3) detect any associated congenital anomalies 4) assess the role of the sociodemographic factors, and 5) study the short term outcome of NTDs. All babies born in Omdurman Maternity Hospital during the period from the 1st of February 2003 to the 31st of January 2004 with clinically detectable NTDs were examined and for each case consecutive normal birth was taken as a control. The surviving cases were followed up for the following three months. The incidence of NTDs was 3.48/1000, 47.6% of the cases were myelomeningocele, 36.5% were anencephaly, 14.2% encephalocele and one case was iniencephaly. Most of the cases were either stillborn or died in the early neonatal period. The male to female ratio was 1:5 and 20 % of the NTDs had other congenital anomalies . About 60% of the mothers were less <25 years of age and there was a significant association between NTDs and mother age (relative risk 2.3, p<O.0001). Most of the parents of babies with NTDs had poor educational background , 54.8% of mothers had a significant history of previous stillbirth delivery. Only 30% of mothers had antenatal care. No mothers from the case or control group had used folic acid preconceptionally. It is concluded that the incidence of NTDs in Omdurman Maternity Hospital is the highest in Africa and this invites a nationwide registry for all congenital anomalies and improvement in the obstetric services including active promotion of folic acid supplementation programs.
Neura,l Tube, Defects,Open,Closed