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Abstract：
BACKGROUND: Neural tube defects are a significant cause of morbidity and mortality that can occur in the early pregnancy periods. Though the burden is high, it gains only limited attention. In Ethiopia, the estimated number of neural tube defect cases was significantly higher. So, identifying factors contributing to it would be significant for planning risk reduction and preventive strategies. Therefore, identifying the possible determinants was aimed at this study.
METHODS: A hospital-based, unmatched case-control study was conducted on 104 cases and 208 controls selected from neonatal intensive care units of teaching hospitals in Gedeo Zone and Sidama Region, southern Ethiopia from December 2021 to November 2022. All neural tube defect cases were included consecutively and controls were selected by using a simple random sampling method. Data were collected using interviewer-administered semistructured questionnaires. Data analysis was done by using SPSS V.25. Binary logistic regression was used, and variables with a p value less than 0.25 in bivariate analysis were entered into the multivariable logistic regression model. An adjusted OR with a 95% CI was estimated, and finally, variables that show a level of p value less than 0.05 in multivariable analysis were declared statistically significant.
RESULTS: After controlling confounders, factors such as unplanned pregnancy 2.20 (95% CI 1.20 to 4.041), history of abortions 2.09 (95% CI 1.19 to 3.67), khat chewing 6.67 (95% CI 2.95 to 15.06), antipyretic and analgesic medications 2.87 (95% CI 1.47 to 5.56) and, being a female neonate 2.11 (95% CI 1.21 to 3.67) were significantly associated with a neural tube defect.
CONCLUSIONS: This study has identified some determinants of neural tube defects. Hence, the behavioural, medical and obstetrical conditions of mothers need serious evaluation in the prepregnancy period. So, improving preconception counselling and prenatal care practices would have a significant role in reducing the risk of neural tube defects.
METHODS: A hospital-based, unmatched case-control study was conducted on 104 cases and 208 controls selected from neonatal intensive care units of teaching hospitals in Gedeo Zone and Sidama Region, southern Ethiopia from December 2021 to November 2022. All neural tube defect cases were included consecutively and controls were selected by using a simple random sampling method. Data were collected using interviewer-administered semistructured questionnaires. Data analysis was done by using SPSS V.25. Binary logistic regression was used, and variables with a p value less than 0.25 in bivariate analysis were entered into the multivariable logistic regression model. An adjusted OR with a 95% CI was estimated, and finally, variables that show a level of p value less than 0.05 in multivariable analysis were declared statistically significant.
RESULTS: After controlling confounders, factors such as unplanned pregnancy 2.20 (95% CI 1.20 to 4.041), history of abortions 2.09 (95% CI 1.19 to 3.67), khat chewing 6.67 (95% CI 2.95 to 15.06), antipyretic and analgesic medications 2.87 (95% CI 1.47 to 5.56) and, being a female neonate 2.11 (95% CI 1.21 to 3.67) were significantly associated with a neural tube defect.
CONCLUSIONS: This study has identified some determinants of neural tube defects. Hence, the behavioural, medical and obstetrical conditions of mothers need serious evaluation in the prepregnancy period. So, improving preconception counselling and prenatal care practices would have a significant role in reducing the risk of neural tube defects.
摘要：
背景：神经管缺陷是妊娠早期可能发生的发病率和死亡率的重要原因。虽然负担很高，它只获得了有限的关注。在埃塞俄比亚,估计的神经管缺损病例数明显较高.所以,确定促成这一点的因素对于规划降低风险和预防策略具有重要意义。因此,本研究旨在确定可能的决定因素.
方法：以医院为基础，从Gedeo区和Sidama地区的教学医院的新生儿重症监护病房中选择的104例和208例对照进行了无匹配的病例对照研究，从2021年12月到2022年11月，埃塞俄比亚南部。连续纳入所有神经管缺陷病例，并使用简单随机抽样方法选择对照。数据是使用采访者管理的半结构化问卷收集的。数据分析采用SPSSV.25。使用二元逻辑回归，将双变量分析中p值小于0.25的变量输入多变量逻辑回归模型。估计了95%CI的调整后OR，最后，在多变量分析中显示p值小于0.05的变量被认为具有统计学意义.
结果：在控制混杂因素后，非计划妊娠2.20(95%CI1.20至4.041)等因素，堕胎史2.09（95%CI1.19至3.67），卡塔咀嚼6.67（95%CI2.95至15.06），解热和镇痛药物2.87（95%CI1.47至5.56）和，女性新生儿2.11(95%CI1.21~3.67)与神经管缺损显著相关。
结论：本研究确定了神经管缺陷的一些决定因素。因此，行为，母亲的医疗和产科状况需要在孕前进行认真评估。所以,改善孕前咨询和产前护理实践将在降低神经管缺陷风险方面发挥重要作用.
方法：以医院为基础，从Gedeo区和Sidama地区的教学医院的新生儿重症监护病房中选择的104例和208例对照进行了无匹配的病例对照研究，从2021年12月到2022年11月，埃塞俄比亚南部。连续纳入所有神经管缺陷病例，并使用简单随机抽样方法选择对照。数据是使用采访者管理的半结构化问卷收集的。数据分析采用SPSSV.25。使用二元逻辑回归，将双变量分析中p值小于0.25的变量输入多变量逻辑回归模型。估计了95%CI的调整后OR，最后，在多变量分析中显示p值小于0.05的变量被认为具有统计学意义.
结果：在控制混杂因素后，非计划妊娠2.20(95%CI1.20至4.041)等因素，堕胎史2.09（95%CI1.19至3.67），卡塔咀嚼6.67（95%CI2.95至15.06），解热和镇痛药物2.87（95%CI1.47至5.56）和，女性新生儿2.11(95%CI1.21~3.67)与神经管缺损显著相关。
结论：本研究确定了神经管缺陷的一些决定因素。因此，行为，母亲的医疗和产科状况需要在孕前进行认真评估。所以,改善孕前咨询和产前护理实践将在降低神经管缺陷风险方面发挥重要作用.
