背景:神经管缺陷(NTDs)是由营养引起的严重出生缺陷,遗传或环境因素。由于NTD继续对儿童和整个社区产生重大的健康和经济影响,为了开发新的NTDs预防方法,调查潜在的危险因素至关重要。NTD发展的决定因素因国家而异,地区以及国内。这项研究的目的是确定在埃塞俄比亚东部三所医院分娩的新生儿中NTD的决定因素。
方法:对2021年在埃塞俄比亚东部三家教学医院分娩的138例病例和138例对照妇女进行了一项基于医院的配对病例对照研究。使用结构化和预先测试的面试官管理的问卷收集数据。病例为母亲,无论胎龄或胎儿生存能力如何,分娩的新生儿均患有任何类型的NTDs。而对照组是分娩明显健康新生儿的母亲。卡方用于评估两组之间的显著差异。使用条件逻辑回归模型生成校正比值比及其相应的95%置信区间,并比较两组。
结果:无脑(51.4%)和脊髓裂(34.1%)是最常见的NTDs。没有研究参与者服用孕前叶酸补充剂。作为非正规母亲(AOR=0.34,95%CI:0.12-0.92,P=0.034),农村住宅,(AOR=3.4,95%CI:1.18-9.78,P=0.023),自然流产史(AOR=2.95,95%CI:1.15-7.55,P=0.023),严重贫血(AOR=3.4,95%CI:1.17-9.87,P=0.024),有发热或感冒病史(AOR=2.75;95%CI:1.05-7.15,P=0.038),和暴露于各种农用化学品(AOR=3.39,95%CI:1.11-10.3,P=0.032)是NTD的独立决定因素。
结论:在这项研究中,NTD与该地区的几个决定因素有关,包括住宅区,自然流产史,严重贫血,发烧/感冒,在怀孕前或怀孕期间使用抗生素,和接触农用化学品。解决确定的决定因素对于避免研究区域中NTD的发生率至关重要。此外,需要更多的研究来调查妇女的饮食习惯以及在埃塞俄比亚目前的医疗保健系统中,孕妇在孕前补充叶酸的做法。
Neural tube defects (
NTDs) are severe birth defects caused by nutritional, genetic or environmental factors. Because
NTDs continue to have a significant health and economic impact on children and community at large, it is crucial to investigate potential risk factors in order to develop novel approaches to NTDs prevention. Determinants for the development of
NTDs differ by country, region as well as within the country. The objective of this study was to identify the determinants of
NTDs among newborns delivered in three hospitals found in eastern Ethiopia.
A hospital-based matched case-control study was conducted among 138 cases and 138 control women who delivered in three teaching hospitals in Eastern Ethiopia in 2021. Data were collected using a structured and pre-tested interviewer-administered questionnaire. Cases were mothers who delivered a neonate with any type of NTDs regardless of gestational age or fetal viability, whereas controls were mothers who delivered an apparently healthy newborn. Chi-square was used to assess the significant difference between the two groups. Conditional logistic regression model was used to generate adjusted odds ratio with its corresponding 95% confidence intervals and compare the two groups.
Anencephaly (51.4%) and spinal bifida (34.1%) were the most frequently observed
NTDs. None of study participants took preconception folic acid supplementation. Being a non-formal mothers (AOR = 0.34, 95% CI: 0.12-0.92, P = 0.034), rural residence, (AOR = 3.4, 95% CI: 1.18-9.78, P = 0.023), history of spontaneous abortion (AOR = 2.95, 95% CI: 1.15-7.55, P = 0.023), having severe anemia (AOR = 3.4, 95% CI: 1.17-9.87, P = 0.024), history of fever or cold (AOR = 2.75; 95% CI: 1.05-7.15, P = 0.038), and an exposure to various agro-chemicals (AOR = 3.39, 95% CI: 1.11-10.3, P = 0.032) were independent determinants of NTDs.
In this study, NTDs were associated to several determinant factors in the area, including residential area, history of spontaneous abortion, severe anemia, fever/cold, antibiotic use before or during early pregnancy, and exposure to agrochemicals. Addressing the identified determinants is critical in averting the incidence of NTDs in the study area. Moreover, more research is needed to investigate women\'s dietary practices as well as the practice of preconception folic acid supplementation for pregnant women in Ethiopia\'s current health care system.