Maternal Risk Factors Associated with Neural Tube Defect at Debre Berhan Referral Hospital, North Shewa, Ethiopia. A Hospital Based Case Control Study

Abstract Background: - Birth defects are congenital anomalies that are present at birth of the neonate, and can be structural, functional, or metabolic. Structural birth defects are those that affect the development of body part. Failure of the neural tube to close at different regions result in positional variations of neural tube defects (NTDs). It is caused through multifactorial disorders, arising from a complex combination of genetic determinants and environmental factors. Therefore, the purpose of this study was to assess the maternal risk factor associated with NTDs among pregnant outcome in Debre Berhan Referral Hospital, North Shewa, Ethiopia.Methods: - Hospital based unmatched case control study was conducted among 50 cases and 100 controls for associated risk factors of NTDs. The study was carried out at Debre Berhan Referral Hospital from August 30/2017 to August 30/2019. The data was checked for completeness and consistencies, and cleaned, coded and entered using Epi data version 4.2 and was exported to Statistical Package for Social Sciences software version 20 for analysis. Variables having p<0.05 was consider as statistically significant.Results: - In this study 50 cases and 100 controls were employed. Logistic regression analysis showed that maternal age, <20 (p=0.046), maternal age 31-35 (p=0.028), no education (p=0.014), family history of NTDs (p=0.034), history of multiparous (p=0.002), history of abortion (p=0.024) and still birth (p=0.009), No ANC follow up, unplanned pregnancy (p=0.000), history of medical illness (p=0.001), hyperthermia (p=0.000), used antipyretics drugs (p=0.002), Never use of folic acid and oral contraceptive use (p=0.001), exposure to smoking (p=0.001) and pesticides (p=0.000), and use of local alcohol (p=0.000) had significant association with NTDs.Conclusions: - Family history of NTDs, coffee and alcohol consumption, maternal no education, maternal hyperthermia and disease, maternal antipyretic use, maternal age <20 and 31-35, exposure to pesticides and smoking were associated with the increasing the risk of NTDs. Comprehensive preventive strategies focused on the identified risk factors should be established and early preconceptional maternal screening for genetic factors and medical illness as well as preconceptional folic acid supplementation are the effective possible approaches to bring about the required reduction in NTDs.