Determinants of Neural Tube Defect Among Newborns Admitted to Neonatal Intensive Care Units of Teaching Hospitals in Gedeo Zone and Sidama Region, Southern Ethiopia; A Case Control Study

Abstract Background: A neural tube defect is a form of congenital malformation that can occur in the early embryonic period and result in child morbidity and mortality. Little emphasis is given to congenital anomalies, especially neural tube defects, which are significant causes of child death. Ethiopia is one of the countries with a high estimated prevalence of neural tube defects. So, identifying factors contributing to it would be significant for planning risk reduction and preventive strategies. Therefore this study aimed to identify determinants of neural tube defects among neonates admitted to neonatal intensive care units. 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. All neural tube defect cases admitted at the time of the data collection period were included, and controls were selected using a simple random sampling method. Data analysis was done using SPSS version 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 odds ratio with a 95% confidence interval was estimated, and finally, variables that show a level of P value less than 0.05 in multivariable analysis were declared statistically significant. Result; after controlling confounders, factors like unplanned pregnancy 2.20(1.20- 4.041), history of abortions 2.09(1.19-3.67), khat chewing 6.67(2.95-15.06), antipyretic and analgesic medications 2.87(1.47-5.56) and, being a female neonate 2.11(1.21-3.67) were significantly associated with a neural tube defect. Conclusion: In this study, different determinants were identified and linked with neural tube defects .hence, the behavioral, medical, and obstetrical conditions of mothers need serious evaluation in the pre-pregnancy period. So it is highly recommended to improve preconception counseling and prenatal care practices, which could reduce the risk of neural tube defects.