Article: Prevalence of neural tube defect and its identification during antenatal period: a cross-sectional study in eastern Indian state

Objective: To estimate the prevalence of neural tube defects among all birth outcomes in Odisha during 2016-2022. Additionally, to estimate the identification rate of neural tube defects during Pradhan Mantri Surakshit Matritva Abhiyan sessions.

Design: A population-based cross-sectional study with a household survey for neural tube defects using pictorial card as well as a hospital-based study for antenatal ultrasonography data.

Setting: The sample population was selected through multistage random sampling. In the first stage, one district from each zone was selected randomly. In the second stage, using simple random sampling, one community health centre and one urban primary health centre were selected from each district. In the third stage, the population from a block and ward were picked from the selected rural and urban settings, respectively.

Participants: All married women in the reproductive age group (18-49 years) residing in these cluster villages in the selected districts were enrolled.

Results: The study surveyed 49 215 women and recorded 50 196 birth outcomes, including 49 174 live births, 890 stillbirths and 132 medical terminations of pregnancy. A total of 30 neural tube defect cases were detected. The overall prevalence rate of neural tube defect was 0.59 per 1000 birth outcomes. Spina bifida was the most prevalent neural tube defect with the prevalence of, followed by anencephaly and encephalocele. Despite 26 860 mothers receiving antenatal ultrasonography Pradhan Mantri Surakshit Matritva Abhiyan session, data on neural tube defects and other birth defects detected through these scans is unavailable.

Conclusion: This study found a low prevalence of neural tube defect in Odisha, which is far lower compared with the older studies from India. There is an urgent need to strengthen the quality of antenatal care services provided under Pradhan Mantri Surakshit Matritva Abhiyan through better training regarding anomaly scans and better data keeping at public healthcare facilities.

Trial Registration Number: CTRI/2021/06/034487.

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References

1.

Allagh K, Shamanna B, Murthy G, Ness A, Doyle P, Neogi S . Birth prevalence of neural tube defects and orofacial clefts in India: a systematic review and meta-analysis. PLoS One. 2015; 10(3):e0118961. PMC: 4358993. DOI: 10.1371/journal.pone.0118961. View

2.

Kant S, Malhotra S, Singh A, Haldar P, Kaur R, Misra P . Prevalence of neural tube defects in a rural area of north india from 2001 to 2014: A population-based survey. Birth Defects Res. 2016; 109(3):203-210. DOI: 10.1002/bdra.23578. View

3.

Bhide P, Sagoo G, Moorthie S, Burton H, Kar A . Systematic review of birth prevalence of neural tube defects in India. Birth Defects Res A Clin Mol Teratol. 2013; 97(7):437-43. DOI: 10.1002/bdra.23153. View

4.

Murphy M, Westmark C . Folic Acid Fortification and Neural Tube Defect Risk: Analysis of the Food Fortification Initiative Dataset. Nutrients. 2020; 12(1). PMC: 7019961. DOI: 10.3390/nu12010247. View

5.

Cherian A, Seena S, Bullock R, Antony A . Incidence of neural tube defects in the least-developed area of India: a population-based study. Lancet. 2005; 366(9489):930-1. DOI: 10.1016/S0140-6736(05)67319-9. View

6.

Zaganjor I, Sekkarie A, Tsang B, Williams J, Razzaghi H, Mulinare J . Describing the Prevalence of Neural Tube Defects Worldwide: A Systematic Literature Review. PLoS One. 2016; 11(4):e0151586. PMC: 4827875. DOI: 10.1371/journal.pone.0151586. View

7.

Dandona R, Majumder M, Akbar M, Bhattacharya D, Nanda P, Kumar G . Assessment of quality of antenatal care services in public sector facilities in India. BMJ Open. 2022; 12(12):e065200. PMC: 9716787. DOI: 10.1136/bmjopen-2022-065200. View

8.

Rai S, Singh R, Pandey S, Singh K, Shinde N, Rai S . High incidence of neural tube defects in Northern part of India. Asian J Neurosurg. 2016; 11(4):352-355. PMC: 4974957. DOI: 10.4103/1793-5482.175628. View

9.

Choudhury A, Mukherjee M, Sharma A, Talukder G, Ghosh P . Study of 1,26,266 consecutive births for major congenital defects. Indian J Pediatr. 1989; 56(4):493-9. DOI: 10.1007/BF02722422. View

10.

Berhane A, Belachew T . Trend and burden of neural tube defects among cohort of pregnant women in Ethiopia: Where are we in the prevention and what is the way forward?. PLoS One. 2022; 17(2):e0264005. PMC: 8856542. DOI: 10.1371/journal.pone.0264005. View

11.

Lennon C, Gray D . Sensitivity and specificity of ultrasound for the detection of neural tube and ventral wall defects in a high-risk population. Obstet Gynecol. 1999; 94(4):562-6. DOI: 10.1016/s0029-7844(99)00399-3. View

Prevalence of Neural Tube Defect and Its Identification During Antenatal Period: a Cross-sectional Study in Eastern Indian State