Neural Tube Defects: Epidemiologic Factors, Clinical Presentation And Outcome In North Eastern Nigeria

Abstract

Background: Neural tube defects (NTDs) are important factors in fetal and infant morbidity and mortality with variations in incidence and ethnic distribution. This study was carried out to determine the epidemiologic factors, clinical presentation, types and immediate neonatal outcome of neural tube defects.
Methods: The clinical records of all babies admitted with NTDs into the Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital (UMTH) were prospectively reviewed over a 5-year period.
Results: A total of 103 babies were admitted with NTDs. The overall incidence of NTDs in this study was 43/1000 admission with a yearly admission rate of between 2.3 – 8%. The age of the mothers ranged from 15 to 38 years. There were 56 (54.4%) males and 47 (45.6%) females. Of the 103 babies, 87 (84.5%) had spina bifida cystica, 15 (14.6%) had occipital encephalocele, while 1 (0.9%) had anencephaly and died within 8 hours of delivery. All the 87 patients with spina bifida cystica were ruptured and infected at presentation, with seven of them dying from overwhelming sepsis. Most of the babies (58.3%) were delivered at home. Only 2 of them were delivered at the University of Maiduguri Teaching Hospital, Maiduguri.
Conclusion: The incidence of NTDs in this study was high and on the increase with many of the mothers booking late for antenatal care and delivering at home. There is the need for improvements in all factors that will encourage women attend antenatal clinic and deliver in the hospital. The need for folic acid supplementation in women of childbearing age and fortification of foodstuff with folic acid is highlighted.


Keywords: Clinical presentation, Immediate neonatal outcome, Nigeria

Sahel Medical Journal Vol. 11 (1) 2008: pp. 34-37