Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries

Abstract Background The Tigray region of Ethiopia has a significantly high prevalence of neural tube defects (NTDs), ranging from 1.31 to 2.15% of total births. The prevalence has worsened due to ongoing regional war and conflict since October 2020. This study aims to assess NTD prevalence in these...

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Main Authors: Birhane Alem Berihu, Afework Mulugeta, Tony Magana, Masresha Tessema, Tafere Gebreegziabher, Yibrah Berhe, Abadi Leul Welderufael, Hayelom Kebede Mekonen
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07254-3
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author Birhane Alem Berihu
Afework Mulugeta
Tony Magana
Masresha Tessema
Tafere Gebreegziabher
Yibrah Berhe
Abadi Leul Welderufael
Hayelom Kebede Mekonen
author_facet Birhane Alem Berihu
Afework Mulugeta
Tony Magana
Masresha Tessema
Tafere Gebreegziabher
Yibrah Berhe
Abadi Leul Welderufael
Hayelom Kebede Mekonen
author_sort Birhane Alem Berihu
collection DOAJ
description Abstract Background The Tigray region of Ethiopia has a significantly high prevalence of neural tube defects (NTDs), ranging from 1.31 to 2.15% of total births. The prevalence has worsened due to ongoing regional war and conflict since October 2020. This study aims to assess NTD prevalence in these challenging conditions. Methods This institution-based, retrospective cross-sectional study was conducted across 11 public hospitals in the Tigray region. The study reviewed all delivery records from October 2020 to December 2023. Data were collected from hospital records, focusing on cases of neural tube defects (NTDs) and relevant maternal and neonatal characteristics. This retrospective analysis aimed to identify the prevalence of NTDs, as well as factors contributing to their occurrence. The data analysis involved using SPSS version 27 for comprehensive data management and statistical evaluation. Descriptive statistics provided an overview of the data, while binary logistic regression offered insights into the factors associated with neural tube defects. The results were systematically presented in both textual, tabular, graph formats to facilitate understanding and interpretation. Results Out of 54,626 delivery records, 1,612 cases of NTDs were identified (1,434 NTD cases and 178 isolated hydrocephalus cases). The specific birth prevalence of NTDs was 262.5 per 10,000 (95% CI, 249.1-276.5 per 10,000), with NTDs being the predominant cause of stillbirths. Anencephaly (136.6 per 10,000), spina bifida (110.6 per 10,000) and encephalocele (15.4 per 10,000) were the most common defects. Risk factors for NTDs include maternal age (20–29 years), rural residency, first pregnancies, a history of early neonatal death, lack of folic acid and multivitamin use, as well as neonatal factors like stillbirth, male sex, and preterm birth. Conclusion This study reveals the alarmingly high prevalence of neural tube defects (NTDs) in the Tigray region, with a birth prevalence of 262.5 per 10,000 births. Anencephaly, spina bifida, and encephalocele were common, contributing to stillbirths. Risk factors include maternal age (20–29), rural residency, first pregnancies, lack of folic acid and multivitamins, and neonatal factors like male sex and preterm birth. The findings stress the need for public health interventions, including folic acid awareness, better prenatal care, maternal nutrition research, stronger health systems, and a national surveillance system to prevent birth defects.
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spelling doaj-art-02202dbaacdb4f75ae80996941991ec72025-02-09T12:59:13ZengBMCBMC Pregnancy and Childbirth1471-23932025-02-0125111210.1186/s12884-025-07254-3Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveriesBirhane Alem Berihu0Afework Mulugeta1Tony Magana2Masresha Tessema3Tafere Gebreegziabher4Yibrah Berhe5Abadi Leul Welderufael6Hayelom Kebede Mekonen7Department of Anatomy, school of medicine, Institute of Biomedical sciences, College of Health Sciences, Mekelle UniversityDepartment of nutrition, School of Public Health, College of Health Sciences, Mekelle UniversityDepartment of neurosurgery, school of medicine, College of Health Sciences, Mekelle UniversityEthiopian public health instituteDepartment of Health Sciences, Central Washington UniversityDepartment of Obstetrics and Gynecology, school of medicine, College of Health Sciences, Mekelle UniversityDepartment of Pediatrics and child health, school of medicine, College of Health Sciences, Mekelle UniversityDepartment of Anatomy, school of medicine, Institute of Biomedical sciences, College of Health Sciences, Mekelle UniversityAbstract Background The Tigray region of Ethiopia has a significantly high prevalence of neural tube defects (NTDs), ranging from 1.31 to 2.15% of total births. The prevalence has worsened due to ongoing regional war and conflict since October 2020. This study aims to assess NTD prevalence in these challenging conditions. Methods This institution-based, retrospective cross-sectional study was conducted across 11 public hospitals in the Tigray region. The study reviewed all delivery records from October 2020 to December 2023. Data were collected from hospital records, focusing on cases of neural tube defects (NTDs) and relevant maternal and neonatal characteristics. This retrospective analysis aimed to identify the prevalence of NTDs, as well as factors contributing to their occurrence. The data analysis involved using SPSS version 27 for comprehensive data management and statistical evaluation. Descriptive statistics provided an overview of the data, while binary logistic regression offered insights into the factors associated with neural tube defects. The results were systematically presented in both textual, tabular, graph formats to facilitate understanding and interpretation. Results Out of 54,626 delivery records, 1,612 cases of NTDs were identified (1,434 NTD cases and 178 isolated hydrocephalus cases). The specific birth prevalence of NTDs was 262.5 per 10,000 (95% CI, 249.1-276.5 per 10,000), with NTDs being the predominant cause of stillbirths. Anencephaly (136.6 per 10,000), spina bifida (110.6 per 10,000) and encephalocele (15.4 per 10,000) were the most common defects. Risk factors for NTDs include maternal age (20–29 years), rural residency, first pregnancies, a history of early neonatal death, lack of folic acid and multivitamin use, as well as neonatal factors like stillbirth, male sex, and preterm birth. Conclusion This study reveals the alarmingly high prevalence of neural tube defects (NTDs) in the Tigray region, with a birth prevalence of 262.5 per 10,000 births. Anencephaly, spina bifida, and encephalocele were common, contributing to stillbirths. Risk factors include maternal age (20–29), rural residency, first pregnancies, lack of folic acid and multivitamins, and neonatal factors like male sex and preterm birth. The findings stress the need for public health interventions, including folic acid awareness, better prenatal care, maternal nutrition research, stronger health systems, and a national surveillance system to prevent birth defects.https://doi.org/10.1186/s12884-025-07254-3Neural tube defectsSpina BifidaAnencephalyEncephaloceleStillbirthsLive births
spellingShingle Birhane Alem Berihu
Afework Mulugeta
Tony Magana
Masresha Tessema
Tafere Gebreegziabher
Yibrah Berhe
Abadi Leul Welderufael
Hayelom Kebede Mekonen
Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries
BMC Pregnancy and Childbirth
Neural tube defects
Spina Bifida
Anencephaly
Encephalocele
Stillbirths
Live births
title Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries
title_full Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries
title_fullStr Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries
title_full_unstemmed Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries
title_short Neural tube defects in a war-torn Tigray regional state of Ethiopia: a retrospective study of 54,626 deliveries
title_sort neural tube defects in a war torn tigray regional state of ethiopia a retrospective study of 54 626 deliveries
topic Neural tube defects
Spina Bifida
Anencephaly
Encephalocele
Stillbirths
Live births
url https://doi.org/10.1186/s12884-025-07254-3
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