Birth prevalence of selected external structural birth defects at four hospitals in Dar es Salaam, Tanzania, 2011–2012

Kishimba, Rogath; Mpembeni, Rose; Mghamba, Janneth; Goodman, David A.; Valencia, Diana

doi:10.7189/jogh.05.020411

Cited by 27 publications

(27 citation statements)

References 18 publications

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“…In Africa, neonatal and perinatal deaths due to congenital abnormalities are much higher compared to Europe. In Tanzania, a high perinatal death of 66.7% and neonatal death of 18.5% are caused by congenital malformations . In Nigeria, an earlier study reported about 16% of total perinatal deaths due to congenital malformation, with cardiovascular malformations accounting for 40% of the perinatal deaths .…”

Section: Introductionmentioning

confidence: 99%

Drug‐related teratogenic and pathologic causes of birth defects in a tertiary hospital in Southwestern Nigeria

Offor

Awodele

Oshikoya

2019

Pharmacology Res & Perspec

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Birth defects are important causes of neonatal morbidity and mortality. A good understanding of the etiology is a vital step toward developing improved treatment and preventive strategies. We conducted an audit of medical records of newborns with birth abnormalities in a tertiary hospital over a 10‐year period, using a Pro forma designed to collect information on obstetric history, antenatal history, sociodemographics of parents, and the type of birth abnormality. Of the 180 medical records reviewed, female babies were 92 (51.1%) and male babies were 86 (47.8%). The mean age of the fathers was 38.2 + 6.2, and mothers 31.8 + 4.9. Majority 115 (63.9%) of the mothers had records of acute illnesses, and 23 (12.8%) chronic illnesses during pregnancy. Unspecified febrile illness 44 (38.3%), malaria 40 (34.8%), typhoid 8 (6.9%), hypertension 13 (56.5%), pregestational diabetes 4 (17.4%), and HIV 3 (13.0%) were the commonest maternal pathologies. Most of the documented birth abnormalities were Down's syndrome 34 (15.2%); congenital hydrocephalus 32 (14.3%); acyanotic congenital heart defect 30 (13.4%); deformity of the digits 26 (11.6%); and ventricular septal defect 20 (8.9%). The prevalence of maternal pathologies calls for concern, as these may be implicated in birth defects, therefore should be further investigated in future studies.

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Section: Introductionmentioning

confidence: 99%

Drug‐related teratogenic and pathologic causes of birth defects in a tertiary hospital in Southwestern Nigeria

Offor

Awodele

Oshikoya

2019

Pharmacology Res & Perspec

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“…In Tanzania like most developing countries, limited estimates exist on the magnitude of folate deficiency[ 2 , 6 , 7 ]. As a proxy measure and sequel of folate deficiency among women of reproductive age, the birth prevalence of neural tube defects (NTDs) in Tanzania is estimated to be as high as 3 NTDs per 1000 live births[ 8 , 9 ]. It is estimated that micronutrient deficiencies cost Tanzania over US$ 518 million, estimated at 2.65% of the country’s GDP annually[ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Large –scale wheat flour folic acid fortification program increases plasma folate levels among women of reproductive age in urban Tanzania

et al. 2017

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There is widespread vitamin and mineral deficiency problem in Tanzania with known deficiencies of at least vitamin A, iron, folate and zinc, resulting in lasting negative consequences especially on maternal health, cognitive development and thus the nation’s economic potential. Folate deficiency is associated with significant adverse health effects among women of reproductive age, including a higher risk of neural tube defects. Several countries, including Tanzania, have implemented mandatory fortification of wheat and maize flour but evidence on the effectiveness of these programs in developing countries remains limited. We evaluated the effectiveness of Tanzania’s food fortification program by examining folate levels for women of reproductive age, 18–49 years. A prospective cohort study with 600 non-pregnant women enrolled concurrent with the initiation of food fortification and followed up for 1 year thereafter. Blood samples, dietary intake and fortified foods consumption data were collected at baseline, and at 6 and 12 months. Plasma folate levels were determined using a competitive assay with folate binding protein. Using univariate and multivariate linear regression, we compared the change in plasma folate levels at six and twelve months of the program from baseline. We also assessed the relative risk of folate deficiency during follow-up using log-binomial regression. The mean (±SE) pre–fortification plasma folate level for the women was 5.44-ng/ml (±2.30) at baseline. These levels improved significantly at six months [difference: 4.57ng/ml (±2.89)] and 12 months [difference: 4.27ng/ml (±4.18)]. Based on plasma folate cut-off level of 4 ng/ml, the prevalence of folate deficiency was 26.9% at baseline, and 5% at twelve months. One ng/ml increase in plasma folate from baseline was associated with a 25% decreased risk of folate deficiency at 12 months [(RR = 0.75; 95% CI = 0.67–0.85, P<0.001]. In a setting where folate deficiency is high, food fortification program with folic acid resulted in significant improvements in folate status among women of reproductive age.

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“…Neural tube defects(NTDs), which include spina bifida, anencephaly, craniorachischisis, and encephalocele, are among the most common human birth defects, with a worldwide prevalence of approximately 1 per 1000 births (Frey and Hauser, ). The prevalence of NTDs varies considerably by geographic areas, with prevalence reported as 0.2 to 14 per 1000 births (Busby et al, ; Li et al, ; Allagh et al, ; Kishimba et al, ). The etiology of NTDs is far from fully understood.…”

Section: Introductionmentioning

confidence: 99%

Levels of folate receptor autoantibodies in maternal and cord blood and risk of neural tube defects in a Chinese population

Yang

Wang

Finnell

et al. 2016

Birth Defects Research

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Background After years of periconceptional folic acid supplementation, the prevalence of neural tube defects (NTDs) remains stable following the remarkable reduction observed immediately after the fortification practice. There is accumulating evidence that folate receptor (FR) autoimmunity may play a role in the etiology of folate-sensitive NTDs. Methods From 2011 to 2013, 118 NTD cases and 242 healthy controls were recruited from a population-based birth defects surveillance system in Northern China. Enzyme-linked immunosorbent assay was used to measure FR autoantibodies in maternal and cord blood. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI). Results Plasma FR autoantibodies levels were significantly elevated in mothers of infants with NTDs compared with mothers of healthy controls. Using the lowest tertile as the referent group, 2.20-fold (95% CI, 0.71–6.80) and 5.53-fold increased odds (95% CI, 1.90–16.08) of NTDs were observed for the second and third tertile of immunoglobulin G (IgG), respectively, and the odds of NTDs for each successive tertile of IgM was 0.98 (95% CI, 0.35–2.75) and 3.49 (95% CI, 1.45–8.39), respectively. A dose–response relationship was found between FR autoantibodies levels and risk of NTDs (P < 0.001 for IgG, P = 0.002 for IgM). The same pattern was observed in both subtypes of spina bifida and anencephaly. No significant difference in levels of cord blood FR autoantibodies was observed. Conclusion Higher levels of FR autoimmunity in maternal plasma are associated with elevated risk of NTDs in a dose–response manner.

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Birth prevalence of selected external structural birth defects at four hospitals in Dar es Salaam, Tanzania, 2011–2012

Cited by 27 publications

References 18 publications

Drug‐related teratogenic and pathologic causes of birth defects in a tertiary hospital in Southwestern Nigeria

Drug‐related teratogenic and pathologic causes of birth defects in a tertiary hospital in Southwestern Nigeria

Large –scale wheat flour folic acid fortification program increases plasma folate levels among women of reproductive age in urban Tanzania

Levels of folate receptor autoantibodies in maternal and cord blood and risk of neural tube defects in a Chinese population

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