Clinical epidemiology and associated factors of folic acid supplements resistant spina bifida in Addis Ababa, Ethiopia: a case-control study
Background: Spina bifida, one of the Neural tube defects (NTDs) is preventable cause of morbidity and mortality worldwide and its burden is not well registered in low income countries. The aim of this study was to determine the clinical epidemiology and associated factors of folic acid supplements resistant spina bifida in Addis Ababa, Ethiopia.
Methodology: A case-control study was conducted in Zewditu Memorial Hospital, Addis Ababa, Ethiopia among mothers came for maternal and child health services. Both case and control participants were selected conveniently, consecutive participants were considered from their respective wards. Data was collected by trained nurses and midwives using structured template and analyzed by SPSS Version 21.0. Descriptive techniques and multiple binary logistic regression were employed. In all the statistical analysis, p-value < 0.05 was considered as statistically significant.
Results: A total of 225 mothers were approached for the study, and 219 (74 Cases Vs 145 Controls) of them were willing to participate. Of the mothers with a spina bifida birth outcomes, 52(70.3%) has gestational diabetes, 47(63.5%) had poor adherence to folic acid supplementation. Mothers who are rural residents, and have gestational diabetes were more likely to have newborn with spina bifida (Adjusted Odds Ratio (AOR) =7.99 [95% Confidence Interval (CI): 3.99, 16.3]) and (AOR=5.01 [95% CI: 2.55, 10.04]) respectively.
Conclusion: Being diabetic during gestational age and rural resident were associated factors with folic acid supplements resistant spina bifida. Therefore, the government should give attention to rural and diabetic mothers to decrease the disease burden in the newborns.