Birth prevalence of neural tube defects and orofacial clefts in India: a systematic review and meta-analysis

• Published in: PloS one 2015-03, Vol.10 (3), p.e0118961-e0118961
• Main Authors: Allagh, Komal Preet, Shamanna, B R, Murthy, Gudlavalleti V S, Ness, Andy R, Doyle, Pat, Neogi, Sutapa B, Pant, Hira B
• Format: Article
• Language: English
• Subjects: Acids; Analysis; Biomedical research; Birth; Birth defects; Children & youth; Cleft Lip - epidemiology; Cleft lip/palate; Cleft Palate - epidemiology; Congenital defects; Consanguinity; Epidemiology; Genetics; Health aspects; Hospitals; Humans; India - epidemiology; Infant mortality; Infectious diseases; Low income groups; Malnutrition; Medical research; Meta-analysis; Mortality; Neural tube defects; Neural Tube Defects - epidemiology; Nutrition; Observational studies; Orofacial clefts; Parturition; Pediatrics; Prevalence; Prevalence studies (Epidemiology); Public health; Reviews; Spina bifida; Studies; Systematic review; Vitamin B
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0118961

In the last two decades, India has witnessed a substantial decrease in infant mortality attributed to infectious disease and malnutrition. However, the mortality attributed to birth defects remains constant. Studies on the prevalence of birth defects such as neural tube defects and orofacial clefts in India have reported inconsistent results. Therefore, we conducted a systematic review of observational studies to document the birth prevalence of neural tube defects and orofacial clefts. A comprehensive literature search for observational studies was conducted in MEDLINE and EMBASE databases using key MeSH terms (neural tube defects OR cleft lip OR cleft palate AND Prevalence AND India). Two reviewers independently reviewed the retrieved studies, and studies satisfying the eligibility were included. The quality of included studies was assessed using selected criteria from STROBE statement. The overall pooled birth prevalence (random effect) of neural tube defects in India is 4.5 per 1000 total births (95% CI 4.2 to 4.9). The overall pooled birth prevalence (random effect) of orofacial clefts is 1.3 per 1000 total births (95% CI 1.1 to 1.5). Subgroup analyses were performed by region, time period, consanguinity, and gender of newborn. The overall prevalence of neural tube defects from India is high compared to other regions of the world, while that of orofacial clefts is similar to other countries. The majority of studies included in the review were hospital based. The quality of these studies ranged from low to moderate. Further well-designed, high quality community-based observational studies are needed to accurately estimate the burden of neural tube defects and orofacial clefts in India.