The Demographics of Cases with Neural Tube Defects in Kahramanmaras

Year 2022, Volume: 17 Issue: 2, 160 - 166, 15.07.2022

Emrullah Cem Kesilmez , Zafer Yüksel

https://doi.org/10.17517/ksutfd.837546

Abstract

Objective: We aimed to determine the features and prevalence of new-borns with neural tube defects (NTD) in Kahramanmaras. We evaluated the sociodemographical features of families, possible teratogenic causes which had been encountered in the first trimester of the pregnancy.
Material and Methods: Records of live and still births between January 2000 and December 2013, as well as records of patients diagnosed with NTD at the Sutcu Imam University Medical Faculty Hospital and neighbouring hospitals with neurosurgery clinics in Kahramanmaras were analysed an evaluated.
Questionnaires were used to collect data on the socıo-demographic factors, teratogenic factors encountered in the first trimester of pregnancy, the professions of the parents as well as their kinship status. The rate of febrile illness, alchol and drug use of the mothers were also evaluated.
Results: Nine hundred and seven patients with NTD were evaluated. Seven hundred and two of them had spina bifida (77,4 %), 528 of them had meningomyelocele (58.2%), 134 had meningocele (14.8%), 40 had dermal sinus tract (4.4%), 107 of them had anencephaly (11.8 %), and 98 of them were diagnosed
with encephalocele (10.8%).The frequency of NTD in Kahramanmaras was ‰3. In our study, 574 of the patients were females (63.2%), 333 of them were males (36.8%).When the parental occupations were evaluated unemployed or those that worked only o few days a month were significantly higher .The
income levels of the parents and the education levels of the mothers were low .The rate of folic acid preparation used by mothers with babies with NTD was considered to be extremely low.
Conclusion: The NTD incidence in Kahramanmaras was found relatively high when compared to similar studies in our country. It has been determined that NTD is more common in individuals with low levels of education, low income , poor nutrition and low occupational status. Folic acid supplementation before
and during pregnancy is known to be very important however the rate of folic acid intake in Kahramanmaras is low and the importance of vitamin supplements is not widely known. In addition, it has been concluded that patients may have additional pathologies that may have occurred during birth or after birth and hence these patients must be followed and treated with a multidisciplinary approach by experienced clinics.

Keywords

Folic acid, Neural tube defect, Nutrition, Sociodemographic factors

Kahramanmaraş İlinde Nöral Tüp Defekti Olgularının Demografik Özellikleri

Abstract

Amaç: Bu çalışmada Kahramanmaraş ili sınırları içerisinde doğan bebeklerde nöral tüp defekti (NTD) sıklığının belirlenmesi, NTD’li bebeğe sahip ailelerin sosyo-demografik özelliklerinin, annelerin gebelikleri süresince özellikle ilk trimestrda teratojen etkenlere maruz kalıp kalmadığının araştırılmasıdır.
Gereç ve Yöntemler: Ocak 2000-Aralık 2013 tarihleri arasında Kahramanmaraş ili sınırları içerisindeki canlı ve ölü doğum kayıtları retrospektif olarak değerlendirilmiş ve Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Hastanesi Nöroşirurji kliniği dahil Kahramanmaraş ilinde Nöroşirurji kliniği barındıran tüm hastanelerde NTD tanısı alan hastalar incelenmiştir. Sosyodemografik özellikler, gebeliğin ilk trimestrında karşılaşılan teratojen etkenler, anne ve babaların meslekleri, aylık maddi gelirleri ve akrabalık durumları, annelerin ateşli hastalık geçirme öyküsü, ilaç ve alkol kullanımları anket yöntemiyle
değerlendirildi.
Bulgular: Çalışmamızda 907 NTD’li hasta değerlendirildi. Hastaların 702’sinde (%77.4), spina bifida, 528’inde (%58.2) meningomyelosel,134’ünde (%14.8) meningosel, 40’ında (%4.4) dermal sinüs traktı, 107’sinde (%11.8) anensefali, 98’inde (%10.8) ensefalosel tanısı mevcuttu. Kahramanmaraş ilinde NTD sıklığı
‰3.83 olarak bulundu. Hastalardan 574’ü (%63.2) kadın, 333’ü (%36.8) erkek cinsiyetteydi. Olguların ebeveyn meslekleri değerlendirildiğinde işsizler veya ayda birkaç gün işçi olarak çalışanlar anlamlı oranda yüksekti. Ailenin gelir seviyesi ve annelerin eğitim seviyesi düşüktü. NTD’li bebeğe sahip annelerin
gebelikleri sırasında folik asit preperatı kullanım oranının ise çok düşük olduğu görüldü (%11.4).
Sonuç: Çalışmamızda Kahramanmaraş ilinde NTD görülme sıklığı ülkemizdeki benzer çalışmalar içinde göreceli olarak yüksek bulunmuştur. NDT’li bebeklerin ailelerinin düşük sosyoekonomik düzeyde olması ve annelerin yetersiz eğitim seviyeleri sonucu gebelik öncesi dönemde veya gebelik esnasında folik asit
kullanımının ilimizde ciddi olarak düşük olması bu yüksek NTD sıklığının sebebi olabilir. Ayrıca NTD hastalarında doğumda veya sonradan ortaya çıkabilecek ek patolojiler olabileceği ve bu hastaların multidisipliner yaklaşımla, deneyimli kliniklerce takip ve tedavisinin yapılması gerektiği sonucuna ulaşılmıştır.

Keywords

Beslenme, Folik asit, Nöral tüp defekti, Sosyodemografik özellik

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