Sangeeta Devaliya, Shashi Prabha Tomar, Preeti Gupta, Vaishali Soni

CONGENITAL MALFORMATIONS OF THE CENTRAL NERVOUS SYSTEM AMONG NEWBORNS DELIVERED AT TERTIARY HEALTH CARE HOSPITAL IN INDIA: A CROSS-SECTIONAL STUDY

Introduction

Congenital malformations of the central nervous system among newborns delivered at tertiary health care hospital in india: a cross-sectional study. Congenital CNS malformations in Indian newborns: a study revealing 0.5% incidence. Hydrocephalus & neural tube defects are common. Key maternal risk factors identified.

Abstract

Background: Malformations of the central nervous system (CNS) are a significant contributor to childhood morbidity and death. Congenital CNS abnormalities may result in long-term disability that affects not only the child's development and well-being but also families, the medical system, and society as a whole. Purpose: The purpose of this study is to determine the incidence, type, and associated risk factors of CNS malformations in newborns who were delivered to the Obstetrics and Gynecology department of Netaji Subhash Chandra Bose Medical College (NSCB Medical College). Methods: An observational hospital-based study was carried out in the departments of pediatrics and obstetrics and gynecology at the NSCB Medical College and Hospital in Jabalpur. Data was entered into MS Excel, and IBM-SPSS 23.0 was used to perform descriptive and inferential statistical analysis. During a one-year study period, 40 cases of CNS malformation out of 7117 deliveries were found to have occurred either before or after birth. Results: During the study period, 40 cases of CNS malformation out of 7117 deliveries were identified either prenatally or at birth, making an incidence of 0.5%. Of all CNS anomalies, hydrocephalus accounted for 52.5 percent, whereas neural tube defects accounted for 27.5 percent. The other two main CNS abnormalities identified in utero were ventriculomegaly and midline defects. Conclusion: This study identified CNS malformations in newborns, with hydrocephalus and neural tube defects as the most common types. Key risk factors included younger maternal age, rural residence, inadequate antenatal care, adverse obstetric history, chronic illness, polyhydramnios, and maternal addiction.

Review

This cross-sectional study from a tertiary health care hospital in India addresses the crucial public health issue of congenital central nervous system (CNS) malformations among newborns. Given the significant burden of morbidity and mortality associated with these conditions globally, and particularly in developing regions, the study's aim to determine the incidence, type, and associated risk factors in a specific Indian context is highly relevant. The research was conducted as an observational hospital-based study over a one-year period at Netaji Subhash Chandra Bose Medical College, utilizing data from both pediatric and obstetrics and gynecology departments to identify cases among 7117 deliveries. The findings indicate an incidence of 0.5% for CNS malformations during the study period, translating to 40 identified cases. The most prevalent anomalies were hydrocephalus, accounting for a significant 52.5%, followed by neural tube defects at 27.5%. Other notable conditions included ventriculomegaly and midline defects. Crucially, the study also identified several key risk factors, encompassing socio-demographic aspects like younger maternal age and rural residence, along with clinical factors such as inadequate antenatal care, adverse obstetric history, chronic maternal illness, polyhydramnios, and maternal addiction. These findings provide valuable, context-specific epidemiological data vital for understanding the local burden of these conditions. While the study provides important baseline data on CNS malformations in a specific tertiary care setting in India, offering insights into local prevalence and associated factors, certain methodological considerations warrant discussion. As a single-center, hospital-based cross-sectional study, its generalizability to the broader regional or national population may be limited, and it inherently cannot establish causality for the identified risk factors. Future research could benefit from multi-center designs and prospective methodologies to strengthen causal inferences and enhance external validity. Nevertheless, this study's identification of predominant anomaly types and modifiable risk factors underscores the urgent need for enhanced antenatal screening, improved maternal health education, and targeted public health interventions, particularly in rural areas, to mitigate the impact of these devastating congenital conditions.

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