Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Mar 13;10(3):e0118961.
doi: 10.1371/journal.pone.0118961. eCollection 2015.

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

Komal Preet Allagh  1 , B R Shamanna  2 , Gudlavalleti V S Murthy  1 , Andy R Ness  3 , Pat Doyle  4 , Sutapa B Neogi  5 , Hira B Pant  1 ; Wellcome Trust- PHFI Folic Acid project team
Affiliations
Meta-Analysis

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

Komal Preet Allagh et al. PLoS One. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Literature search and selection of studies (PRISMA Flow diagram).
Fig 2
Fig 2. Prevalence of neural tube defects among studies included in the systematic review and meta-analysis.
(A) Pooled prevalence of neural tube defects using the random effects model. (B) Pooled prevalence of neural tube defects using fixed effects model.
Fig 3
Fig 3. Prevalence of orofacial clefts among studies included in the systematic review and meta-analysis.
(A) Pooled prevalence of orofacial clefts using the random effects model. (B) Pooled prevalence of orofacial clefts using fixed effects model.
See this image and copyright information in PMC

References

    1. Prevention and Control of Birth Defects in South-East Asia Region. Strategic Framework. World Health Organization. 2013–2017.
    1. Ram U, Jha P, Ram F, Kumar K, Awasthi S, Shet A, et al. Neonatal, 1–59 month, and under-5 mortality in 597 Indian districts, 2001 to 2012: estimates from national demographic and mortality surveys. Lancet Global Health. 2013; 1: e219–26. 10.1016/S2214-109X(13)70073-1 - DOI - PubMed
    1. Congenital Anomalies. WHO Fact sheet No 370, October 2012.
    1. Christianson A, Howson CP, Modell B. The hidden toll of dying and disabled children. March of Dimes Global report on birth defects. 2006.
    1. Birth defects in South- East Asia—A public Health challenge. Situational Analysis. World Health Organisation. 2013.

Publication types