Awareness and uptake of measures for preventing CNS birth defects among mothers of affected children in a sub-Saharan African neurosurgeon's practice.
BACKGROUND
The two main measures used in the reduction of the birth prevalence of CNS birth defects are (i) folic acid, FA, supplementation/food fortification for reproductively active women as the primary one, and (ii) timely screening/intrauterine diagnosis, and possibly termination of the affected pregnancies.


METHODS
We performed a cross-sectional survey of the levels of awareness and uptake of these measures in a consecutive cohort of mothers of children with CNS birth defects presenting for neurosurgical treatment in an African clinical practice.


RESULTS
There were 151 cases, 101 of them neural tube defects, NTDs. The level of awareness of the role of FA in prevention of these defects was low, 18.8%, and dietary multivitamin supplementation was ingested by only10.7% of the study subjects. The mothers' obstetric behavior in the index pregnancies was suboptimal: pregnancy registration and commencement of obstetric supplements were at median gestational age of 4 months, and obstetric ultrasonography was obtained infrequently, and in an unregulated milieu. Only 17.8% of these CNS birth defects were diagnosed prenatally, but >80% of the mothers would have liked to have the intrauterine diagnosis, and about 23% might have asked for termination of these pregnancies.


CONCLUSIONS
The levels of awareness and uptake of measures for preventing CNS birth defects among mothers of affected children in this sub-Saharan African women cohort are low. Interestingly, many of the mothers were very favorably disposed to receiving, and acting on, the information about the screen detected CNS birth defects in their fetuses.
Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, and University College Hospital, UCH, PMB 5116, Ibadan, 200001, Nigeria. femdoy@yahoo.com.
Amos O
AO
Adeleye
Department of Paediatrics and Child Health, Ladoke Akintola University of Technology, Ogbomoso, and LAUTECH Teaching Hospital, Ogbomoso, Nigeria.
Victor I
VI
Joel-Medewase
D017954:Africa South of the Sahara / Q000453:epidemiology; D001364:Awareness / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000517:prevention & control*; D009493:Neurosurgery / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D016896:Treatment Outcome
CNS birth defects; FA awareness; Intrauterine screening; Obstetric ultrasonography; Primary prevention; Sub-Saharan Africa