Preterm birth and low birthweight are strongest risk factors associated with increased case fatality of infants with spina bifida

Objectives:
Does spina bifida increase risk of neonatal and infant mortality?

Study design:
This review article included 20 population-based cohort studies conducted in high-income countries.
These studies included a total study population of over 30 million liveborn infants (median study sample size: 1,178,452 (251,699-14 million)) in which approximately 12,000 (median: 231 (27-3,903)) were affected by spina bifida.
All infants included were born at ≥20 weeks gestational age with a birthweight ≥500g.

Results and conclusions:
The investigators found significant declines in spina bifida associated infant and neonatal mortality rates [e.g. 4.76% decrease in IMR per 100, 000 live births per year] and case fatality [e.g. 2.70% decrease in infant case fatality per year] were consistently observed over time.

The investigators found preterm birth [RR = 4.45, 95% CI = 2.30 to 8.60] and low birthweight [RR = 4.77, 95% CI = 2.67 to 8.55] were the strongest risk factors associated with increased spina bifida infant case fatality.

The investigators concluded that a decline in spina bifida associated infant/neonatal mortality and case fatality are consistently observed, in which advances in medical and surgical treatment and mandatory folic acid food fortification likely to play an important role. Preterm birth and low birthweight are strongest risk factors associated with increased case fatality of infants with spina bifida, which warrant particular attention from clinicians caring for these vulnerable babies.

Original title:
Neonatal and infant mortality associated with spina bifida: A systematic review and meta-analysis by Ho P, Quigley M, […], Kurinczuk JJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115829/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, folic acid, pregnancy and food fortification/malnutrition right here.

Taking 400 micrograms (mcg) of folic acid before and during pregnancy can reduce the risk of certain birth defects. These include spina bifida, anencephaly and some heart defects. Birth defects occur within the first 3-4 weeks of pregnancy.