Abstract
Background: Spina bifida leads to unfavourable outcomes for the fetus, particularly in developing countries. This study aims to investigate the characteristics and risk factors associated with spina bifida in Surabaya, Indonesia. The findings could inform improved management strategies.
Methods: This study is a descriptive retrospective study that utilized medical records data of pregnant women with fetuses diagnosed with congenital spina bifida, who were treated in the delivery room at Dr. Soetomo General Hospital, Surabaya, from 2016 to 2021. Data on maternal characteristics, risk factors, pregnancy management, and prenatal outcomes were collected. Data was processed descriptively to calculate and display the percentage of each case.
Results: Over a span of five years, ten cases of spina bifida were identified. More than 50% of these cases occurred in multigravida pregnancies, with mothers aged 20-29 years. Seventy percent of the cases were referrals. Recorded maternal risk factors included obesity (30%) and low socio-economic status (60%). Only 30% of pregnant women received antenatal check-ups in the first trimester, and most cases were detected after 28 weeks of gestation. Only 10% of cases were associated with other syndromes. Eighty percent of the cases were born after 37 weeks of gestation. The neonates' outcomes were recorded, revealing that the majority of them were male, with 60% having open spina bifida. Ninety percent of cases were non-isolated, and 40% of them were accompanied by hydrocephalus. Only 60% of neonates underwent surgery to close the defect. Perinatal mortality was observed in 50% of cases.
Conclusion: Maternal risk factors for spina bifida included obesity and low socio-economic status. The majority of cases involved male neonates, and most were non-isolated spina bifida cases, resulting in a perinatal survival rate of 50%. Most of the cases were detected in the third trimester.