Researchers in Tanzania studied nearly 1,000 children to understand how often brain and spine birth defects happen and what causes them. They found that about 1 in 7 children had these conditions, with the most common being fluid buildup in the brain. The study showed that mothers who didn’t get enough folic acid (a B vitamin), had infections during pregnancy, or didn’t see a doctor early in pregnancy were more likely to have babies with these birth defects. The good news is that many of these risks can be reduced with proper prenatal care and nutrition.

The Quick Take

  • What they studied: How common are brain and spinal cord birth defects in children, and what factors increase the risk of these conditions?
  • Who participated: 978 children treated at a major hospital in Tanzania between May 2023 and April 2024. The study looked back at medical records to find children born with brain or nervous system birth defects.
  • Key finding: About 14 out of every 100 children (14.3%) had a brain or spinal cord birth defect. The most common was fluid buildup in the brain (8.3%), followed by spinal cord defects (5%). Mothers who didn’t get enough folic acid and didn’t see a doctor early in pregnancy were 2.5 times more likely to have babies with these conditions.
  • What it means for you: If you’re pregnant or planning to become pregnant, taking folic acid supplements, getting regular prenatal checkups, and managing health conditions like diabetes and high blood pressure may help reduce the risk of these birth defects in your baby. This is especially important in areas with limited healthcare access.

The Research Details

Researchers looked back at medical records from a hospital in Tanzania over a 12-month period (May 2023 to April 2024). They reviewed information on 978 children to see how many had brain or spinal cord birth defects and what their mothers’ health was like during pregnancy. This type of study is called “looking back” research because doctors examine past medical records rather than following patients forward in time.

The researchers used special computer programs to organize the data and find patterns. They used a statistical method called logistic regression, which helps identify which factors (like folic acid deficiency, infections, or premature birth) were connected to higher rates of birth defects. This method helps separate which factors truly matter from those that might just be coincidence.

The study focused on four main types of brain and nervous system birth defects: hydrocephalus (fluid buildup in the brain), neural tube defects (problems with the spinal cord and brain development), Chiari malformations (brain tissue extending into the spine), and encephalocele (part of the brain pushing through the skull).

This research approach is important because it shows what’s actually happening in a real hospital in Tanzania, not in a laboratory. By looking at actual patient records, researchers can identify which risk factors are most common and most strongly connected to these birth defects. This information helps doctors know what to focus on when counseling pregnant women and helps public health officials plan prevention programs.

This study has some strengths: it included a large number of children (978), used a real hospital setting, and looked at multiple risk factors. However, because it only looked at children who came to this one hospital, the results might not apply to all children in Tanzania or other countries. Also, since researchers looked back at old records, some information might be missing or incomplete. The study cannot prove that these factors definitely cause birth defects, only that they are associated with them.

What the Results Show

The study found that brain and spinal cord birth defects were fairly common, occurring in about 1 out of every 7 children (14.3%). The most common condition was hydrocephalus (fluid buildup in the brain), which affected about 8 out of every 100 children. Neural tube defects (problems with spinal cord development) occurred in about 5 out of every 100 children. The other two conditions—Chiari malformations and encephalocele—were less common, each affecting less than 1 out of every 100 children.

The research identified several factors that were connected to higher rates of these birth defects. The strongest connection was with folic acid deficiency combined with delayed prenatal care. Mothers who didn’t get enough folic acid and didn’t see a doctor early in pregnancy were 2.5 times more likely to have babies with neural tube defects or hydrocephalus. This is important because folic acid is a vitamin that helps the baby’s brain and spinal cord develop properly, and it’s most important in the first few weeks of pregnancy.

Other factors that showed connections to birth defects included babies being born too early (prematurely), weighing too little at birth, mothers having infections during pregnancy, mothers using unprescribed drugs, mothers being malnourished, mothers having gestational diabetes (high blood sugar during pregnancy), and mothers having high blood pressure. Each of these factors appeared to increase the risk, though some were stronger connections than others.

The study also found that the combination of multiple risk factors made birth defects even more likely. For example, a mother who had both folic acid deficiency and an infection during pregnancy had a higher risk than a mother with just one of these problems. This suggests that preventing birth defects requires addressing multiple health issues, not just one factor. The research also showed that these birth defects were present from birth, meaning they developed during pregnancy rather than after the baby was born.

These findings fit with what other researchers have found around the world. Studies from many countries have shown that folic acid deficiency is one of the most important preventable causes of neural tube defects. The connection between maternal infections, diabetes, and high blood pressure with birth defects has also been found in previous research. However, this study is valuable because it shows these patterns in Tanzania specifically, where healthcare access and nutrition may be different from other countries. The rates found in this study (14.3% overall) are higher than in many developed countries, which suggests that improving prenatal care and nutrition in Tanzania could have a big impact.

This study has several important limitations to keep in mind. First, it only looked at children who came to one hospital in Tanzania, so the results might not apply to all children in the country or in other places. Second, because researchers looked at old medical records, some information might be missing—for example, doctors might not have recorded everything about the mother’s diet or health during pregnancy. Third, the study can show that certain factors are connected to birth defects, but it cannot prove that these factors directly cause the defects. Finally, the study didn’t look at genetic factors or family history, which can also play a role in these birth defects.

The Bottom Line

Based on this research, pregnant women (or women planning to become pregnant) should: (1) Take folic acid supplements as recommended by their doctor, ideally starting before pregnancy; (2) Get prenatal checkups early in pregnancy and attend all scheduled appointments; (3) Manage health conditions like diabetes and high blood pressure before and during pregnancy; (4) Avoid unprescribed drugs and maintain good nutrition; (5) Get treatment for any infections during pregnancy. These recommendations have moderate to strong evidence supporting them based on this and other studies.

This research is most relevant for pregnant women, women planning to become pregnant, and healthcare providers in Tanzania and similar settings with limited healthcare access. It’s especially important for women who may have limited access to prenatal care, proper nutrition, or folic acid supplements. Healthcare workers should use this information to educate women about the importance of early prenatal care and folic acid. Women in developed countries with good access to prenatal care and folic acid fortification may have lower risk, but the basic recommendations still apply.

The benefits of folic acid and prenatal care happen during pregnancy, not after the baby is born. Folic acid is most important in the first 28 days of pregnancy, before many women even know they’re pregnant. This is why women who might become pregnant should start taking folic acid before they get pregnant. Prenatal checkups throughout pregnancy help catch and manage other risk factors. If a woman follows these recommendations, the risk of these birth defects can be reduced during the pregnancy itself.

Want to Apply This Research?

  • If you’re pregnant or planning pregnancy, track daily folic acid supplement intake (yes/no each day) and prenatal appointment attendance. Set reminders for taking supplements at the same time each day and for upcoming doctor appointments.
  • Use the app to set a daily reminder to take your folic acid supplement. Create a checklist for prenatal appointments and health goals (managing blood sugar, blood pressure, avoiding unprescribed drugs). Log any infections or health concerns to discuss with your doctor at your next visit.
  • Track folic acid supplement adherence weekly and monitor prenatal visit completion. Set monthly health goals related to managing any existing conditions like diabetes or high blood pressure. Use the app to record questions for your healthcare provider and track their recommendations.

This research describes patterns found in one hospital in Tanzania and cannot be applied as medical advice for individual cases. The study shows associations between risk factors and birth defects but does not prove direct causation. Pregnant women or those planning pregnancy should consult with their healthcare provider about folic acid supplementation, prenatal care, and management of any health conditions. This information is not a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about pregnancy or birth defects, please speak with your doctor or healthcare provider.