Mapping the burden prevalence of neural tube defects across Indian regions: a systematic review and meta-analysis

Neural tube defects (NTDs) are a major public health concern that greatly raises newborn mortality and morbidity rates. The aim of this systematic review and meta-analysis was to determine the overall prevalence of NTDs across various regions of India. A random-effects model was used to analyze 33 observational studies with a total of 963,577 births from five Indian regions (North, South, East, West, and Central) that were obtained from PubMed, Embase, and Google Scholar. The overall pooled prevalence was found to be 5.05 per 1,000 births (95% CI: 2.68-9.49), with high heterogeneity (I²=98.9%). The prevalence varied significantly by region: south (6.61 per 1,000), north (6.50), central (4.66), west (4.21), and east (0.81). Urban areas had higher prevalence rates (8.92 per 1,000) than mixed settings (2.64 per 1,000), although these differences between were not statistically significant. The findings highlight the importance of increasing folic acid fortification, improving prenatal care, addressing regional healthcare imbalances, and intra-regional factors like dietary practices.