Environmental Risk Factors for Anterior Encephaloceles: 15 Years’ Experience at a Tertiary Centre in India

Anterior encephalocele (AE) is a rare congenital malformation in the central nervous system with a reportedly high prevalence in Assam, Northeast India. As there exists substantial variations in the etiology of the disease, determination of risk factors and timely intervention could reduce associated morbidity. A retrospective chart review of patients with AE who were born at or referred to Assam Medical College & Hospital (AMCH), a tertiary health care centre between January 1999 and December 2013 was performed to assess the environmental risk factors associated with AE. 64 patients were treated at the pediatric surgery department during the period with a male to female ratio of 1:1.2 and mean age of 36 months. 62.5% patients had naso-ethmoidal followed by 31.3% naso-frontal and 6.2% naso-orbital encephalocele. 61 cases were of the tea garden community with low socio economic status. Parental exposure to pesticides was reported in 58 cases. Maternal age < 20 years and >39 years accounted for 40.6% of the cases. 73.5% of the mothers had parity ≥3 and 15 reported of past abortions. Maternal malnutrition was observed in 38% cases and parental consanguinity was noted in 12 cases. Thus the study suggest that low socioeconomic status, pesticides exposure, advanced maternal age, increasing parity, parental consanguinity and maternal malnutrition may contribute to the occurrence of AE. Figure 1: A child with frontonasal encephalocele.