Matched birth/death file Other state based registries: Programs for children with special needs Delivery hospitals: Disease index or discharge index Pediatric & tertiary care hospitals: Disease index or discharge index Case Ascertainment Conditions warranting chart review in newborn period: Any chart with selected defects or medical conditions (i.e. abnormal facies, congenital heart disease) Coding: ICD-9-CM/ICD-10-CM Data Collected Infant/fetus: Identification information (name, address, date-of-birth, etc.), Demographic information (race/ethnicity, sex, etc.), Birth measurements (weight, gestation, Apgars, etc.), Tests and procedures, Infant complications, Birth defect diagnostic information Mother: Identification information (name, address, date-of-birth, etc.), Demographic information (race/ethnicity, sex, etc.), Gravidity/parity, Illnesses/conditions, Prenatal care, Pregnancy/delivery complications, Family history Father: Identification information (name, address, date-of-birth, etc.), Demographic information (race/ethnicity, sex, etc.) Data Collection Methods and Storage Data collection: Electronic file/report submitted by other agencies (hospitals, etc.) Database collection and storage: Access, Dedicated server for birth defects data Data Analysis Data analysis software: SAS, SQL, dBASE Quality assurance: Validity checks, Re-abstraction of cases, Comparison/verification between multiple data sources, Timeliness Data use and analysis: Routine statistical monitoring, Public health program evaluation, Baseline rates, Rates by demographic and other variables, Monitoring outbreaks and cluster investigations, Time trends, Time-space cluster analyses, Capture-recapture analyses, Observed vs. expected analyses, Epidemiological studies (using only program data), Identification of potential cases for other epidemiologic studies, Grant proposals, Education/public awareness, Prevention projects Neural Tube Defects and Associated Factors among Neonates Admitted to the Neonatal Intensive Care Units in Hiwot Fana Specialized University Hospital, Harar, Ethiopia Yunus Edris, MD1, Hanan Abdurahman, MD1, Assefa Desalew, MSc1 , and Fitsum Weldegebreal, MSc1 Abstract Background: Neural tube defects are a major public health problem and substantially contribute to morbidity and mortality, particularly in low-income countries, including Ethiopia. There are a paucity of data on the magnitude and associated factors of neural tube defects in Ethiopia, particularly in the study setting. Objective: This study aimed to assess the magnitude of neural tube defects and associated factors among neonates admitted to the neonatal intensive care unit in Hiwot Fana Specialized University Hospital, Harar, Ethiopia. Methods: A hospital-based cross-sectional study was employed from October 2019 to January 2020. A total of 420 newborn-mother pairs were included consecutively. Data were collected using a face-to-face intervieweradministered questionnaire and clinical examination. Data were entered into Epi Data version 3.1 and analyzed using the statistical package for Social Sciences version 20.0 software. An adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the associated factors. A p-value < .001, * = P < .05. Edris et al. 7 spontaneous abortions or premature stillbirths occur as a result of congenital defects that might be related to chromosomal abnormalities. The present finding indicated that mothers who were exposed to radiation were 5 times more likely to had children with NTDs, supported by findings in Turkey20 and China.21 However, this should be seen cautiously as it is compared with a trial on mice.50 Furthermore, maternal AEDs intake during pregnancy was approximately 5 times more likely to have a newborn with NTDs, which is supported by findings in Ethiopia51 and the Netherlands.52 The use of AEDs increases the risk of spinal bifida, especially if used during the first trimester of pregnancy. Moreover, newborns whose mothers consumed coffee (3 or more cups per day) were more likely to have infants with NTDs, which is supported by studies conducted in Ethiopia53 and Italy.40 In an animal-based experimental study done in Singapore, they employed early chick embryos as a developmental model to assess the effects of caffeine on the development of the fetal nervous system in which administration of caffeine led to defective neural tube closures and expression of several abnormal morphological phenotypes, which included thickening of the cephalic mesenchymal tissues and scattering of somites. Furthermore, the number of neurons expressing neurofilaments and the degree of neuronal branching were both significantly reduced following caffeine administration.54 In the present study, preterm babies (Since 1989, the Illinois Department of Public Health (IDPH) Adverse Pregnancy Outcomes Reporting System (APORS) has collected statewide data about congenital anomalies (birth defects) and other serious neonatal conditions identified in newborn infants. Birth defects are the leading cause of infant mortality in the United States (Ely & Driscoll, 2020) and the second leading cause of infant mortality in Illinois (Illinois Department of Public Health, 2021) and they contribute substantially to childhood morbidity and long-term disability. By collecting information about infants with