Congenital Malformations in Primary Health Care in Al-Qassim Region

Abstract

the extensive examination of family health files coupled with door-to-door survey identified 1736 patients with CMs. The results showed that the prevalence of CMs was 6.9/1000 population. The male to female ratio was 1.3:1. The patient's age, sibling order, co-morbid disorders of CMs, parental age, chronic maternal diseases, and the family history of CMs were significantly associated with groups of arbitrarily classified CMs. The most frequently encountered CMs were of central nervous system (39.2%) followed by cardiovascular (22.3%), alimentary (13.1%), musculoskeletal (6.85%), urogenital (6.16%), communicative and audiovisual (5.5%), and miscellaneous (6.9%). Further one-way ANOVA found significant differences among CM categories and age of patients and parents. Unlike Western trends, our study tentatively concludes that overall the inheritance rather than socioenvironmental factors contributes significantly in the etiology of different congenital malformations. We further suggest that the basic information of this research might be useful foundation data in future analytic studies on congenital malformations. Ann Saudi Med 1995;15 (1) Major congenital malformations are. the leading cause not only of perinatal deaths 1,2 but also of infant mortality and morbidity.3,4 They have multifactorial origin and about 40% of cases have idiopathic etiology. The major, minor, and variant features of CMs 5 occur during the process of organogenesis. During the last two decades there have been several anecdotal case reports and reports of case series of different congenital malformations. Additionally, the large hospital-based studies carried out among neonates have explored the patterns of CMs and also made references to the CMs as the prime contributors to perinatal deaths.1,2,6,7 Furthermore, some studies have explored the individual specific body system's CMs. [8][9][10][11] The former studies have, however, some limitations as a majority of these are hospital-based, do not reflect the prevalence of CMs in the general population, are carried out in neonates only, and moreover do not provide data regarding other age groups surviving with congenital malformations. Notably, as a result of multiple favorable factors, the perinatal and infant mortality and morbidity rates attributable to major congenital malformations have considerably decreased in the developing world, though not as sharply as in developed countries. Consequently, it is expected that survival rates of neonates born with CMs would increase in underdeveloped nations, hence posing a major chronic sociomedical health problem. To our knowledge, there is no study which has explored the epidemiological parameters of CMs among different age strata in Saudi Arabia. Therefore, we piloted this study with the goals of finding out the prevalence, possible etiological correlates, and the patterns of congenital malformations in a population less than 20 years of age in the Al-Qassim Region. Material and MethodsThe Al-Qassim Region is geographically located in the center of...

Major Congenital Malformations among Saudi Infants Admitted to Asir Central Hospital

“…This is at par with the experience in the central area of Saudi Arabia. 4,5 Surveys in another Gulf country, the United Arab Emirates, 10 and Hungary 11 have revealed a similar picture. In contrast, surveys in the USA 12 and the United Kingdom 13 identified the CNS as leading among these top three.…”

“…male preponderance corroborates the results of other researchers. 5,[7][8][9] It may be speculated that either the females were afflicted with more lethal CM and could not survive to be transferred, or that their malformations were so mild that they did not require referral.…”

“…This is in consonance with the observation in Al Qassim in the central region of Saudi Arabia. 5 Regarding the central nervous system, the most prevalent anomaly encountered was hydrocephalus with and without meningomyelocele. With special reference to the neural tube defect, the incidence of this condition has markedly declined in most of the developed world countries following mass promotion and mandatory prescription of folic acid for pregnant mothers.…”

Five Year Experience in Prenatal Ultrasound Diagnosis of Esophageal Atresia in Saudi Arabia

“…3,6,7 In our series, the incidence of EA was 0.13%, which reflects a high incidence of this anomaly in Saudi Arabia. 1,4,8 The total number of congenital anomalies diagnosed in this period were 1345, or 2.3% of all births in our hospital, which represents 5.7% of all congenital anomalies detected. Levi et.…”

“…3,10 The ultrasonographer should be aware of the association between esophageal atresia and major cardiac 14 as well as other anomalies. 5 Other studies indicate that the age of the mother is a risk factor for congenital anomalies, 4,8,13 especially fetal chromosomal anomalies. 8 Parity is also a risk factor for EA with or without TOF In our study, the risk of EA with or without TOF was 3 times more in the high parity group.…”