Frequency of Congenital Anomalies in Newborns and Its Relation to Maternal Health in a Tertiary Care Hospital in Peshawar, Pakistan

Abstract

Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) of newborns had various congenital anomalies.b Hydrocephalus (22.6%), anencephaly (12.9%), and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%); parities 2 to 4 had lower incidences (35.4%). The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination. Low intake of folic acid and a high consanguinity rate were the most common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy.

Epidemiological study of congenital and hereditary anomalies in Sialkot District of Pakistan revealed a high incidence of limb and neurological disorders

“…Polydactyly types were most prevalent, followed by clubfoot, arthrogryposis, reduction defects, and syndactyly types. Most of the limb/digit defects do not cause severe disability and, owing to their minor nature, such anomalies remain less reported in epidemiological studies [12,25,26]. As witnessed in the present cohort, the majority of limb defects were of milder nature and did not result in any disability.…”

Prevalence, Pattern and Outcome of Congenital Anomalies among Babies Admitted in a Neonatal Unit in Southern Nigeria

“…Maternal age > 35years was observed to be significantly associated with anomalies of the urogenital system in the present study. This corroborates other studies [28,46,47,48] which also showed increased incidence of CA with increasing maternal age especially in mothers > 35years thus agrees with the known theory of advanced maternal age as a risk of CA [49] In addition, increased maternal age has been associated with an increase in chromosomal meiotic errors [33]. This therefore calls for a high index of suspicion in mothers > 35years who are pregnant.…”

“…The reason is not far-fetched as 45% of CA in the latter study was syndromic of which 47% had Down's syndrome which has been associated more with maternal age > 35years. This is because increased maternal age is associated with increase in chromosomal meiotic errors [33].…”

Frequency of congenital birth defects in newborn babies born at Hyderabad, Sindh.

“…Our study has shown the prevalence of interfamily marriage is 64%. 15 A slight higher prevalence of interfamily marriage (80%) has been observed in Peshawar but Northern Area of India has shown the interfamily marriage is quite different (1-4%) 16 , this is because of religious constraints which refrain them from interfamily marriages. 17,18 The prevalence of interfamily birth defect is varying in different regions like in Pakistan it is higher (11%) and in developed countries it is (6%).…”