Trends and characteristics of fetal and neonatal mortality due to congenital anomalies, Colombia 1999–2008

Abstract

Objective To describe fetal and neonatal mortality due to congenital anomalies in Colombia. Methods We analyzed all fetal and neonatal deaths due to a congenital anomaly registered with the Colombian vital statistics system during 1999–2008. Results The registry included 213,293 fetal deaths and 7,216,727 live births. Of the live births, 77,738 (1.08%) resulted in neonatal deaths. Congenital anomalies were responsible for 7321 fetal deaths (3.4% of all fetal deaths) and 15,040 neonatal deaths (19.3% of all neonatal deaths). The fetal mortality rate due to congenital anomalies was 9.9 per 10,000 live births and fetal deaths; the neonatal mortality rate due to congenital anomalies was 20.8 per 10,000 live births. Mortality rates due to congenital anomalies remained relatively stable during the study period. The most frequent fatal congenital anomalies were congenital heart defects (32.0%), central nervous system anomalies (15.8%), and chromosomal anomalies (8.0%). Risk factors for fetal and neonatal death included: male or undetermined sex, living in villages or rural areas, mother's age >35 years, low and very low birthweight, and <28 weeks gestation at birth. Conclusions Congenital anomalies are an important cause of fetal and neonatal deaths in Colombia, but many of the anomalies may be preventable or treatable.

Determinants of High Neonatal Mortality Rates in Migori County Referral Hospital in Kenya

“…A study analysed all foetal and neonatal deaths due to a congenital anomaly registered with the Colombian vital statistics system from 1999 to 2008 (Roncancio et al 2018(Roncancio et al :1749.…”

“…It reported that male sex was associated with slightly higher mortality due to congenital anomalies than female sex (Roncancio et al 2018(Roncancio et al :1749. In rural Tanzania, a study found that neonatal mortality was higher for male newborns than females; it suggested that this increased hazard for newborn males may also be due to the large proportions of neonatal deaths occurring in the first week of life, which is the time when gender differences in neonatal mortality are most pronounced (Selemani, Mwanyangala, Mrema, Shamte, Kajungu & Mkopi 2014:6).…”

“…A large population-based study of 421,144 mothers in Ontario found that mothers at advanced maternal age had a higher risk of developing an adverse composite outcome consisting of pre-eclampsia, intrauterine growth retardation, stillbirth, and placental abruption, compared to younger counterparts(Wu et al 2019:4).Kahveci et al (2018:1) demonstrate that advanced maternal age nulliparous Turkish women with no previous chronic diseases, including obesity, had increased odds of adverse perinatal and neonatal outcomes, including gestational diabetes, gestational hypertension, preeclampsia, SGA babies, spontaneous late-preterm delivery between 34 and 37 weeks of gestation, and caesarean delivery(Kahveci et al 2018:1). An analysis on all foetal and neonatal deaths due to a congenital anomaly registered with the Colombian vital statistics system from 1999 to 2008 also showed that maternal age was an important predictor of mortality due to congenital anomalies; rates were approximately 70% higher when mothers were above 35 years of age compared to younger mothers(Roncancio et al 2018(Roncancio et al :1750. This may be because older mothers are more likely to have babies with congenital anomalies such as Down Syndrome(Roncancio et al 2018(Roncancio et al :1750.A study in Turkey, involving 1,374 pregnant teenagers and 1,294 pregnant adult participants reported that adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine foetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors(Demirci, Yılmaz, Tosun, Kumru, Arınkan & Mahmutoğlu 2016:344).…”

“…An analysis on all foetal and neonatal deaths due to a congenital anomaly registered with the Colombian vital statistics system from 1999 to 2008 also showed that maternal age was an important predictor of mortality due to congenital anomalies; rates were approximately 70% higher when mothers were above 35 years of age compared to younger mothers(Roncancio et al 2018(Roncancio et al :1750. This may be because older mothers are more likely to have babies with congenital anomalies such as Down Syndrome(Roncancio et al 2018(Roncancio et al :1750.A study in Turkey, involving 1,374 pregnant teenagers and 1,294 pregnant adult participants reported that adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine foetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors(Demirci, Yılmaz, Tosun, Kumru, Arınkan & Mahmutoğlu 2016:344). In Kenya, a retrospective audit of maternal and neonatal records conducted with detailed analysis of the most recent 150 maternal deaths and 200 neonatal deaths in a tertiary hospital found that half (51%) of the early neonatal mortalities were among younger mothers (15-24 years)(Yego et al 2013:3).…”

US Mortality Due To Congenital Heart Disease Across the Lifespan from 1999-2017 Exposes Persistent Racial/Ethnic Disparities

“…Congenital heart disease is the leading cause of birth defect-related mortality, accounting for approximately 40% percent of deaths in children with birth defects in the United States and worldwide. [1][2][3][4] Prior studies have demonstrated decreasing mortality over time in CHD in the United States, likely due to marked advances in medical and surgical care. 5,6 The most comprehensive assessment in the United States to date was a population-based study evaluating CHD mortality from 1999 through 2006.…”