Frequency of Congenital Anomalies in Newborns and Its Relation to Maternal Health in a Tertiary Care Hospital in Peshawar, Pakistan
Keywords:Congenital Abnormalities, Nervous System Malformations, Neural tube defects, Folic acid, Consanguinity
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....
2. Singh A, Gupta RK. Pattern of congenital anomalies in newborn: a hospital based prospective study. JK Science. 2009 Jan-Mar;11(1):34-6.
3. Bittles AH. Consanguineous marriage: current global incidence and its relevance to demographic research. Ann Arbor(MI): University of Michigan, Population Studies Center; 1990. (Research Report No. 90-186)
4. Kumar MR, Bhat BV, Oumachigui A. Perinatal mortality trends in a referral hospital. Indian J Pediatr. 1996 May-Jun;63(3):357-61.
5. Korejo R, Bhutta S, Noorani KJ, Bhutta ZA. An audit and trends of perinatal mortality at the Jinnah Postgraduate Medical Centre, Karachi. J Pak Med Assoc. 2007 Apr;57(4):168-72.
6. Kalter H, Warkany J. Medical progress. Congenital malformations: etiologic factors and their role in prevention. N Engl J Med. 1983 Feb 24;308(8):424-31.
7. Costa CM, da Gama SG, Leal Mdo C. Congenital malformations in Rio de Janeiro, Brazil: prevalence and associated factors. Cad Saude Publica. 2006 Nov;22(11):2423-31.
8. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007 Oct 16;4(10):e296.
9. Rankin J, Pattenden S, Abramsky L, Boyd P, Jordan H, Stone D, et al. Preva¬lence of congenital anomalies in five British regions,1991-99. Arch Dis Child Fetal Neonatal Ed. 2005 Sep;90(5):F374-9.
10. Gul F, Jabin M, Khan AS. Frequency of congenital malformations and associated risk factors at Liaqat Memorial Hospital, Kohat. Khyber Med Univ J. 2012;4(3):119-24
11. Perveen F, Tyyab S. Frequency and pattern of distribution of congenital anomalies in the newborn and associated maternal risk factors. J Coll Physicians Surg Pak. 2007 Jun;17(6):340-3.
12. Taksande A, Vilhekar K, Chaturvedi P, Jain M. Congenital malformations at birth in Central India: a rural medical college hospital based data. Indian J Hum Genet. 2010 Sep;16(3):159-63.
13. Movafagh A, Zadeh ZP, Javadi MH, Mohammed FM, Ghaderian SM, Heidari MH, et al. Occurrence of congenital anomalies and genetic diseases in a population of Ghazvin Province, Iran: a study of 33380 cases. Pak J Med Sci. 2008 Jan-Mar;24(1):80-5.
14. Alberta Health and Wellness. Alberta Congenital Anomalies Surveillance
System: ninth report 1997–2009. Edmonton (AB): Alberta Health and Wellness; 2012.
15. Tomatir AG, Demirhan H, Sorkun HC, Köksal A, Ozerdem F, Cilengir N. Major congenital anomalies: a five-year retrospective regional study in Turkey. Genet Mol Res. 2009 Jan 13;8(1):19-27.
16. Shawky RM, Elsedfy HH, Abolouz SK, Labatia GY. Prevalence of congenital malformations in a thousand consecutive Egyptian liveborn. Egypt J Med Hum Genet. 2001;2(1):43-53.
17. Khan SM, Ahmad GS, Abu-Talib A. Are congenital anomalies more frequent in Saudi Arabia? Ann Saudi Med. 1990;10:488-9.
18. Lisi A, Botto LD, Rittler M, Castilla E, Bianca S, Bianchi F, et al. Sex and congenital malformations: an international perspective. Am J Med Genet A. 2005 Apr 1;134A(1):49-57.
19. de Costa CM. Consanguineous marriage and its relevance to obstetric practice. Obstet Gynecol Surv. 2002 Aug;57(8):530-6.
20. Rukanuddin AR, Hasan KZ. Maternal and Child Health. In: Pakistan De¬mographic and Health Survey 1990/1991. Islamabad: National Institute of Population Studies; 1992. p. 125-48.
21. Mosayebi Z, Movahedian AH. Pattern of congenital malformations in consanguineous versus non consanguineous marriages in Kashan, Islamic Republic of Iran. East Mediterr Health J. 2007 Jul-Aug;13(4):868-75.
22. Centers for Disease Control and Prevention. Folate status in women of childbearing age, by race/ethnicity—United States, 1999-2000, 2001-2002, and 2003-2004. MMWR Morb Mortal Wkly Rep. 2007 Jan 5;55(51-52):1377-80.
23. Yoon PW, Freeman SB, Sherman SL, Taft LF, Gu Y, Pettay D, et al. Advanced maternal age and the risk of Down syndrome characterized by the meiotic stage of chromosomal error. a population based study. Am J Hum Genet. 1996 Mar;58(3):628-33.
24. Sipilä P, von Wendt L, Hartikainen-Sorri AL. The grand multipara—still an obstetrical challenge? Arch Gynecol Obstet. 1990;247(4):187-95.
25. Qazi G. Relationship of selected prenatal factors to pregnancy outcome and congenital anomalies. J Ayub Med Coll Abbottabad. 2010 Oct- Dec;22(4):41-5.
26. Khoury MJ, Erickson JD, Cordero JF, McCarthy BJ. Congenital malformations and intrauterine growth retardation: a population study. Pediatrics. 1988 Jul;82(1):83-90.
27. Leonardi-Bee J, Britton J, Venn V. Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: a meta-analysis. Pediatrics. 2011 Apr;127(4):734-41.
How to Cite
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to firstname.lastname@example.org
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to email@example.com