Anencephaly and Pregnancy Outcome in Iran

Abstract

Objectives: The aim of this research is to study the complications of pregnancy associated with anencephaly. Study Methods: Thirty-five mothers who delivered an anencephalic baby (as a case group) and forty-three mothers who delivered a non-anencephalic baby (as a control group)were included in this analytical research study. All cases and controls had singleton pregnancies. More than one matched control was chosen for each case when possible. The cases were selected by a survey of 149,000 births in six educational centers located in Tehran. The control group matched with the study group regarding birth date, maternal age, socioeconomic status and living environment. The outcomes for the control and study groups were studied and compared in the following areas: premature rupture of membrane, pregnancy length, fetal presentation, hydramnios, fetal death, sex ratio (male to female ratio) and other anomalies. Results: Anencephaly increased the likelihood of premature rupture of membrane by a factor of seven (p < 0.001). Pre-term birth was six times more likely (p < 0.005) and acephalic fetal presentation was 46% (p < 0.0005). In the study group, sex ratio was 0.52 and in control was 1.68 (p < 0.025). Further, hydramnios appeared in 90% of the study group. Finally, the general likelihood of any abnormality was 19 times (p < 0.0005) greater in the study group than the control group. Conclusions: Considering the clear correlation between anencephaly and pregnancy complications, precise prenatal care, early diagnosis and treatment are strongly indicated in order to avoid serious maternal complications.

Complicações obstétricas em gestações com feto portador de anomalia incompatível com a sobrevida neonatal

“…This research identified a predominantly young population, which was not significant in other studies (11)(12)(13) . Regarding the duration of pregnancy, preterm birth found in other studies ranged from 50% to 53% meeting the results of this survey, which shows a 55% incidence of this type of delivery.…”

“…The prevalence of polyhydramnios, with a wide variation ranging from 27% to 90%. If we look alone, in our study this was present in 50% of cases (11)(12)(13) . Authors, in their studies found an association between polyhydramnios and congenital anomalies in 81.1% of pregnancies analyzed (14) .…”

“…Another fact observed in the study (11) with anencephalic fetus was the occurrence of 46% of abnormal fetal presentation. It was found that the anomalous presentation is associated frequently with congenital abnormalities and in 29.2% of the cases resulted in cesarean delivery of emergency and elective caesarean section in 23.3% (16) .…”

“…Authors, despite their claim that anencephaly increases by seven times the chance of premature rupture of membranes, had no observations in the five-year study with evaluated 30 pregnancies with anencephalic fetus and there were no cases of abruptio placenta, placenta previa or any dystocia (11) . These findings go against this study, which showed five cases of abruptio placenta, and three were anencephalic.…”

“…In another study it was observed that the chance of oligohydramnios in the pregnancy is five times higher when there are congenital anomalies (15) . As for the fetal death, data in the literature range from 7% to 50% of intra uterine fetal death in anencephaly (11)(12)(13) . In our study, among the cases of anencephaly this figure was over 23%, and overall, counting all the anomalies, 20%.…”