Neurological congenital malformations in a tertiary hospital in south Brazil

Abstract

-Background: Congenital anomalies are one of the main causes of morbidity and mortality among infants. The involvement of the central nervous system (CNS) occurs in 21% of cases. Objective: To identify incidence of CNS malformations and associated factors in newborns at a Terciary Hospital of Porto Alegre. Method: Case-control study conducted between 2000 and 2005 based on the Latin American Collaborative Study of Congenital Malformations database. Results: Among 26,588 births registered in this period, 3.67% presented with malformations (IC=95%; 3.44-3.9), being 0.36% of the CNS (IC=95%,(0.29-0.43)). The most common CNS malformation was meningomielocele (10.4%). Young maternal age (p=0.005); low birth weight (p=0.015); large cephalic perimeter (p=0.003); post term birth (p=0.000) and low APGAR indexes at the 1 st and 5 th minutes were associated with CNS malformations. Conclusion: We found an incidence of CNS malformations similar as compared to literature.KeY WoRdS: neurological malformations, neural tube defects, risk factors, congenital malformations. Malformações neurológicas congênitas observadas em hopsital terciário no sul do Brasilresumo -Anomalias congênitas são umas das principais causas de morbimortalidade infantil. o sistema nervoso central (SNC) é acometido em 21% dos casos. Objetivo: Identificar a incidência e fatores associados a malformações do SNC em recém nascidos na maternidade de um hospital terciário de Porto Alegre. Método: estudo controle realizado de janeiro de 2000 a dezembro de 2005, baseado no banco de dados do estudo Colaborativo Latino Americano de Malformações Congênitas. Resultados: dos 26.588 nascimentos, 3,67% apresentaram malformação (IC=95%; 3,44-3,9), com 0,36% do SNC (IC=95%, (0,29-0,43)). A malformação do SNC mais comum foi hidrocefalia (10,9%). Menor idade materna (p=0,005); menor peso ao nascimento (p=0,015), maior perímetro cefálico (p=0,003); nascimentos pré-termo (p=0,000) e menores índice APGAR no 1 o e 5 o minutos (p<0,000) apresentaram associação com malformações do SNC. Conclusão: Foi encontrada incidência similar de malformações do SNC comparada à literatura.PALAvRAS-CHAve: malformações neurológicas, defeitos tubo neural, pé torto, fatores de risco.

Mothers of Children with Hydrocephalus: Aspects about Prenatal Care

“…With respect to age, many of the mothers were relatively young. This finding corroborates other studies [6], [8] in the literature showing that prevalence of hydrocephalus is higher in children of young mothers.…”

“…Other authors have also demonstrated a minimum standard of education in studies of this disease [20]. Brazilian studies showed that 46.1% of mothers of children with congenital malformations had only basic education and educational level ranged from 1 to 11 years of study [8], [21]. The low educational levels observed in this study might be related to the local research institution, which serves the lower social classes of the Brazilian Unified Health System.…”

“…Ninety six percent of the fetuses were correctly evaluated as having abnormal central nervous system findings on both fetal ultrasonography and fetal magnetic resonance imaging [9]. In 21.3% of cases of congenital malformation were diagnosed prenatally [8].…”

“…Exams as abdominal ultrasounds, abdominal magnetic resonance imaging and Doppler imaging of cranial arteries and fetal spine provided in routine prenatal care can facilitate the diagnosis of intrauterine fetal myelomeningocele or hydrocephalus [8], [9]. These tests can verify the presence of ventriculomegaly and other malformations when performed after 15 weeks of gestation [10], [11].…”

Neural tube defects in Latin America and the impact of fortification: a literature review

“…(29) . This NTD prevalence was almost half the 9?60/1000 prevalence reported from Porto Alegre for the time period 2000-2005 (30) . In contrast, NTD prevalence in hospital registry data from Minais Gerais and Sao Paulo for comparable time periods ranged from 1?13 to 4?87 per 1000 live births (16,31) .…”