Pattern and factors associated with congenital anomalies among young infants admitted at Bugando medical centre, Mwanza, Tanzania

Abstract

BackgroundCongenital anomalies or birth defects are among the leading causes of infant mortality and morbidity around the world. The impact of congenital anomalies is particularly severe in middle- and low-income countries where health care resources are limited. The prevalence of congenital anomalies varies in different parts of the world, which could reflect different aetiological factors in different geographical regions.MethodsBetween October 2012 and January 2013, a cross-sectional study was conducted involving young infants below 2 months of age, admitted at a university teaching hospital in Tanzania. Face-to-face interviews with parents/caretakers of young infants were carried out to collect socio-demographic and clinical information. Physical examinations were performed on all young infants. Echocardiography, X-ray, cranial as well as abdominal ultrasonographies were performed when indicated.ResultsAnalysis of the data showed that among 445 young infants enrolled in the study, the prevalence of congenital anomalies was 29%, with the Central Nervous System (CNS) as the most commonly affected organ system. Maternal factors that were significantly associated with congenital anomalies included the lack of peri-conceptional use of folic acid (OR = 3.1; 95% CI = 1.4-6.7; p = 0.005), a maternal age of above 35 years (OR = 2.2; 95% CI = 1.1-4.3; p = 0.024) and an inadequate attendance to antenatal clinic (OR = 2.1; 95% CI = 1.4-3.3; p < 0.001). Infant factors that were significantly associated with congenital anomalies were female sex, a birth weight of 2.5 kg or more, singleton pregnancy and a birth order above 4.ConclusionsDue to the high prevalence of congenital anomalies observed in this particular context, the hospital should mobilize additional resources for an optimal and timely management of the patients with congenital anomalies. In this study, the proportion of women taking folic acid supplements during early pregnancy was very low. Efforts should be made to ensure that more women use folic acid during the peri-conceptional period, as the use of folic acid supplement has been linked by several authors to a reduced occurrence of some congenital anomalies.

Congenital anomalies: the spectrum of distribution and associated maternal risk factors in a tertiary teaching hospital

“…11,12,14 It was significantly seen to be higher in mothers of gravida 4 or more. 11,15,16 This study had 51% of primigravida and 49% of multigravida mothers having babies with anomalies without any such noted predominance.…”

“…A high prevalence ocongenital anomalies (7.0%) was noted in families with consanguinity there. 4 In England and US, the prevalence is 2% and 2-3% respectively. 9 Higher usage of alcohol, cigarettes and substance abuse in the Western population could explain this similarity in occurrence there where consanguinity was rare.…”

“…[4][5][6][7] In the West, malformations constituted 30-50% of neonatal deaths. 3 Prevalence of congenital anomalies vary from country to country due to the various racial, socio-cultural and ethnic influence.…”

Morbidity profile of children referred to Genetic Unit of Mansoura University Childrens Hospital, Egypt.

“…These are then followed by endocrine and metabolic disorders (17.8%) and diseases of the nervous system (9.9%). However, a considerable variation in the frequency of various genetic/malformations disorders had been previously reported in different Arab and NonArab countries [2,[19][20][21][22]. Some studies, however, recorded higher proportions of central nervous system and cardiovascular system malformations followed by gastrointestinal tract and musculoskeletal systems [23][24][25][26][27][28].…”

“…In Tanzania, Mashuda et al, [22] found that the most frequent congenital anomalies of the musculoskeletal system among hospitalized infants were omphalocele and gastroschisis.…”