Prevalence, Pattern, and Outcome of Congenital Anomalies Admitted to a Neonatal Unit in a Low-Income Country—a Ten-Year Retrospective Study

Abstract

Objective The incidence of congenital abnormalities is highest in low-and-middle-income countries. However, the prevalence, spectrum, trends of neonatal congenital anomalies and their admission outcomes have not been well explored. This study was a 10 year retrospective hospital-based research in a low-income country to address the above. Methods All infants hospitalized in the Special Care Baby Unit at the Cape Coast Teaching Hospital in Ghana, between 1st January 2010 and 31st December 2019, had their demographic, obstetric, and clinical data recorded. Results Over the decade, 236 neonates with congenital abnormalities were admitted to the unit, accounting for 2.8% of total neonatal admissions and 8.6 per 1000 births. Mortality occurred in 33.2% of neonates with congenital abnormalities, corresponding to 4.6% of all neonatal deaths. Mortality was significantly associated with place of delivery and gravidity of more than five. The commonest anomalies were in the nervous system, particularly neural tube defects, followed by suspected chromosomal abnormalities and then cardiac defects. Neonates with cardiac defects had a higher chance of dying. Health center/clinic delivery proffered a better survival than hospital delivery, but this should be interpreted with caution. Conclusion Neural tube defects were the most predominant anomalies; hence, intensification of preconception and antenatal folic acid supplementation is pivotal towards their reduction. Making prenatal screening for early detection of fetal anomalies an integral part of routine antenatal care is also essential. This research was conducted in a single center and did not include stillbirths and abortions so cannot give an accurate estimation of the number of congenital abnormalities in the population. A national registry of congenital anomalies is recommended.

Risk factors associated with neonatal mortality among neonates admitted to neonatal intensive care unit of the University Teaching Hospital in Lusaka

“…Globally, congenital anomalies are the fourth leading cause of neonatal mortality with an annual death of 240,000 of which 90% with serious disorders are from low-and-middle-income countries 33 . Our findings are similar to previous studies in Nigeria 34 , Ghana 35 , and South Africa 36 where congenital anomalies was found to have accounted for 10.4–33.5% of neonatal mortality of neonates admitted to NICU. Measures to promote primary prevention and improve the health of neonates with congenital disorders via improved surveillance, building capacity and increase expertise on prevention and care, increasing awareness on newborn screenings, strengthening research on major birth defects, and supporting affected families may help reduce the burden of congenital anomalies 33 .…”

Risk factors associated with neonatal mortality among neonates admitted to neonatal intensive care unit of the university teaching hospital in Lusaka, Zambia: A retrospective analysis

“…Globally, congenital anomalies are the fourth leading cause of neonatal mortality with an annual death of 240,000 of which 90% with serious disorders are from low-and-middle-income countries 33 . Our ndings are similar to previous studies in Nigeria 34 , Ghana 35 , and South Africa 36 where congenital anomalies was found to have accounted for 10.4%-33.5% of overall neonatal mortality. Measures to promote primary prevention and improve the health of neonates with congenital disorders via improved surveillance, building capacity and increase expertise on prevention and care, increasing awareness on newborn screenings, strengthening research on major birth defects, and supporting affected families may help reduce the burden of congenital anomalies 33 .…”

Congenital Anomalies and their Outcomes in the Neonate Intensive Care Unit in Misurata Center

“…In our previous published study, in 2015, the mortality rate was significantly lower (29%) [11]. A similar rate of 36.7% and 33.4 was seen in a study in Malta [12] in 2014, and recent 10-years-retrospective study in Ghana [13], while a significantly lower rates of 10.4%, 15.4%, were seen among other studies [14][15]. There was a higher number of males, but there wasn't a significant association could between male sex and death.…”