Title: Study of Prevalence and Spectrum of Congenital Anomalies in Muzaffarpur, Bihar: A Hospital Based Longitudinal Study

Authors: Amrita Pritam­­­­­­­­, Pallawi Singh, Sanjeev Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.32

Abstract

Objective: Congenital anomalies are defined as structural or functional anomalies that occur during intrauterine life and can be identified antenatally, at birth or later in life. Congenital malformations are becoming increasingly important and are the leading cause of infant mortality and morbidity. Neonatal morbidity and mortality is a matter of great concern in our society in context of health care delivery system. The occurrence and pattern of presentation vary from region to region. The aim of present study was to determine the prevalence and types of congenital anomalies in newborns and to study the associated factors.

Materials and Methods: This longitudinal hospital based study was conducted in Department of Obstetrics and Gynecology, at S.K. Medical College and Hospital, Muzaffarpur, Bihar. Total 100 cases of congenital malformation, detected antenatally or after delivery, were analyzed within a study period of April 2016 to March 2017. All the relevant information’s were collected by conducting an interview using a predesigned questionnaire. A thorough post-natal screening and examination was performed and anomalies were recorded.

Result: Total 100 cases of anomalies were studied out of 9060 pregnancies. The prevalence of congenital malformation was 1.10%. Most common age group with congenital anomalies were 20-30 years (63%). Most of the anomalous babies (74%) were born to multigravida mothers. Commonest system involved was central nervous system (44%). Maximum (60%) babies were diagnosed to have anomalies in the postpartum period. Amniotic fluid abnormalities were the most commonly (56%) associated maternal conditions. 63% of cases had history of absence of intake of peri conceptional folic acid intake.

Conclusion: Congenital anomalies are important causes of still births and infant mortality, and also contribute to childhood morbidity. The study helped to know the pattern of congenital anomalies and the presence of various associated factors. This study showed the need  and importance of peri conceptional folic acid intake and significance of prenatal diagnosis through screening tests and targeted scans in first and second trimester as an  important step to reduce its prevalence.

Keywords: Antenatal visit, congenital anomalies, prenatal diagnosis.

References

  1. Bhende, Asha A. and Tara Kanitkar (1985). Principles of Population Studies, 3rd, Himalaya Publishing House, Mumbai.
  2. WHO (1968). Techn. Rep. Ser., No.400.
  3. Park K. Congenital Malformations: Preventive Medicine In Obstetrics, Pedia-trics and Geriatrics.In: Park's Textbook of Preventive and Social Medicine 24th Jabalpur: Banarsidas Bhanot 2017:p.613
  4. WHO(2012), Congenital Anomalies, Fact Sheet No, 370, Oct.2012.
  5. Sachdeva S. Nanda S. Bhalla K. Sachdeva R. Gross congenital malformation at birth in a government hospital. Indian J Public Health. 2014;58:54-56.
  6. Penchaszadeh VB. Preventing congenital anomalies in developing countries. Community Genet. 2002;5:61-69.
  7. 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; 16:159-63.
  8. Socioeconomic inequalities in risk of congenital anomaly. Arch Dis Child 2000,82(5);349-352.
  9. Studies HUIoP. Turkey Demographic and Health Survey 2003. In: Hacettepe University Institute of Population Studies Mo HGDo Ma CHaFP, State Planning Organization and European Unioin, editor. Ankara, Turkey 2004. Vrijheid M, Dolk H, Stone D, Abramsky L, Alberman E, Scott J:
  10. Mohanty C. Mishra OP, Das BK, Bhatia BD, Singh G. Congenital malformations in newborn: A study of 10,874 consecutive births. J Anat Soc India. 1989; 38:101-11.
  11. Mathur BC. Karan S. Vijaya Devi KK. Congenital malformations in the newborn. Indian Pediatr. 1975;12:179-83.
  12. Madi SA. Al-Nagger RL. Al-Awadi SA. Bastaki LA. Profile of major congenital malformations in neonates in Al-Jahra region of Kuwait. East Mediterr Health J. 2005; 11:700­-06.
  13. Ordonez MP. Nazer J. Aguila A. Cifuentes L. Congenital malformations and chronic diseases of the mother. Latin American collaborative study of congenital malformations (ECLAMC) 1971-1999. Rev Med Chil. 2003; 131:404­11.
  14. Schaefer-Graf UM, Buchanan TA,Xing A, Songster G,Montoro M, Kjos SL. Patterns of congenital anomalies and relationship to initial maternal fasting glucose levels in pregnancies complicated by type 2 and gestational diabetes. Am J Obstet Gynecol.2000 Feb;182(2):313-20
  15. Macintosh MC, Flemming KM, Bailey JA, Doyle P, Modder J, Acolet D, Golightly S, Miller A, Perinatal mortality and congenital anomalies in babies of women with type 1 or 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ. 2006 Jul 22; 333(7560): 177. Epub 2006 Jun 16
  16. Hay S, Barbano H. Independent effects of maternal age and birth order on the incidence of selected congenital malform-ations. Teratology. 1972 Dec;6(3):271-9
  17. Hollier LM, Leveno KJ, Kelly MA, MCIntire DD, Cunningham FG. Maternal age and malformations in singleton births. Obstet Gynecol. 2000 Nov; 96(5 Pt 1): 701-6
  18. Bhat BV, Ravikumara M. Perinatal mortality in India-Need for introspection. Indian J Matern Child Health. 1996;16: 159-63.
  19. Kalra A. Kalra K. Sharma V. Singh M. Dayal RS. Congenital malformations. Indian Pediatr. 1984;24:945-50.
  20. Hall J, Solehdin F. Folic acid for the prevention of congenital anomalies. Eur J Pediatr. 1998 Jun; 157 (6): 445-50.

Corresponding Author

Amrita Pritam­­­­­­­­

Senior Resident, Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar