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Defects,
Epidemiology,
1. Introduction
Congenital anomalies (CA) can be defined as structural or
functional abnormalities including metabolic disorders,
present at birth. These defects of prenatal origin result from
defective embryogenesis or intrinsic abnormalities in the
development process. Birth defects can be isolated
abnormalities or part of a syndrome and continue to be an
important cause of neonatal and infant morbidity and
mortality [1, 2] .
2. Methods
2.1. Type of the Study
This is a retrospective hospital based records,
cross-sectional study with consecutive sampling of
newborns babies, who had been delivered in two Lebanese
Hospital, based in Mount-Lebanon, Lebanon. These
hospitals serve mainly urban areas in the region and were
therefore chosen as an example of an average public health
maternity hospital. The survey included 1000 neonates
delivered between January 2009 and December 2009. All the
charts identified from the Medical Birth Registry of the
deliveries taking place at the hospital were reviewed for the
presence of CA, based on medical records of antenatal care,
delivery care, and pediatric examination of the newborn [12].
All singletons newborns delivered in this hospital during the
study period were examined at birth and screened for major
CA.
Variables recorded included demographic data: date of
birth, sex of the newborn and age of the mother as well as
weight, length, head circumference and apgar scores of the
newborn [13].
Malformations were classified into systems according to
World Health Organization (WHO) recommendations [11].
The abnormalities were divided into several groups relative
to the following systems: Genitourinary, Musculoskeletal,
Nervous, Gastrointestinal, Cardiovascular and Pulmonary
systems and to limbs abnormalities and miscellaneous
disorders.
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3. Results
3.1. Sample Description
60
Table 1. Systemic distribution and percentage of congenital malformations (CA) among 1000 birth
Number of births with the corresponding
malformation
(/24 cases)
Cardiovascular system
16.66
Nervous system
8.4
Respiratory system
8.4
Genitourinary system
8.4
Musculoskeletal system
8.4
Anomalies of limbs
16.66
4.1
Behcet syndrome
4.1
Cephalohematoma
4.1
Chromosomal Abnormalities
4.1
Malformation/System
Miscellaneous
16.66
Total
24
(100%)
Congenital
malformation
N=24 (2.4%)
19(2.2%)
5(3.6%)
10(2.1%)
14(2.7%)
790(98.3%)
123(94.6%)
61(95.3%)
14(1.7%)
7(5.4%)
3(4.7%)
936(97.6%)
38(97.4%)
941(97.5%)
33(100%)
790(97.8%)
184(96.8%)
23(2.4%)
1(2.6%)
24(2.5%)
0
18(2.2%)
6(3.2%)
No
Yes
964(97.8%)
9(81.8%)
22(2.2%)
2(18.2%)
No
Yes
No
Yes
969(97.6%)
5(100%)
693(98.0%)
280(96.6%)
24(2.4%)
0
14(2.0%)
10(3.4%)
No
Yes
618(97.9%)
356(97.0%)
13(2.1%)
11(3.0%)
0.351
631
367
No
Yes
937(98.1%)
37(86.0%)
18(1.9%)
6(14.0%)
<0.001
955
43
No
Yes
No
Yes
No
Yes
146(95.4%)
827(98.0%)
202(95.3%)
772(98.2%)
831(97.3%)
143(99.3%)
7(4.6%)
17(2.0%)
10(4.7%)
14(1.8%)
23(2.7%)
1(0.7%)
No
Yes
839(98.4%)
135(93.1%)
14(1.6%)
10(6.9%)
Characteristics
Hospital
Sex
Consanguinity of
Parents
Mother works
Siblings malformation
Smoking mother
during pregnancy
Mother consumed
alcohol during
Pregnancy
Baby conception by In
vitro fertilization
Premature birth
Birth by Caesarean
section
Stillbirth or perinatal
death
Mother took iron during
pregnancy
Mother took calcium
during pregnancy
Mother took vitamins
during pregnancy
Mother took other drugs
during
Pregnancy
1
2
Females
Males
No
First degree
Second degree
or more
No
yes
No
Yes
No
Yes
p-value
0.360*
0.485
0.015*
0.620*
1.000
0.433
0.027
1.000
0.170
0.079
0.013
0.236
<0.001
Total
N=998
861
137
486
512
804
130
64
959
39
965
33
808
190
986
11
993
5
707
290
153
844
212
786
854
144
853
145
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Table 2b. Characteristics of births with and without congenital malformation (continued)
Characteristics
No congenital l malformation
N=974
Mean (SD)
Congenital malformation
N=24
Mean (SD)
Mothers age
28.54(6.02)
28.74(6.30)
0.874
Mothers gestity
2.65(1.74)
2.96(2.03)
0.387
0.69(1.10)
0.92(1.14)
0.323
1.64(1.36)
1.58(1.53)
0.847
3154.98(477.11)
2908.95(584.02)
0.027
49.62(2.35)
48.56(3.03)
0.058
33.97(1.77)
33.44(1.72)
0.209
8.80(1.82)
5.71(3.63)
<0.001
p-value
Perinatal birth
/stillbirth
Apgar score
Babys weight
Babys cranial
perimeter
Independent variables
Parents consanguinity
Mothers consumption of
alcohol
Mothers consumption of
drugs
Congenital malformations
Caesarean section delivery
Lower gestity
Mothers number of abortions
Mothers number of live
children
Mothers smoking during
pregnancy
Mothers vitamins intake
Mothers iron intake
In vitro Fertilization
conception
Parents consanguinity
Mothers smoking
Caesarean section delivery
Siblings congenital
malformation
Mothers number of abortions
Mothers smoking
Prematurity
ORa
/Beta
[95% CI]
p-value
R2
H-L*
1.72
10.42
5.23
0.94;3.15
1.91;56.73
2.20;12.42
0.078
0.007
<0.001
0.10
0.629
7.63
1.86
1.72
1.73
2.67;21.79
0.98;3.55
1.23;2.38
1.13;2.66
<0.001
0.058
0.001
0.013
0.16
0.551
0.16
-0.45
0.54
0.40
-1.79
-0.22
0.07;0.25
-0.76;-0.15
0.20;0.89
0.06;0.73
-3.49;-0.10
-0.44;-0.01
<0.001
0.004
0.002
0.020
0.038
0.048
0.04
NA
-236.74
-74.03
-313.91;-159.57
-136.72;-11.35
<0.001
<0.001
0.04
NA
1.52
0.19
-0.34
-0.26
0.84;2.19
0.07;0.30
-0.63;-0.06
-0.51;-0.01
<0.001
0.001
0.019
0.042
0.05
NA
62
4. Discussion
Acknowledgments
REFERENCES
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
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