342 Congenital Anomalies and Perinatal Resource Utilization: A Population Study

Abstract

Background and aims: Congenital anomalies pose significant health, social and economic challenges to society. The Fetal Alert Network (FAN) integrates antenatal care for pregnancies with anomalies in Ontario (population >13 million) and allows us examine the impact of antenatal diagnosis on maternal and fetal outcomes.Methods: Retrospective analysis of all infants admitted to Level III NICUs in the Province of Ontario Canada, between Jan 2005 and Dec 2008, using CNN and FAN data. Infants were stratified into anomaly (based on ICD codes), versus nonanomaly groups and pre or postnatal diagnosis of anomaly. Data were analyzed using descriptive statistics and bivariate and multivariate analyses were used to assess fetal and maternal outcomes.Results: Over the four year period 15,237 infants were admitted to regionalized tertiary level NICUs (2.8% of all births) and 4,400 (29%) had at least 1 congenital anomaly. There was significant difference in maternal age between the 2 groups p< 0.0001, but not in maternal diabetes or mode of delivery. There were significantly more male infants in the anomaly group p< 0.005. Birth weight (mean 2.3kg) and GA (mean 34 weeks) although low, were greater in the anomaly group. Illness severity as measured by SNAP-II scores, duration of ventilation and length of hospital stay were all greater in the anomaly group, p< 0.0001.Conclusions: This study provides new insights into the impact of congenital anomalies on perinatal health care provision in a regionalised setting and the rationale for continued efforts to decrease the prevalence of these defects.