“At fingers’ ends”: risk factors and perinatal outcome of pregnancies complicated by digital malformations

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To identify the incidence, risk factors, and perinatal outcome of newborns with congenital finger or toe (digital) anomalies. A retrospective study including all neonates born at a tertiary medical center during 2001-2006 with congenital digital anomalies was conducted. The comparison group consisted of newborns without such anomalies born during the same period. Of 115,876 newborns delivered during the study period, 360 (31 per 10,000) were diagnosed with digital anomalies. Polydactyly was the most common diagnosis (n=263; 73% of digital anomalies). Associated anomalies in these patients were congenital heart malformations (n=93; 25.8% of the newborns with congenital digital anomalies), central nervous system anomalies (n=17; 4.7%), and musculoskeletal anomalies (n=13; 3.6%). Newborns with congenital digital anomalies were more likely to be males (62.2 vs. 37.8%; P<0.001), and of a Bedouin Arab descent compared to Jewish ethnicity (61.4 vs. 38.6%; P=0.004). Significantly higher rates of severe pre-eclampsia, recurrent abortions, transverse lie, and low birth-weight (<2,500g) infants were found among newborns with digital anomalies. The incidence of digital anomalies can vary according to the population characteristics. It may be associated with other skeletal and non-skeletal malformations as well as with certain adverse obstetrical and perinatal outcomes. If a fetal digit anomaly is suspected, a detailed assessment of fetal anatomy is mandatory to exclude other malformations.