Abstract
BackgroundCongenital anomalies or birth defects are among the leading causes of infant mortality and morbidity around the world. The impact of congenital anomalies is particularly severe in middle- and low-income countries where health care resources are limited. The prevalence of congenital anomalies varies in different parts of the world, which could reflect different aetiological factors in different geographical regions.MethodsBetween October 2012 and January 2013, a cross-sectional study was conducted involving young infants below 2 months of age, admitted at a university teaching hospital in Tanzania. Face-to-face interviews with parents/caretakers of young infants were carried out to collect socio-demographic and clinical information. Physical examinations were performed on all young infants. Echocardiography, X-ray, cranial as well as abdominal ultrasonographies were performed when indicated.ResultsAnalysis of the data showed that among 445 young infants enrolled in the study, the prevalence of congenital anomalies was 29%, with the Central Nervous System (CNS) as the most commonly affected organ system. Maternal factors that were significantly associated with congenital anomalies included the lack of peri-conceptional use of folic acid (OR = 3.1; 95% CI = 1.4-6.7; p = 0.005), a maternal age of above 35 years (OR = 2.2; 95% CI = 1.1-4.3; p = 0.024) and an inadequate attendance to antenatal clinic (OR = 2.1; 95% CI = 1.4-3.3; p < 0.001). Infant factors that were significantly associated with congenital anomalies were female sex, a birth weight of 2.5 kg or more, singleton pregnancy and a birth order above 4.ConclusionsDue to the high prevalence of congenital anomalies observed in this particular context, the hospital should mobilize additional resources for an optimal and timely management of the patients with congenital anomalies. In this study, the proportion of women taking folic acid supplements during early pregnancy was very low. Efforts should be made to ensure that more women use folic acid during the peri-conceptional period, as the use of folic acid supplement has been linked by several authors to a reduced occurrence of some congenital anomalies.
Highlights
Congenital anomalies or birth defects are among the leading causes of infant mortality and morbidity around the world
The incidence of congenital anomalies varies between geographical regions but it is estimated that 3-7% of children are born with birth defects [1,2,3]
Reports on the incidence of congenital anomalies in the developing world should be taken with caution, as the absence of birth defect registries in most of these countries, the deficiency in diagnostic capabilities and unreliable medical records and health statistics might increase the chances of underestimation
Summary
Congenital anomalies or birth defects are among the leading causes of infant mortality and morbidity around the world. The incidence of congenital anomalies varies between geographical regions but it is estimated that 3-7% of children are born with birth defects [1,2,3]. The magnitude of congenital anomalies in Asia has been shown to vary with reported incidences of 2.5% in India and 1.3% in China [5,6]. Reports on the incidence of congenital anomalies in the developing world should be taken with caution, as the absence of birth defect registries in most of these countries, the deficiency in diagnostic capabilities and unreliable medical records and health statistics might increase the chances of underestimation. Most of the studies done in Africa have been retrospective hospital-based studies which are usually affected by underreporting and other sources of ascertainment bias [11]
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