Abstract
Introduction: Birth defects are defined as structural and functional defects that develop during the organogenesis periods and present at birth or detected later in life. They are an important cause of morbidity and mortality in infants. The known causes of birth defects are mostly genetic effect modified by environmental factors which may be prevented.
 Objective: The main objective of the study was to determine the association of certain risk factors with birth defects occurring in newborn and infant seeking care in Dhulikhel Hospital, Kavre, Nepal.
 Methodology: This is a hospital based, cross sectional and comparative study involving 219 young infant below 2 months of age admitted in the Dhulikhel Hospital, Kathmandu University Hospital. We enrolled infants admitted at Neonatal intensive care unit, Neonatal ward, and neonates staying with mother in post natal wards, from 1stJanuary 2015 to 31stDecember 2017.
 Results: Incidence of congenital malformations involvement of neonates in our hospital was 1.1% among the live births. The most frequent was cardiovascular systems 29(26.8%) followed by musculoskeletal system 17(15.7%) and face 15(13.8%). Less than 4 in number of Antenatal visit (p=0.017), not using folic acid during early pregnancy (p<0.001) and low socioeconomic conditions (p<0.001) were significantly associated with congenital malformations. Among all congenital anomalies complex congenital heart disease has poor outcome.
 Conclusion: The most common congenital defects involved cardiovascular and musculoskeletal system. Lack of antenatal visit, lack of folic acid during periconceptional age and low socioeconomic conditions are the most common risk factors identified for congenital anomalies.
Highlights
Congenital anomalies are defined as structural or func onal abnormali es including metabolic disorders present at birth
Lack of folic acid during periconcep onal age and low socioeconomic condi ons are the most common risk factors iden fied for congenital anomalies
In born babies were those who born within our hospital and out born babies were those who born outside our hospital including other hospital, health center, home delivery and ambulance delivery
Summary
Congenital anomalies are defined as structural or func onal abnormali es including metabolic disorders present at birth. It can be isolated abnormality or part of syndrome that con nue to be an important cause of neonatal and infant morbidity and mortality.[1,2] Fetal development is influenced by various gene c and environmental factors that leads to defec ve embryogenesis and intrinsic abnormali es resul ng birth defect.[3] In 60% cases, the certain causa ve factor are unexplained in 40% of the cases there are recognized causa ve factors.[4] The factors most commonly implicated are gene c condi ons, environmental pollu ons, teratogens, infec ons, drugs and uncontrolled medical disorders. There are mul factorial inheritances responsible in most of anomalies. 4
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