Abstract
BackgroundCongenital anomalies are a significant cause of death and disability for infants, especially in low and middle-income countries (LMIC), where 95% of all deaths due to anomalies occur. Limited data on the prevalence and survival of infants with congenital anomalies are available from Central America. Estimates have indicated that 53 of every 10,000 live births in Guatemala are associated with a congenital anomaly. We aim to report on the incidence and survival of infants with congenital anomalies from a population-based registry and classify the anomalies according to the International Classification of Disease, Tenth Revision (ICD-10).MethodsWe conducted a planned secondary analysis of data from the Maternal Newborn Health Registry (MNHR), a prospective, population-based study carried out by the Global Network for Women’s and Children’s Health Research in seven research sites. We included all deliveries between 2014 and 2018 in urban and rural settings in Chimaltenango, in the Western Highlands of Guatemala. These cases of clinically evident anomalies were reported by field staff and reviewed by medically trained staff, who classified them according to ICD – 10 categories. The incidence of congenital anomalies and associated stillbirth, neonatal mortality, and survival rates were determined for up to 42 days.ResultsOut of 60,142 births, 384 infants were found to have a clinically evident congenital anomaly (63.8 per 10,000 births). The most common were anomalies of the nervous system (28.8 per 10,000), malformations and deformations of the musculoskeletal system (10.8 per 10,000), and cleft lip and palate (10.0 per 10,000). Infants born with nervous system anomalies had the highest stillbirth and neonatal mortality rates (14.6 and 9.0 per 10,000, respectively).ConclusionsThis is the first population-based report on congenital anomalies in Guatemala. The rates we found of overall anomalies are higher than previously reported estimates. These data will be useful to increase the focus on congenital anomalies and hopefully increase the use of interventions of proven benefit.Trial registrationClinalTrial.gov ID: NCT01073475.
Highlights
Congenital anomalies are a significant cause of death and disability for infants, especially in low and middle-income countries (LMIC), where 95% of all deaths due to anomalies occur
Congenital anomalies are a significant cause of stillbirths, neonatal mortality, and disability in low- and middle-income country (LMIC) settings, where 95% of all deaths occur
From available Ministry of Health (MOH) data, an estimated 2% of neonatal deaths are caused by congenital anomalies, with 67% of the reported anomalies identified as nervous system defects and 15% as cleft lip and palate [6]
Summary
Congenital anomalies are a significant cause of death and disability for infants, especially in low and middle-income countries (LMIC), where 95% of all deaths due to anomalies occur. From available Ministry of Health (MOH) data, an estimated 2% of neonatal deaths are caused by congenital anomalies, with 67% of the reported anomalies identified as nervous system defects and 15% as cleft lip and palate [6]. It is likely that the role of anomalies is under-estimated, since rural areas lack access to trained health personnel to identify and report congenital anomalies properly. This is of particular concern in this region and in LMICs in general, as many anomalies associated with environmental exposures, nutrient deficits and even some viral infections are potentially preventable [8, 9]
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