Abstract
Background: Although major external structural birth defects continue to occur globally, the greatest burden is shouldered by resource-constrained countries largely with no surveillance systems. To the best of our knowledge, few studies have been published on the risk factors for these defects in developing countries. The objective of this study was to identify the risk factors for major external structural birth defects among children in Kiambu County, Kenya. Methods: A hospital-based case-control study was used to identify the risk factors for major external structural birth defects in Kiambu County. A structured questionnaire was used to gather information retrospectively on exposure to environmental teratogens, multifactorial inheritance, and sociodemographic-environmental factors during the study participants' last pregnancies.Descriptive analyses (means, standard deviations, medians, and ranges) were used to summarize continuous variables, whereas, categorical variables were summarized as proportions and percentages in frequency tables. Afterward, logistic regression analyses were conducted to estimate the effects of the predictors on major external structural birth defects in the county. Results: From the multivariable analyses, maternal age ≤34 years old, (aOR: 0.41; 95% CI: 0.18-0.91; P=0.03), and preceding siblings with history of birth defects (aOR: 5.21; 95% CI; 1.35-20.12; P =0.02) were identified as the significant predictors of major external structural birth defects. Conclusions: Maternal age ≥35 years old, and siblings with a history of birth defects were identified as the risk factors for major external structural birth defects in Kiambu County, Kenya. This pointed to a need to create awareness among couples against delaying childbearing beyond 35 years of age and the need for clinical genetic services for women of reproductive age with history of births affected by congenital anomalies.
Highlights
Worldwide, an estimated 7.9 million children are born every year with a birth defect, of which approximately 3.3 million die before age five and around 3.2 million could be physically disabled for life[1,2]
This study investigated maternal periconceptional exposure to environmental, sociodemographic-environmental, and multifactorial inheritance-related risks factors for major external structural birth defects’ (MESBDs) in Kiambu County, Kenya
Some limitations were inherent in this study; there was a likelihood of differential recall bias among the study respondents; cases were more likely to remember their preconception period owing to the experience of MESBDs in the last birth than the controls, could affect their estimates
Summary
An estimated 7.9 million children are born every year with a birth defect, of which approximately 3.3 million die before age five and around 3.2 million could be physically disabled for life[1,2]. Birth defects are defined as abnormalities of body structures or functions that develop during the organogenesis period (first-trimester of gestation) and are detectable during pregnancy, at birth, or soon after[2,3] These defects may be classified as major when associated with significant adverse health effects requiring medical/surgical care; otherwise, they are described as minor[1,2]. The phrase ‘major external structural birth defects’ (MESBDs) denotes congenital physical abnormalities that are clinically obvious at birth or soon after which call for medical and/or surgical interventions[1,2] The causes of these defects can be classified into three categories: (i) identifiable environmental factors (teratogens/micronutrient deficiencies); (ii) identifiable genetic factors; and (iii) complex genetic and idiopathic environmental factors, described as multifactorial inheritance[1,4,7,8,9,10]. Results: From the multivariable analyses, maternal age ≤34 years old, (aOR: 0.41; 95% CI: 0.18-0.91; P=0.03), and preceding siblings with history of birth defects (aOR: 5.21; 95% CI; 1.35-20.12; P =0.02) were identified as the significant predictors of major external structural birth defects
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