Risk Factors For Congenital Malformations Research Articles

Prevalence and Risk Factors for Congenital Malformations in Morocco

Background: Congenital malformations are among the most pressing health concerns globally. In Morocco, minimizing the morbidity and mortality associated with congenital malformations is a key health policy objective. In the Marrakech-Safi region, the prevalence and etiology of congenital malformations remain unclear. Objectives: This study seeks to ascertain the prevalence of clinically evident congenital malformations and identify the factors contributing to their incidence in the Marrakech-Safi region. Methods: A retrospective study was conducted in the maternity ward of the Mohamed VI University Hospital Center in Marrakech in 2022. An obstetric chart was utilized to gather sociodemographic, obstetrical, maternal, and neonatal data from the target population, including risk factors. The data were analyzed using SPSS 21 software. Results: Out of 17 250 files reviewed, 159 births with malformations were identified, resulting in a prevalence of 0.92% of births. Newborns with multiple malformations constituted 22.64% of all cases, with a prevalence of 2.08/1000 births. Neural tube defects were the most common, with a prevalence of 3.65/1000 births, followed by musculoskeletal defects and digestive tract defects. Chromosomal malformations, specifically trisomy 21, were the fifth most common, with a prevalence of 1.4/1000 births. Facial and urogenital malformations were the least frequent in this study. The occurrence of congenital malformations in this region is influenced by various risk factors, including maternal age, male sex, parity, medical history, and newborn weight at birth. Conclusions: In the Marrakech-Safi region, congenital malformations are influenced by a wide range of risk factors. Identifying these factors is crucial for healthcare providers to enhance surveillance among at-risk populations and develop effective preventive, diagnostic, and therapeutic strategies.

181-LB: Congenital Malformations and Medication Use in Women With Type 2 Diabetes—Preliminary Results

Background: Congenital malformations occur more frequently in pregnancies of women with type 2 diabetes, mainly attributed to poor glycemic control. However, using certain medications may also contribute. Aim: To describe medication use by conception time in women with type 2 diabetes. Methods: In this retrospective cohort, women with singleton pregnancies from two tertiary care hospitals were enrolled. Data on maternal age, time of diabetes diagnosis, medication use, BMI, HbA1c, and congenital malformations were collected from medical records between May 2005 and June 2021. We excluded four neonates with genetic/chromosomic diseases. Poisson regression with robust estimates was used to evaluate risk factors for congenital malformations. Results: We included 634 women; 212 (33.5%) presented overt diabetes; 136 (21.5%) arrived at prenatal care in the first trimester; 18 (2.8%) had a miscarriage; 560 (88.3%) delivered alive newborns, and 17 (2.7%), stillbirth. Only 227 women (35.8%) had an HbA1c measured in the first trimester, and 304 (48.6%) had an HbA1c before 28 weeks of gestation. Congenital malformations were diagnosed in 77 (13.7%) neonates; of these, 56 (73%) were cardiac defects, isolated or combined with other malformations. Few women used folate in the first trimester (115; 18.1%), almost always introduced after pregnancy diagnosis; 353 (55%) used oral antidiabetics; 116 (18.3%), any anti-hypertensive medication, and 16 (2.5%), statins. In adjusted models including age, BMI and HbA1c, sulfonylurea was associated with increased risk of congenital malformation: RR 2.7, 95% CI 1.3-5.6, p=0.009, when HbA1c in the first trimester entered the model (n=200); and RR 1.64, 95% CI 1.0-2.6, p=0.038, with an HbA1c measured before 28 weeks (n=539). Conclusion: In this cohort of women with type 2 diabetes, congenital malformations were more frequent than in the general population. Sulfonylurea was the only medication associated with an increased risk of congenital malformation. Disclosure A. A. J. Reichelt: None. G. L. Guerra: None. M. A. De campos: None. V. N. Hirakata: None. M. R. Oppermann: None. Funding FIPE-HCPA (2016-0331)

Exploratory Study of Risk Factors for Congenital Malformations in Morocco

Exploratory Study of Risk Factors for Congenital Malformations in Morocco

Prevalence and maternal risk factors of congenital malformations in newborns from Sergipe, Northeastern Brazil

Introduction: Due to the importance of infant death caused by congenital malformations worldwide, more studies are necessary to determine the prevalence of these disorders serving as the basis for more effective control measures. Objective: To determine the prevalence and evaluate maternal risk factors for congenital malformations in newborns. Methods: A cross-sectional and retrospective study was performed in the reference maternity hospital for high-risk pregnancies in the state of Sergipe, northeastern Brazil. Data were collected from the medical records and declarations of live births of 16,518 births between January 2014 and December 2016, being included children with identified congenital malformations. Data were analyzed using the odds ratio, chi-square, and Fisher's exact test with p<0.05. Results: The study population was composed of 369 newborns with congenital malformations, which corresponds to 2.23% of total births. 53.9% were male, 47.9% had low birth weight and, 52.5% had adequate Apgar score. Anomalies affecting the musculoskeletal system were the most prevalent (30.9%), with polydactyly being the most frequent (53.5%). The number of prenatal consultations, education, and gestational age were the main observed maternal risk factors of congenital malformations. Anomalies of the circulatory system (OR=3.2 CI95% 1.3-7.84), multiple malformations (OR=9.24 CI95% 3.07-27.83), and chromosomal syndromes (OR=2.72 CI95% 1.48-5.01) were the most commonly associated with newborn deaths. Conclusion: The study presents the prevalence and risk factors related to malformations in the state of Sergipe, and improvements on maternal care and socioeconomic variables are important to decrease the number of malformations cases in Brazil.

Risk Factors for Congenital Malformations among Population in the Agadir Region at Morocco

A prospective case-control study at the regional level was conducted in the pediatrics and neonatology department of Hassan II hospital in Agadir in Morocco from April 2016 to April 2018. In this study, we aimed to study congenital anomalies in the population of the study region regarding the frequency and highlight the associated risk factors. The types of congenital malformations have been classified according to the International Classification of Diseases (ICD-10). Univariate analyzes were performed to identify the variables associated with the etiology of the malformations. Multiple logistic regression was used to characterize the associations between the MC, and the determining explanatory variables are taken into account simultaneously. The results found that congenital disabilities were significantly associated with the consanguinity level of the child, the prematurity of childbirth, the family history of CMs, the Body Mass index. (BMI) of the mother and the presence of a significant trauma during pregnancy. Our results have made it possible to highlight the existence of an association between a certain number of risk factors and the occurrence of congenital malformations

Study of clinical profile and associated risk factors for congenital malformations in neonates: a hospital based prospective study

Background: Congenital malformations are major cause of neonatal morbidity and mortality and account for 8-10% of all peri-natal deaths especially in developing countries. Incidence of congenital malformation is increasing owing to reduction in other causes of neonatal deaths due to improvement in perinatal care worldwide. This study was aimed to evaluate the incidence, perinatal variables and contributing risk factors associated with birth defects that will help to plan future strategies for prevention, early diagnosis and timely management. Methods: This is a hospital-based prospective observational study conducted in department of pediatrics of a tertiary care centre of western India over period of two year. All new-borns with anatomical congenital malformations detected antenatal or postnatal (prior to discharge) period were included in this study. Detailed and careful clinical examination was carried out for all new-born.Results: The incidence of congenital malformation in the present study is 1.27%. Prematurity (76.1%), low birth weight (68%) and male neonates (67%) were associated with increased risk of congenital malformation. Most common system involved in this study was cranio-spinal system (47.3%). Overall, most common congenital anomaly was Hydrocephalus with meningomyelocele (8%). Among maternal variables, malnutrition (90%), consanguinity (40%) and abortions (40%) are strongly associated with malformations. Conclusions: Congenital malformations are important cause of neonatal death. Strategies to diagnose, prevent, treat and rehabilitate the neonate are utmost necessary. Early screening to identify high risk pregnancies and timely management is strongly recommended.

Editors' note: Reducing birth defects in women with epilepsy: Research leading to results

In “Reducing birth defects in women with epilepsy: research leading to results,” Pennell and Meador discuss: (1) the need for neurologists to carefully consider selection of antiepileptic drugs (AEDs) in women of childbearing age and (2) the impact of EURAP—a prospective registry of women on AEDs in 42 countries—on facilitating further understanding of the risks of congenital malformations and neurodevelopmental abnormalities associated with AEDs. Braillon and Bewley comment that (1) increased advocacy is needed to ensure whether EURAP's findings affect practice expediently and (2) to make the results more meaningful, EURAP should include detailed data on other risk factors for congenital malformations and neurodevelopmental abnormalities. Finally, the findings of EURAP should have influence on regulatory agencies to improve drug safety. Sethi further notes that it is particularly important for steps to be taken to ensure whether EURAP's findings be used to improve AED prescribing practices in low- and middle-income countries. Pennell and Meador respond that it is challenging to change practice, but partnership with governmental and regulatory organizations and performance of meta-analyses can help disseminate information about medications associated with of congenital malformations and neurodevelopmental abnormalities. Pennell further notes that the International League against Epilepsy is working to facilitate education of all specialists who care for women with epilepsy using knowledge acquired from EURAP in an effort to decrease the frequency of congenital malformations and neurodevelopmental abnormalities in patients on AEDs. In “Reducing birth defects in women with epilepsy: research leading to results,” Pennell and Meador discuss: (1) the need for neurologists to carefully consider selection of antiepileptic drugs (AEDs) in women of childbearing age and (2) the impact of EURAP—a prospective registry of women on AEDs in 42 countries—on facilitating further understanding of the risks of congenital malformations and neurodevelopmental abnormalities associated with AEDs. Braillon and Bewley comment that (1) increased advocacy is needed to ensure whether EURAP's findings affect practice expediently and (2) to make the results more meaningful, EURAP should include detailed data on other risk factors for congenital malformations and neurodevelopmental abnormalities. Finally, the findings of EURAP should have influence on regulatory agencies to improve drug safety. Sethi further notes that it is particularly important for steps to be taken to ensure whether EURAP's findings be used to improve AED prescribing practices in low- and middle-income countries. Pennell and Meador respond that it is challenging to change practice, but partnership with governmental and regulatory organizations and performance of meta-analyses can help disseminate information about medications associated with of congenital malformations and neurodevelopmental abnormalities. Pennell further notes that the International League against Epilepsy is working to facilitate education of all specialists who care for women with epilepsy using knowledge acquired from EURAP in an effort to decrease the frequency of congenital malformations and neurodevelopmental abnormalities in patients on AEDs.

Growth patterns and associated risk factors of congenital malformations in twins

BackgroundThe rate of twinning continues to increase due to the combined effect of a rise in parental age and increased use of assisted reproductive technology. The risk of congenital anomalies in twins is higher than in singletons, but it is less well reported in relation to growth patterns. We focused to the auxological outcome of twin pregnancies when one or both of twins are affected by one or more malformations.MethodsWe conducted a retrospective observational study reviewing the clinical charts of twins admitted in the period between January 2003 and December 2018 at the University Hospital of Palermo. The associations between malformations and anthropometric variables at birth were analyzed by comparison within each twin pair and regarding each variable as ordered difference between the two twins.ResultsWe studied data of 488 neonates (52% females) from 244 pregnancies. The rate of major congenital anomalies was 11%, affecting significantly the smaller twin (p = .00018; Odds ratio 3.21; 95% CI 1.65 6.59). Malformation class distribution was as following: genitourinary (24%), gastrointestinal (20%), cardiovascular (18.5%), musculoskeletal (11%), central nervous system (9%), syndromic (9%), ocular (5.5%) and diaphragmatic hernia (2%). The most predictive value, the Birthweight (BW) difference mean ratio in malformed versus not malformed neonates (− 0.31 vs 0.02; p = .0016) was distributed equally lower than zero in all malformed twins, except for those with congenital heart defects (p = .0000083).Microcephaly (head circumference < 2 standard deviation, SD) was present in 3% of symmetrically smaller twin, and severe microcephaly (< 3 SD) was present in 0.6%. We found that an intertwin BW discordance of 18% or greater identified 50% of neonates with microcephaly, but only 11% of malformed twins.ConclusionsIn case of one twin with a BW < 10th centile, a concomitant intertwin BW discordance ≥18% could reveal an increased risk for microcephaly but not for malformation. Lower values of BW, Ponderal index, Body mass index but above all negative value of BW difference mean ratio are associated with malformations in twin pairs.

Modifiable risk factors of congenital malformations in bale zone hospitals, Southeast Ethiopia: an unmatched case-control study

BackgroundCongenital malformations are structural, functional, and metabolic defects that develop during the organogenesis period and present at birth or later in life. There has been little research on congenital malformations in Ethiopia, knowledge on the incidence of birth defects at birth is unknown and the etiologies of the anomalies are limited. This study, therefore, aimed to assess the modifiable risks of congenital anomalies among women in Bale zone hospitals, Ethiopia.MethodsAn unmatched case-control study was conducted from February 2018 to January 2019 in the Bale zone; namely Goba referral hospital, Robe, Ginnir and Dolomena hospitals. A total of 409 women were selected. Mothers who gave birth with any type of congenital malformation were assigned as cases and those who gave live births without any congenital abnormalities were assigned as controls. Controls were selected by the lottery method from the labor ward. For each case, two consecutive controls were included. Data were entered into Epi-data 3.1 and exported into Statistical Package for the Social Sciences (SPSS) version 21 for analysis. Logistic regression was conducted to analyze the data.ResultsAlarmingly, women who had been exposed to pesticides during the current pregnancy were two times more prone to give congenital malformed infants than their counterparts (AOR = 3.19; 95% CI = 1.31, 10.96). Additionally, those women who chewed khat during the periconceptional period were two times more likely to have congenital malformed infants as compared to women who did not engage in this activity (AOR = 2.40; 95% CI = 1.11, 5.19).ConclusionsUrgent attention needs to be given by public health professionals and services to khat chewing and maternal exposure to pesticides during pregnancy to reduce the risk of congenital malformations.

Analysis of detection rate and risk factors for congenital malformation among neonates

Objective To analyze the detection rate of neonatal congenital malformation, and to explore the risk factors for neonatal malformation. Methods A total of 29 831 infants born in Shenzhen People′s Hospital from January 2011 to December 2015 were analyzed retrospectively, the detection rate of congenital malformations was calculated, 381 infants with congenital malformation were selected as malformation group, and 381 healthy infants were selected as healthy control group, and the risk factors of congenital malformation were analyzed. Results A total of 381 infants with congenital malformation were screened out, the incidence rate of congenital malformation being was 12.77‰(381/29 831 cases). The incidence rates of multi-finger or multi-toe, cleft lip, congenital heart disease were the high, which were 18.64%(71/381 cases), 17.32%(66/381 cases) and 16.80%(64/381 cases), respectively.The multiple Logistic analysis showed that birth children with low weight newborns( 1, low literacy levels of mothers, living in towns, late childbirth(≥35 years of age), pregnancy syndrome, viral infection during early pregnancy, medication history during pregnancy, rubella unvaccinated, exposure to harmful substance, smoking and alcohol during pregnancy and paternal smoking, chronic diseases, total 16 items were related risk factors for neonatal congenital malformations(all P<0.05). Among them, the impact of viral infection during early pregnancy, alcohol, smoking, pregnancy syndrome, exposure to harmful substance, medication history during pregnancy on the incidence of malformations in neonates was relatively serious. Conclusions The incidence rate of congenital malformations among neonates conforms to the present situations in China, which was closely correlated with genetic and environmental factors.Health education targeting pregnant women and the women of childbearing age should be carried cut to reduce the birth of neonatal congenital malformations. Key words: Infant, newborn; Congenital malformation; Risk factor; Logistic regression analysis

A Systematized Review of Atypical Antipsychotics in Pregnant Women: Balancing Between Risks of Untreated Illness and Risks of Drug-Related Adverse Effects.

To summarize risks related to (1) illness and (2) second-generation antipsychotic (SGA) treatment in pregnant women and their offspring. Concerning illness-related risks, we focused on bipolar disorder and schizophrenia, psychiatric disorders for which SGAs are preferentially prescribed. PubMed, Ovid, Scopus, PsycINFO, and Cochrane Library were searched from the date of the first available article to October 2015 using the following key terms: pregnancy OR gestation OR bipolar disorder OR schizophrenia. We also included cross-references from identified articles. We included 49 English-language articles regarding illness-related and SGA-related risks in bipolar disorder and schizophrenia. First, searches were done for epidemiologic or experimental studies (from January 2000 to October 2015), then for systematic reviews and meta-analyses. Data were extracted independently, after removing duplicates and studies that were not relevant or not pertinent. Abrupt discontinuation of treatment-exposed mothers with bipolar disorder or schizophrenia led to a high risk of relapses during pregnancy. Both bipolar disorder and schizophrenia were linked to a slightly increased risk of obstetric complications for mothers (schizophrenia) and the newborn (bipolar disorder and schizophrenia), although data on drug exposure during pregnancy were not given in the majority of studies. Maternal morbidity (schizophrenia but not bipolar disorder) may be associated with the worst neonatal outcomes (stillbirth, neonatal or infant deaths, and intellectual disability). Untreated bipolar disorder and schizophrenia may be considered independent risk factors for congenital malformations, while SGAs were not associated with increased recurring defects in fetuses. Evidence regarding the potential effects of SGAs on child neurodevelopment remains reassuring. After taking into account the parents' will and after they provide informed consent, the most reasonable and less harmful choice for treating future mothers with bipolar disorder or schizophrenia appears to be maintaining them at the safest minimum dosage.

To The Question of Optimization of Diagnostics and Treatment of Congenital Anomalies of Urinary Tract for the Children

The aim. Identification of the main risk factors for congenital malformations of the urinary system.Materials and methods. Have made a retrospective and prospective analysis of clinical materials of 135 mother-infant pairs with malformations of the kidneys and urinary tract. Patients were divided into two groups: the first group (study group) were 58 children who underwent ultrasound diagnostics congenital malformations in the prenatal period; the second group (control group) were 77 children aged 0-3 years who are prenatal ultrasound was conducted.Results and discussions. The basic mediko-social factors of risk of development of congenital anomalies of urinary tract are certain in the article. The features of parents obstetric anamnesis are set, the flow of intranatal period is gone into detail, the basic clinical displays of manifestation of congenital anomalies of urinary tract are certain for children with or without of prenatal ultrasound research. As a result of the conducted research the basic factors of risk of development of congenital anomalies of urinary tract are certain for children. It is set that antenatal factors (health of parents, flow of pregnancy and births) influence on forming of the urinary system for children. Using prenatal methods of diagnostics for congenital anomalies of urinary tract can allow not only before diagnose found out vices and determine the wide enough spectrum anomalies of development kidneys and overhead urinary ways but also to prevent development of complications. Conclusions. The early exposure of action of ante- and intranatal factors can improve diagnostics and treatment of this group of patients.

Risk Factors of Congenital Malformations in North India: A Case Control Study

ABSTRACT An increasing incidence of congenital malformations (CMF) has been reported in India. Objective To ascertain the determinants of CMF. Methodology This hospital based age-sex matched pair case control study was done at advanced pediatric center (APC), obstetrics and gynecology department (ANC clinic, maternity ward, labor room, etc.) and special clinics, PGIMER, Chandigarh, India in 2008. The mothers were interviewed to collect information about risk factors. Results Two hundred three CMF (under five children and gestational CMF) cases and same number of controls were studied. Significant association of CMF was observed with the use of sex selection drugs by mothers (OR = 4.35), habits of fathers like taking alcohol (OR = 3), smoking (OR = 4.5) and using tobacco (OR = 2.7). Mother's age at marriage &lt; 18 years and history of abortion were also important predictors of CMF. Conclusion Most of the risk factors for CMF were avoidable viz. addiction, early marriage and use of sex selection drugs. People need to be educated about this. How to cite this article Singh A, Sinha S. Risk Factors of Congenital Malformations in North India: A Case Control Study. J Postgrad Med Edu Res 2016;50(1):22-27.

Risk Factors of Congenital Malformations in North India: A Case—control Study

ABSTRACT An increasing incidence of congenital malformations (CMF) has been reported in India. Background and objective To ascertain the determinants of congenital malformations. Materials and methods This hospital based age-sex matched pair case control study was done at Advanced Pediatric Centre, Obstetrics and Gynecology Department (ANC clinic, Maternity ward, labor room, etc.) and Special Clinics, PGIMER, Chandigarh, India in 2008. The mothers were interviewed to collect information about risk factors. Results Two hundred three CMF (under five children and gestational CMF) cases and same number of controls were studied. Significant association of CMF was observed with the use of sex selection drugs by mothers (OR = 4.35), habits of fathers like taking alcohol (OR = 3), smoking (OR = 4.5) and using tobacco (OR = 2.7). Mother's age at marriage &lt; 18 years and history of abortion were also important predictors of CMF. Conclusion Most of the risk factors for CMF were avoidable viz addiction, early marriage and use of sex selection drugs. People need to be educated about this. How to cite this article Singh A, Sinha S. Risk Factors of Congenital Malformations in North India: A Case—control Study. J Postgrad Med Edu Res 2016;50(2):59-63.

Functional variant in methionine synthase reductase intron-1 is associated with pleiotropic congenital malformations.

Congenital malformations, such as neural tube defects (NTDs) and congenital heart disease (CHD), cause significant fetal mortality and childhood morbidity. NTDs are a common congenital anomaly, and are typically induced by higher maternal homocysteine (Hcy) levels and abnormal folate metabolism. The gene encoding methionine synthase reductase (MTRR) is essential for adequate remethylation of Hcy. Previous studies have focused on the coding region of genes involved in one-carbon metabolism, but recent research demonstrates that an allelic change in a non-coding region of MTRR (rs326119) increases the risk of CHD. We hypothesized that this variant might contribute to the etiology of NTDs as well, based on a common role during early embryogenesis. In the present study, 244 neural tube defect cases and 407 controls from northern China were analyzed to determine any association (by χ (2) test) between rs326119 and disease phenotypes. Significant increased risk of anencephaly was seen in MTRR variant rs326119 heterozygote (het) and homozygote (hom) individuals [odds ratios (OR)het=1.81; ORhom=2.05)]. Furthermore, this variant was also a risk factor for congenital malformations of the adrenal gland (OR=1.85), likely due to multiple systemic malformations in the NTDs case population. Our present data indicate that the rs326119 non-coding variant of MTRR has a pleiotropic effect on the development of multiple tissues, especially during early stages in utero. This suggests the allelic state of MTRR is a significant clinical factor affecting Hcy levels and optimal folic supplementation.

Pattern of clinically recognisable congenital malformations in babies born in a tertiary referral centre in Sri Lanka.

To record incidence, pattern and prevalence of risk factors of congenital malformations (CM) in live new born babies at a Teaching Hospital in Sri Lanka. All newborn babies delivered over a period of six months at the Teaching Hospital, Mahamodara were included in this cross sectional study and they were subjected to thorough medical examination to detect any CM. An interviewer administered questionnaire was used to collect information on socio-demographics and risk factors associated with CM. Overall prevalence of CM in the study group was 4.3%. Occurrence was higher in males (61.4%) than females (36.9%). Highest frequency of CM was in the musculoskeletal system. Parents' age, previous history of abortions or stillbirths, consanguinity and pre-conceptual folic acid deficiency were the most prevalent risk factors related to CM. Prevalence of CM in the study group is high compared to other countries in the region. Emphasis on preventing CM is recommended and public health actions is required in improving well-being of affected babies.

Identification of risk factors for congenital malformations

The relative importance of congenital malformations as a cause of death in the first year of life is increasing along with the control of preventable causes of perinatal mortality. To identify risk factors for congenital malformations. Retrospective case-control study of births registered in the database of The Latin American Collaborative Study of Congenital Malformations (ECLAMC), in the period 2001-2010. Birth weight and gestational age were significantly lower in cases than controls, behaving as risk factors and associated with a greater severity of congenital malformations. The risk and severity of congenital malformations increased along with mother's age. Fetal growth retardation, a history of congenital malformations in the family, physical factors and acute illnesses of the mother in the first trimester of pregnancy were also significant risk factors for congenital malformations and their severity. The educational level of the mother was a protective factor for congenital malformations and their severity. Variables previously identified as risk factors for congenital malformations, were significantly related with the occurrence of congenital malformations and their severity.

Associated Risk Factors and Prevalence of Congenital Malformations in Ardabil, Iran

Introduction: Congenital anomalies are the most common cause of disability in developed and developing countries. Costs of hospitalization and treatment of congenital anomalies pose a significant burden to families and societies. The objective of the present study was to determine the associated risk factors and prevalence of congenital malformations in Ardabil, Iran. Methods: This cross-sectional study was conducted during November 2010 and July 2011 in three maternity hospitals, located in Ardabil, Iran. All live newborns were examined during the first 24 hours of life. Out of 6,868 live births during the study period, 57 neonates with congenital malformations were selected as the case group and 180 normal neonates were included as the control group. Data were collected using a researcher-made questionnaire and prenatal and delivery records. Data were entered to SPSS version 11, and statistical analysis was performed, using Chi-square along with univariate and multivariate logistic regressions. Results: The prevalence of congenital malformations was 8.2 per 1,000 live births. Musculoskeletal system malformation was the most common congenital abnormality (35.1%), followed by central nervous system disorders (22.8%), digestive system disorders (17.5%), urogenital system diseases (15.8%), and chromosomal anomalies (8.8%). Also, polyhydramnion (P=0.001, OR=14.4, CI:3.07-68.0), oligohydramnios (P=0.009, OR=13.09, CI:1.9-89.0), preeclampsia (P=0.000, OR=11.37, CI:2.99-43.14), unwanted pregnancy (P=0.000, OR=4.9, CI:2.0-13.0)), urinary tract infection in weeks 6-10 of pregnancy (P=0.045, OR=2.88, CI:1.0-18.11), and consanguinity (P=0.038, OR=2.23, CI:1.0-4.78) were determined as risk factors for congenital malformations. Conclusion:Early diagnostic survey of pregnant women with polyhydramnios, oligohydramnios, preeclampsia, unwanted pregnancy, urinary tract infection in weeks 6-10 of pregnancy, and consanguinity may be an appropriate solution toward the prevention of congenital anomalies.

The influence of visual impairment on pregnancy outcomes.

To investigate whether visually impaired women are at higher risk for adverse maternal and perinatal complications, with an emphasis on visual impairment due to autoimmune etiology. A retrospective cohort study compared obstetric, delivery complications and perinatal outcomes of patients with and without a diagnosis of visual impairment in one or both eyes. Multivariable models were conducted to control for confounders. During the study period (1988-2012), 265,741 deliveries were included; of these 80 (0.03%) occurred in visually impaired patients. These patients were significantly older than the comparison group, and had higher rates of gestational diabetes mellitus (GDM) and severe preeclampsia. Visually impaired women had higher rates of delivery prior to 37 weeks gestation and significantly higher rate of delivery by cesarean section (CS). A multivariable analysis model demonstrated that the risk factor for CS and packed cell transfusion in visually impaired women remained significantly high even after controlling for confounders such as maternal age, ethnicity, etc. (weighted OR = 2.04; 95% CI 1.23-3.37; p = 0.006). However, visual impairment was not an independent risk factor for congenital malformations, using another multivariable model (weighted OR = 1.96; 95% CI 0.99-3.85; p = 0.051). Perinatal outcome was comparable between the groups. The sub-group of visually impaired women due to possible autoimmune etiology was 19.4% and they had higher rates of recurrent miscarriages and CS compared to the other sub-groups. Visually impaired pregnant women are at high risk for CS and packed cell transfusion. Nevertheless, perinatal outcome is comparable to the general population.

P1-18 Studying early pregnancy during infertility treatment may identify novel risk factors for congenital malformations

IntroductionThe study of early pregnancy risk is generally very difficult, but potentially feasible in women during clinical infertility treatment with gamete and embryo data, known gestation, routine ultrasound in early...