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Background: Congenital malformations (CM) are significant causes of childhood morbidity and mortality impacting negatively on the affected family’s emotional and financial life. It also results in an enormous burden on a nation’s health and socio-economic systems. However, few studies on CM have emanated from developing countries including Nigeria and specifically from Yenagoa, Bayelsa State which is located in the oil rich Niger Delta region. We therefore analyzed the prevalence, pattern and outcome of management of babies with CM seen at the Neonatal unit (SCBU) of the Federal Medical Centre, Yenagoa. This could be used as evidence for policy makers to develop and implement CM surveillance, prevention and supportive programs.
Methods: This was a descriptive observational study of all neonates with CM admitted into the Special Care Baby Unit (SCBU) over a one year period from 1st February 2017 to 31st January 2018. Identification and confirmation of congenital anomalies was done by physical examination, diagnostic investigations and surgical interventions. The conditions were classified organ and system-wise except for the chromosomal abnormalities. The prevalence and pattern of defects were determined, while factors related to the outcome of the anomalies were calculated with odds ratio and 95% confidence interval. Data entry and analysis were performed using excel and SPSS version 22.
Results: Among the 502 newborn admissions during the study period, congenital anomalies were found in 61 newborns, giving a prevalence rate of 12.2% with a female preponderance of 55.7%. The commonest CM were those related to the cardiovascular system (47.5%) followed by the digestive system (32.8%) then musculoskeletal system (19.7%). The mean duration of care was 9.7± 9.0 days with mortality of 30.5% recorded at that period. Babies with CM affecting the cardiovascular system and chromosomal anomalies were less likely to survive although these relationships were not statistically significant (p > 0.05). However, duration of care showed a statistically significant relationship with outcome as babies who spent one day and less in the neonatal unit had reduced odds of a favourable outcome (OR – 0.07). An increased odd of survival (OR – 2.09) was seen in babies with only one congenital birth defect.
Conclusion: A high prevalence of Congenital malformations in newborns was demonstrated in this study. This has highlighted the need for a well-designed surveillance, prevention and supportive hospital, State and National programme for affected babies and their families.
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Sadler TW. Birth defects and prenatal diagnosis. In: Langman’s medical embryology. 13th ed. Philadelphia: Wolters Kluwer. 2015;126–40.
Ndibazza J, Lule S, Nampijja M, Mpairwe H, Oduru G, Kiggundu M et al. Adescription of congenital anomalies among infants in Entebbe, Uganda. Birt Defects Res A Clin Mol Teratol. 2011;91:857–61.
Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: A systematic analysis of Progress, projections and priorities. PLoS Med. 2011;8:e1001080.
Bruederle A, Hodler R. The effect of oil spills on infant mortality: Evidence from Nigeria. CESifo Working Paper Series No. 6653; 2017.
Abbey M, Oloyede OA, Bassey G, Kejeh BM, Otaigbe BE, Opara PI et al. Prevalence and pattern of birth defects in a tertiary health facility in the Niger Delta area of Nigeria. Int J Womens Health. 2017;9:115-121.
MOD (March of Dimes) The march of dimes global report on birth defects: The hidden toll of dying and disabled children. White Plains: NY: March of Dimes Birth Defects Foundation; 2006. Available:http://www.marchofdimes.com/MOD-Report-PF.pdf
Egbe A, Uppu S, Lee S, Stroustrup A, Ho D, Srivastava S. Congenital malformations in the newborn population: A population study and analysis of the effect of sex and prematurity. Pediatr Neonatol. 2015;56:25–30.
Dolk H, Loane M, Garne E. The prevalence of congenital anomalies in Europe. Adv Exp Med Biol. 2010;686:349–364.
US. Department of health and human services. Centre for Disease Control and Prevention, National Centre for Health Statistics, Birth Defects; 2020.
Ahuka OL, Toko RM, Omanga FU, Tshimpanga BJ. Congenital malformations in the North-Eastern democratic republic of Congo during civil war. East Afr Med J. 2006;83:95- 9.
Obu HA, Chinawa JM, Uleanya ND, Adimora GN, Obi IE. Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria-a retrospective study. BMC Res Notes. 2012;5:177.
Bakare TIB, Sowande OA, Adejuyigbe OO, Chinda JY, Usang UE. Epidemiology of external birth defects in neonates in South Western Nigeria. Afr J Paediatr Surg. 2009;6:28.
Adeyemo AA, Gbadegesin RA, Omotade OO. Major congenital malformations among neonatal referrals to a Nigerian university teaching hospital. East Afr Med J. 1997;74:699–701.
Ekanem TB, Okon DE, Akpantah AO, Mesembe OE, Eluwa MA, Ekong MB. Prevalence of congenital malformations in cross river and akwa ibom states of Nigeria from 1980–2003. Congenit Anom (Kyoto). 2008;48(4):167–170. [PubMed]
Ekanem B, Bassey IE, Mesembe OE, Eluwa MA, Ekong MB. Incidence of congenital malformation in 2 major hospitals in rivers state of Nigeria from 1990 to 2003. East Mediterr Health J. 2011;17(9):701–705.
Ajao AE, Adeoye IA. Prevalence, risk factors and outcome of congenital anomalies among neonatal admissions in OGBOMOSO, Nigeria. BMC Pediatrics. 2019;19:88.
Abudu OO, Uguru V, Olude O. Contribution of congenital malformation to perinatal mortality in Lagos, Nigeria. Int J Gynecol Obstet. 1988;27:63–7.
Francine R, Pascale S, Aline H. Congenital anomalies: Prevalence and risk factors. Univers J Public Health. 2014;2:58–63.
Tennant PW, Pearce MS, Bythell M, Rankin J. 20-year survival of children born with congenital anomalies: A population-based study. Lancet. 2010;375:649–56.
Ekwere EO, McNei lR, Agim B, Jeminiwa B,Oni O,Pam S. A retrospective study of congenital anomalies presented at tertiary health facilities in Jos, Nigeria. Journal of Physics: Conference Series (JPCS); 2011.
Lawal T, Adeleye AO, Ayede AI, Ogundoyin OO, Olulana D, Olusanya A et al. Congenital paediatric surgical cases in Ibadan: Patterns and associated malformations. Afr J Med Med Sci. 2017;46:49–55.
Chowdhury P, Devi RP, Singh LB, Thakare AS, Tamang ZD, Debroy S et al. Clinical study on congenital malformations at Birth in a tertiary level Hospital in North-East India. IOSR J Dent Med Sci IOSR-JDMS. 2017;1:24–7.
Chen B-Y, Hwang B-F, Guo Y-L. Epidemiology of congenital anomalies in a population-based birth registry in Taiwan, 2002. J Formos Med Assoc. 2009;108:460–8.
Cosme HW, Lima LS, Barbosa LG. Prevalence of congenital anomalies and their associated factors in newborns in the city of Sao Paulo from 2010 to 2014. Rev Paul Pediatr Orgao Of Soc Pediatr Sao Paulo. 2017;35:33–8.
Tennant P, Samarasekera D, Pless-Mulloli T, Rankin J. Sex differences in the prevalence of congenital anomalies: A population-based study. Birth Defects Res Clin Mol Teratol. 2011;91:894–901.
World Health Organization. Sixty- third World Health Assembly Provisional Agenda item 11.7. A63/10. Geneva; 2010.
Unicef. United Nations Interagency Group for Child Mortality Estimation, Levels and Trends in Child Mortality: Report; 2017.
Adewemimo A, Kalter HD, Perin J, Koffi AK, Quinley J, Black RE. Direct estimates of cause-specific mortality fractions and rates of under-five deaths in the northern and southern regions of Nigeria by verbal autopsy interview. Ryckman KK, ed. PLoS ONE. 2017;12(5).
Hill MA Embryology. International classification of diseases – XVII congenital malformations. Available:https://embryology.med.unsw.edu.au/embryology/indec.php/International_Classification_of Diseases_XVII_Congenital_Malformations
Bhide P, Gund P, Kar A. Prevalence of congenital anomalies in an Indian maternal cohort: Healthcare, prevention and surveillance implications. PLoS ONE. 2016;11(11).
Jose Ambe, Madziga A, George Akpede, Yakubu Mava. Pattern and outcome of congenital malformations in newborn babies in a Nigerian teaching hospital. West African Journal of Medicine. 2010;29:24-9.
Iroha EO, Egri-Okwaji MTC, Odum CU, Anorlu ROI, Oye-Adeniran B, Banjo AAF. Prenatal outcome of obvious congenital malformations as seen at the Lagos university teaching hospital, Nigeria. Niger J Paediatr. 2001;28(3):73–77.
Mukhtar-Yola M, Ibrahim M, Belonwu R. Prevalence and perinatal outcome of obvious congenital malformations among inborn babies of Aminu Kano university teaching hospital, Kano. Niger J Paediatr. 2005;32(2):47–51.
Onyearugha CN, Onyire BN. Congenital malformations as seen in a secondary healthcare institution in Southeast Nigeria. J Med Investig Pract. 2014;9:59–62.
Ahmed O Abdulazeez, Emmanuel S. Kolo, Nafisatu Bello-Mohammed, Sadiq Hassan. Waardenburg’s syndrome Type 1 in a Hausa/Fulani child: Imp,ications for genetic counseling. Journal of Tropical Research. 2016;19(1);64-67.
Duong HT, Hoyt AT, Carmichael SL et al. Is maternal parity an independent risk factor for birth defects? Birth Defects Res A Clin Mol Teratol. 2012;94(4):230-236.
Emodi VC, Osifo DO. Challenges of congenital malformations: An African perspective. Ann Pediatr Surg. 2018;14:1–7.
Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: Evidence from the 2008 demographic and health survey. BMC Public Health. 2014;14: 521.