Gross Congenital Anomalies at Birth in Northeast India- A Retrospective Observational Study

Introduction: Congenital Anomalies (CA) are a significant cause of neonatal mortality both in developed and developing nations. Congenital abnormalities can have different patterns, prevalence rates, and risk factors across time and across different geographic regions.

Aim: To find out the incidence of CA occurring among institutional live births and to study the associated maternal and perinatal risk factors in Northeast region of India.

Materials and Methods: This retrospective observational study was carried out in the Neonatal Intensive Care Unit (NICU) at a Tertiary Care Hospital, Guwahati, Assam, India. The duration of the study was from January 2019 to December 2019. All newborns with CA during this period were included. Maternal and labour ward records were obtained. Data of maternal and antenatal factors such as age, parity, history of consanguinity, family history of congenital abnormality and mode of delivery were collected. The data were analysed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) version 26.0 (IBM SPSS Statistics for Windows, Armonk, NY, USA). Proportion was calculated and the association was tested with Chi-square test and Fisher’s-exact test. p<0.05 was considered to be statistically significant. Multivariate regression analysis was done to find the independent factor(s) for congenital anomaly.

Results: During this study, there were 13530 deliveries, which include 13290 (98.2%) live births and 240 (1.8%) stillbirths. Out of 13290 newborns, 349 had one or more CA accounting for an incidence of 2.6%. The Gastrointestinal (GIT) System was the most commonly affected (33.8%), followed by the Central Nervous System (CNS) (20.9%) and craniofacial (11.7%) system. Cases of the congenital anomaly were found in 2.7% of multiparas, whereas in primiparas, the proportion was only 2.3%. In univariate analysis birth weight, gender, gestational age, maternal age, parity and mode of delivery showed significant association with incidence of congenital anomaly p<0.05*. Regression analysis showed three variables were significantly affecting the occurrence of CAs: gender Odd's Ratio (OR) (OR=0.341), gestational age (OR=32.7) and parity (OR=0.016).

Conclusion: This study highlights the prevalence of GIT, CNS and craniofacial anomalies in this region. The major determinants for CAs were gestational age, gender and parity.