Prevalence of overt congenital anomalies, and associated factors among newborns delivered at jimma university medical center, southwest Ethiopia from may 1 to june 30,2018

Abstract

BACKGROUND: Congenital anomalies, also known as birth defects, are structural, functional and metabolic disorders that occur during intrauterine life and can be identified prenatally, at birth or later in life. According to the World Health Organization, an estimated 270,000 deaths globally were attributable to congenital anomalies during the first 28 days of life. Neural tube defects are one of the most serious and most common of these anomalies. However, scientific data on the magnitude, contributing factors and health impact of birth defects in Ethiopia in general and in Jimma particularly is currently inadequate. OBJECTIVES: To assess the prevalence of overt congenital anomalies and associated factors among neonates delivered at Jimma university medical center. METHODS: An institutional based cross-sectional study was conducted from May 1 to June 30, 2018. Data was collected from 754 delivered neonates with their respective mothers using structured and interviewer administered questionnaire. Neonatal weight, head circumference and length were measured after birth. Mid upper arm circumference was measured to assess nutritional status of the mother. All data were cleaned, coded and entered into EPI data 3.1 and exported to SPSS software version 20:0 for analysis. Analysis included descriptive statistics and logistic regression. Multivariate logistic regression model was fitted to assess the association between the independent and dependent variables. Adjusted Odds ratios were calculated with 95% CIs and considered significant with a pvalue <0.05. RESULTS: A total of 754neonates were delivered from 754 mothers and participated in this study which yielded93.6% response rate. The study finding showed that the prevalence of overt congenital anomalies among live and still births neonates was 4.1%. From 31 cases, Majority of anomalies were isolated and major in 93.5% and 96.7% of cases respectively. Central nervous system anomalies had the highest prevalence 45.1% and followed by orofacial clefts 25.8% and musculoskeletal system defects 13%. Anencephaly was the most common central nervous system anomaly in 50% of cases followed by hydrocephalus 21.4%. Unspecified cleft palate with unilateral cleft lip and bilateral cleft lip were most prevalent forms of orofacial clefts in50% and 25% of the cases respectively. Unknown medication uses during early pregnancy (AOR = 15.1; 95% CI: 5.5-40.2, p-value=<0.00), history of maternal khat chewing in early pregnancy (AOR = 3.4; 95% CI: 1.462-7.95, p-value= 0.004), and maternal chronic illness before conception (AOR = 4.3; 95% CI = 1.65-11.37, p-value=0.031), were independent predictors of congenital anomalies. Folate use (AOR = 0.18; 95% CI: 0.02-0.92, p-value=0.003) during periconception had a protective effect from congenital anomaly. CONCLUSION AND RECOMMENDATION: The Prevalence of overt congenital anomalies among the study participants was high. Unknown medication use, maternal chronic illness and history of maternal khat chewing were independent predictors of congenital anomalies. Folic acid supplementation, prevention and treatment of chronic medical illness and provision of health education regarding impact of khat chewing and unknown medication use should be recommended.