Magnitude and patterns of congenital malformation and associated factors among neonates admitted to jimma medical center neonatal and pediatrics wards, south west Ethiopia

Abstract

Background: According to World Health Organization, the word congenital anomaly include any morphological, functional, biochemical or molecular defects that may develop in the embryo and fetus from conception until birth, and present at birth, whether detected at the time of birth or later. There are several known factors that are associated with congenital malformations, which can relate to genetics, environment, or maternal health/well-being. There is paucity of data on prevalence and risk factors of congenital malformation in newborns in Ethiopia in general and Jimma Medical Center in particular. Objectives: To assess the magnitude, pattern and factors associated to congenital malformation in neonates admitted to neonatal and pediatrics wards of Jimma Medical Center. Methods: Institution based prospective cross-sectional study was conducted in the neonatology and pediatrics wards, Department of pediatrics and child health, Jimma Medical Center from March to July 2020. Structured questionnaire was used to capture the relevant data. EpiData version 4.0 and SPSS version 20.0 were used for data entry and analysis respectively. Descriptive statistics was carried out to see the patterns of congenital malformation whereas bivariate and multivariate logistic regression analyses were performed to identify the factors associated with congenital malformations at p-value of 0.05 and confidence interval of 95%. Results: 422 neonates admitted to neonatology and pediatrics wards were enrolled in the study, yielding 100% response rate. Closer to one in five admitted neonates (78, 18.5%, 95% CI 14.7-22.3) in the study had congenital malformation. Central nerves system is the most commonly involved (29, 6.87%) followed by the gastrointestinal system (24, 5.68%). In multi-variable logistic regression analysis, having less than four antenatal care follow up (AOR 2.05, 95% CI 1.21, 3.48, p=0.008), lack of periconceptional folic acid supplementation (AOR 2.38, 95% CI, 1.13, 5.03, p=0.023), and maternal under nutrition (AOR 7.73, 95% CI, 1.60, 34.61, p=0.008), are significantly associated with congenital malformation. Conclusion and recommendation: Congenital malformation is one of the commonest reasons of admission to the neonatology and pediatrics wards of Jimma Medical Center. The most commonly affected system is the central nerves system. There is significant association between congenital malformation and poor antenatal attendance, lack of periconceptional folic acid supplementation, and maternal under nutrition. Large scale, multicenter center study is III recommended in collaboration with different stakeholders to understand the real burden of congenital malformation and associated factors so that possible preventive and curative interventions can be designed.