Pattern of birth defects at a university teaching hospital in Northern Nigeria: Retrospective review over a decade

Abstract

Background: Major birth defects are common causes of perinatal morbidity and mortality which have become a global phenomenon. Its occurrence in the developing nations like Nigeria requires due consideration most especially to its pattern and risk factors.

Objectives: This review was conducted to determine the pattern of birth defects and investigate the factors associated with birth defects and its outcome at Aminu Kano Teaching Hospital (AKTH), Kano.

Methods: This was a 10‑year retrospective study conducted in the Department of Obstetrics and Gynaecology and the Department of Paediatrics (Special Care Baby Unit) of AKTH, Kano, between April 2007 and March 2017. Data retrieved from patients’ file were collected using a purpose‑designed proforma to obtain information on the required parameters and analyzed using IBM SPSS version 20, 2009 software. Frequencies and percentages were calculated and the results were presented in tabular forms.

Results: There were 6990 deliveries within the study period, out of which 305 babies had birth defects, giving a prevalence of 4.4%. Among women who delivered baby with birth defects, maternal age ranged from 16 to 45 years with a mean age of 30 ± 5 years. The highest incidence (48%) of birth defects occurred among the 26–35 years age group. Anomalies that affected single system are significantly higher than anomalies that affected multiple systems. A higher percentage (52.5%) of birth defects occurred in male neonates. The gastrointestinal system was the most commonly affected (32.5%), while musculoskeletal system was the least (3.75%) affected system. Drug intake among 120 mothers who delivered neonates with birth defects when considered as a risk factor was found to constitute 81% of traditional concoction/herbs; while 12.5% were orthodox and intake of social drug was found to be only 6.5%. Hypertension was found to be the highest chronic medical disorder, while chorioamnionitis following premature rupture of membrane was recorded as the most commonly occurring maternal infection. Sixty percent of these neonates with birth defects were managed conservatively, surgical treatment was given in 23.5%, while 16.5% underwent medical treatment. Discharge rate was 82.5%; 9% left against medical advice, while neonatal mortality rate was about 8.5% and a majority (91.8%) of the death occurred among the neonates with multiple birth defects.

Conclusion: The prevalence of birth defect in AKTH was 4.4% of the total deliveries over the study period. Gastrointestinal system was found to be the most commonly affected system. Hypertensive disorders of pregnancy and ingestion of traditional herbs were found to be the most common medical disorder and drug intake, respectively, among the mothers who delivered neonates with birth defects. Although the outcome of the management was good, and the study could not establish direct causation, there is need to counsel  mothers on the inherent dangers of traditional herbs ingestion and the need to pay adequate attention to medical conditions in pregnancy.

Keywords: Anomaly; birth defect; morbidity; neonate; prevalence rate