Aloui M, Nasri K, Ben Jemaa N, Ben Hamida A M, Masmoudi A, Gaïgi S S, Marrakchi R
Faculté des sciences de Bizerte, université de Carthage, 7021 Zarzouna, Bizerte, Tunisia; UR 06/SP14 troubles du développement embryofœtal et placentaire, service d'embryo-fœtopathologie, centre de maternité et de néonatologie de Tunis, 1007 Tunis, Tunisia.
Faculté des sciences de Bizerte, université de Carthage, 7021 Zarzouna, Bizerte, Tunisia; UR 06/SP14 troubles du développement embryofœtal et placentaire, service d'embryo-fœtopathologie, centre de maternité et de néonatologie de Tunis, 1007 Tunis, Tunisia.
J Gynecol Obstet Hum Reprod. 2017 Oct;46(8):651-655. doi: 10.1016/j.jogoh.2017.05.006. Epub 2017 May 21.
Despite the high risk of recurrence of congenital malformations, there are no well-accepted preventive measures in developing countries like Tunisia. It is recommended that thorough epidemiological studies of congenital anomalies in this country are needed. The aim of this study is to assess the frequency and types of congenital anomalies in Tunisia and research some risk factors associated with occurrence of these anomalies.
In this retrospective study, all the fetuses who were autopsied during 21years period from February 1991 to December 2011 (n=9678) at Service of embryofetopathology in the Center of Maternity and Neonatology of Tunis (CMNT) were studied. The classification of malformations was based upon the anatomical system affected. The differences in fetal/maternal characteristics between cases with or without congenital malformations were assessed using Chi test.
Of the all 9678 autopsied fetuses, 4498 (46.47%) were diagnosed as being malformed fetuses. Anomalies of limbs (22.71%) and digestive and abdominal wall defects (14.76%) were mostly detected, followed by congenital brain defects (13.41%) and nephrourologic abnormalities (11.23%). A marked association of parental consanguinity with increased congenital anomalies rates was found (P<10, OR=1.89, CI=1.69-2.13).
In Tunisia, surveillance and epidemiological evaluation of congenital anomalies underline the high frequency of these events. This will help to better target congenital anomalies prevention and screening policies in our population.
尽管先天性畸形复发风险很高，但在突尼斯这样的发展中国家，尚无广泛认可的预防措施。建议对该国先天性异常进行全面的流行病学研究。本研究的目的是评估突尼斯先天性异常的发生率和类型，并研究与这些异常发生相关的一些风险因素。
在这项回顾性研究中，对1991年2月至2011年12月21年间在突尼斯妇产和新生儿中心胚胎胎儿病理学服务部接受尸检的所有胎儿（n = 9678）进行了研究。畸形的分类基于受影响的解剖系统。使用卡方检验评估有无先天性畸形的胎儿/母亲特征差异。
在所有9678例接受尸检的胎儿中，4498例（46.47%）被诊断为畸形胎儿。最常检测到的是肢体异常（22.71%）以及消化和腹壁缺陷（14.76%），其次是先天性脑缺陷（13.41%）和肾泌尿系统异常（11.23%）。发现近亲结婚与先天性异常发生率增加之间存在显著关联（P < 0.001，OR = 1.89，CI = 1.69 - 2.13）。
在突尼斯，对先天性异常的监测和流行病学评估突显了这些事件的高发生率。这将有助于更好地针对我国人群制定先天性异常预防和筛查政策。
