Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Obstetrics and Gynaecology, Cape Coast Teaching Hospital, Cape Coast, Ghana.
Matern Child Health J. 2023 May;27(5):837-849. doi: 10.1007/s10995-023-03591-x. Epub 2023 Feb 28.
The incidence of congenital abnormalities is highest in low-and-middle-income countries. However, the prevalence, spectrum, trends of neonatal congenital anomalies and their admission outcomes have not been well explored. This study was a 10 year retrospective hospital-based research in a low-income country to address the above.
All infants hospitalized in the Special Care Baby Unit at the Cape Coast Teaching Hospital in Ghana, between 1st January 2010 and 31st December 2019, had their demographic, obstetric, and clinical data recorded.
Over the decade, 236 neonates with congenital abnormalities were admitted to the unit, accounting for 2.8% of total neonatal admissions and 8.6 per 1000 births. Mortality occurred in 33.2% of neonates with congenital abnormalities, corresponding to 4.6% of all neonatal deaths. Mortality was significantly associated with place of delivery and gravidity of more than five. The commonest anomalies were in the nervous system, particularly neural tube defects, followed by suspected chromosomal abnormalities and then cardiac defects. Neonates with cardiac defects had a higher chance of dying. Health center/clinic delivery proffered a better survival than hospital delivery, but this should be interpreted with caution.
Neural tube defects were the most predominant anomalies; hence, intensification of preconception and antenatal folic acid supplementation is pivotal towards their reduction. Making prenatal screening for early detection of fetal anomalies an integral part of routine antenatal care is also essential. This research was conducted in a single center and did not include stillbirths and abortions so cannot give an accurate estimation of the number of congenital abnormalities in the population. A national registry of congenital anomalies is recommended.
先天性异常的发病率在中低收入国家最高。然而，新生儿先天性畸形的流行率、范围、趋势及其住院结局尚未得到充分探索。本研究是在一个低收入国家进行的一项为期 10 年的回顾性医院为基础的研究，旨在解决上述问题。
记录 2010 年 1 月 1 日至 2019 年 12 月 31 日期间在加纳开普敦教学医院特殊护理婴儿病房住院的所有婴儿的人口统计学、产科和临床数据。
在这十年中，共有 236 名患有先天性异常的新生儿入住该病房，占新生儿总住院人数的 2.8%，每 1000 例活产中有 8.6 例。先天性异常新生儿的死亡率为 33.2%，相当于所有新生儿死亡的 4.6%。死亡率与分娩地点和孕次超过 5 次显著相关。最常见的异常是神经系统，特别是神经管缺陷，其次是疑似染色体异常，然后是心脏缺陷。患有心脏缺陷的新生儿死亡的可能性更高。卫生中心/诊所分娩的存活率高于医院分娩，但这需要谨慎解释。
神经管缺陷是最主要的异常；因此，加强孕前和产前叶酸补充至关重要，以减少其发生。将产前筛查作为常规产前保健的一个组成部分，以便早期发现胎儿异常也很重要。本研究仅在一个中心进行，未包括死产和流产，因此不能准确估计人群中先天性异常的数量。建议建立先天性畸形国家登记处。
