Shaheen Fatima, Humayoon Qaisar Shehzad, Malik Sajid, Mumtaz Sara
Fatima Shaheen, M.Phil, Human Genetics Program, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan.
Qaisar Shehzad Humayoon, MBBS, FCPS Department of Pediatrics, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan.
Pak J Med Sci. 2023 Nov-Dec;39(6):1673-1679. doi: 10.12669/pjms.39.6.7408.
Congenital anomalies (CA) or birth defects cause substantial healthcare burden in developing countries. There are few studies from Pakistan on the prevalence-pattern of CA. The purpose of this study was to determine the prevalence-pattern and genetic attributes of CA at a tertiary care facility in Rawalpindi, Pakistan.
In a cross-sectional study design, patients with CA were ascertained from Pediatric and Neonatal Section of Holy Family Hospital, Rawalpindi from March-2022 to June-2022. International Classification of Diseases (ICD-10) and Online Mendelian Inheritance in Man (OMIM) databases were utilized for uniformity in classification. The pattern of CA as well as familial/sporadic nature, syndromic/isolated presentations, and prenatal consanguinity were estimated. Descriptive summaries were generated.
A total of 517 independent cases with certain types of CA were recruited. There were eight major and 70 minor categories. Among the major categories, neurological disorders (39.1%) were predominating followed by neuromuscular disorders (21.1%), limb defects (13.5%), musculoskeletal defects (7.4%), blood disorders (4.3%), orofacial defects (3.9%), metabolic disorders (3.7%), and Others (7.1%). The sporadic cases were in majority (72.5%) compared to familial cases (27.5%). Further, 63% patients had syndromic presentations and there were 37% cases with isolated appearances. A total of 70% cases had parental consanguinity.
The majority of anomalies were of preventable nature and certain healthcare measures including antinatal care and counseling can be adopted to minimize their burden. Additionally, there is an urgent need to raise awareness of the negative consequences of consanguineous marriages, which constitute a significant risk factor in cases with inherited CA.
先天性异常(CA)或出生缺陷在发展中国家造成了巨大的医疗负担。巴基斯坦关于CA患病率模式的研究较少。本研究的目的是确定巴基斯坦拉瓦尔品第一家三级医疗机构中CA的患病率模式和遗传特征。
在一项横断面研究设计中,于2022年3月至2022年6月从拉瓦尔品第圣家医院的儿科和新生儿科确定患有CA的患者。利用国际疾病分类(ICD-10)和《人类孟德尔遗传在线》(OMIM)数据库确保分类的一致性。评估了CA的模式以及家族性/散发性性质、综合征性/孤立性表现和产前近亲结婚情况。生成了描述性总结。
共招募了517例患有特定类型CA的独立病例。有8个主要类别和70个次要类别。在主要类别中,神经系统疾病(39.1%)占主导,其次是神经肌肉疾病(21.1%)、肢体缺陷(13.5%)、肌肉骨骼缺陷(7.4%)、血液疾病(4.3%)、口面部缺陷(3.9%)、代谢紊乱(3.7%)和其他(7.1%)。散发病例占多数(72.5%),而家族性病例占(27.5%)。此外,63%的患者有综合征性表现,37%的病例为孤立性外观。共有70%的病例父母为近亲结婚。
大多数异常是可预防的,可以采取包括产前护理和咨询在内的某些医疗措施来减轻其负担。此外,迫切需要提高对近亲结婚负面影响的认识,近亲结婚是遗传性CA病例的一个重要危险因素。