Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
J Trop Pediatr. 2024 Oct 4;70(6). doi: 10.1093/tropej/fmae038.
Recent evidence shows a shift in neonatal mortality causes, with an increasing proportion due to birth defects. This study aimed to determine the prevalence and treatment outcomes of congenital anomalies (CAs) at a tertiary referral center in Northern India. This retrospective observational study was conducted over 7 years (May 2014-December 2021) and included all inborn and outborn neonates admitted with a diagnosis of CA as per ICD-10 classification in a level 3 NICU in North India. The prevalence of CAs was 8.9% (332 out of 3734 neonates). The most commonly affected systems were cardiovascular (33.4%), gastrointestinal (19.8%), and genitourinary (19.8%). While 57.5% of these defects could potentially be addressed through pediatric and cardiovascular surgery, only a small proportion of eligible neonates received timely surgical intervention due to delayed referrals and financial constraints. The mortality rate was 16.8%. This study highlights the significant burden of CAs in Northern India, emphasizing the need for enhanced capacity building, better facilities, and increased awareness for timely referrals. The findings underscore the importance of multidisciplinary collaborations and upgraded healthcare services to inspire further research and preventive strategies to mitigate birth defects. Given the context of a low- and middle-income country, this study's insights into the prevalence, challenges, and outcomes of CAs are particularly relevant, highlighting the necessity of accessible and affordable healthcare solutions in such settings.
最近的证据表明，新生儿死亡率的原因发生了转变，其中由于出生缺陷导致的比例不断增加。本研究旨在确定印度北部一家三级转诊中心先天性异常（CA）的患病率和治疗结果。这是一项回顾性观察研究，历时 7 年（2014 年 5 月至 2021 年 12 月），包括在印度北部三级新生儿重症监护病房（NICU）中，根据国际疾病分类第 10 版（ICD-10）分类，对所有患有 CA 诊断的入院内源性和外源性新生儿进行了研究。CA 的患病率为 8.9%（332 例/3734 例新生儿）。受影响最严重的系统是心血管系统（33.4%）、胃肠道系统（19.8%）和泌尿生殖系统（19.8%）。虽然这些缺陷中有 57.5%可以通过儿科和心血管手术解决，但由于转诊延迟和经济限制，只有一小部分符合条件的新生儿及时接受了手术干预。死亡率为 16.8%。本研究强调了印度北部 CA 的巨大负担，强调需要加强能力建设、改善设施和提高认识，以便及时转诊。研究结果突出了多学科合作和升级医疗保健服务的重要性，以激发进一步的研究和预防策略，以减轻出生缺陷。鉴于这是一个中低收入国家的背景，本研究对 CA 的患病率、挑战和结果的见解尤其相关，强调了在这些环境中提供可及和负担得起的医疗保健解决方案的必要性。
