Pattern and Factors associated with Congenital Anomalies among NICU admitted Neonates in TASH: Case-Control study
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Date
2024-03
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Addis Ababa University
Abstract
Background: Congenital anomalies have imposed a sizable burden on global mortality,
disability and medical cost worldwide. Several studies have investigated the risk factors
attributed to lethal congenital anomalies
Objective: To assess pattern and associated factors of congenital anomalies, in neonatal
intensive care unit, Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia 2023
Methodology: The case-control study was employed to investigate factors associated with
congenital anomalies at Tikur Anbesa Specialized hospital. Cases included all newborns with
congenital anomalies admitted to the ICU, while controls were randomly selected unmatched
newborns without congenital anomalies. The normal distribution of continuous variables was
assessed using Shapiro-Wilk test. The mean and standard deviation calculated for normality
distributed data while median and interquartile range calculated for skewed data. A univariate
and multivariate binary logistic regression analysis was performed to examine the factors
associated Congenital anomalies. The results of logistic regression reported as adjusted odds
rations (OR) with 95% confidence intervals and p-value < 0.05 are considered statistically
significant.
Results: An analysis involving 131 cases and 128 controls revealed that the median age of
mothers stood at 28(±IQR= 6) years. Respiratory anomalies were identified as the most common,
accounting for 21.4 % of the cases, followed by multiple congenital anomalies at 20.6 %, and
gastrointestinal anomalies at 19.8 % of cases. After adjusting for all variables in the multivariate
analysis, folic acid supplementation was found to have a significant impact on preventing
congenital anomalies (AOR=0.58, 95% CI 0.3, 0.99, p=0.032). Further analysis of the data
revealed that maternal age over 35 years (AOR=2.3, 95% CI 0.8, 6.5, p=0.12), maternal smoking
(AOR=6.7, 95% CI 0.8, 58.1, p=0.08), a history of previous congenital anomalies (AOR=2.1,
95% CI 0.4, 11.8, p=0.4), exposure to environmental toxins (AOR=0.2, 95% CI 0.3, 3.8,
p=0.78), maternal alcohol consumption (AOR=2.4, 95% CI 0.6, 9.6, p=0.21), and maternal
chronic medical conditions (AOR=1.8, 95% CI 0.7, 4.4, p=0.23) were non-statistical positive
association with congenital anomalies.
Conclusion: Numerous factors have been linked to the occurrence of congenital anomalies. The
pattern of these anomalies differed from those found in other local studies and global evidence,
despite similar contributing and aggravating factors.
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Keywords
Congenital Anomalies, NICU, Neonates