Prevalence and Pattern of Birth Defects in a Tertiary Hospital in Lalitpur, Nepal

H. Shakya, Meenu Maharjan, A. Lakhey
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Abstract

Introduction: Birth defect is one of the least studied areas in most developing countries like Nepal where low birth weight, prematurity, sepsis, and perinatal asphyxia are still the leading causes of neonatal and infant mortality. However, studies have shown that the incidence of birth defects is increasing trend and has significant impacts on individuals, families, healthcare, and society. Awareness of birth defects is essential in both prevention as well as early intervention. The objective of this study was to find out the pattern and prevalence of birth defects presenting in newborns in KIST Medical College Teaching Hospital, Lalitpur, Nepal.Materials and Methods: This is a hospital-based cross-sectional, descriptive study conducted in the NICU, Nursery, and postnatal wards of KIST Medical College Teaching Hospital, Lalitpur, Nepal from August 2018 to August 2020. The study population included all inborn newborns with birth defects, stillbirths, and IUFD of more than 22 weeks gestation with birth defects. Outborn babies admitted in Nursery/NICU and abortions of less than 22 weeks gestation were excluded from the study. The data was collected using WHO based surveillance system with a clinicalreview. Data were analyzed using SPSS version 23. Prevalence and pattern of birth defects were expressed in frequency and percentages. Results: In a total delivery of 3360, the incidence of the birth defect was 3.75% (n=126). Of the total birth defects, 28.9% (n=112) were born alive and 11.1% (n=14) were stillborn. Among the live births, 2.4% (n=3) died during their hospital stay. The commonly occurring birth defects were cardiovascular (35.7%, n=45) followed by oro-facial defects (23%, n=29), genitourinary (15.9%, n=20), musculoskeletal (15%, n=19), central nervous system (15%, n=19), various syndromes (7.1%, n=9), gastrointestinal (4.7%, n=6) and respiratory (0.8%, n=1).Conclusions: The true magnitude of birth defects in Nepal is unknown due to the lack of national birth defect surveillance. The lack of proper data regarding birth defects is undermining its impact on perinatal health. Awareness about the birth defect and their prevalence can significantly affect the prevention strategy and the management plan in decreasing perinatal mortality and subsequent neonatal and infant mortality as well.
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尼泊尔拉利特普尔一家三级医院出生缺陷的患病率和模式
在大多数发展中国家,出生缺陷是研究最少的领域之一,如尼泊尔,低出生体重,早产,败血症和围产期窒息仍然是新生儿和婴儿死亡的主要原因。然而,研究表明,出生缺陷的发生率呈上升趋势,并对个人、家庭、医疗保健和社会产生重大影响。对出生缺陷的认识对于预防和早期干预都至关重要。本研究的目的是了解尼泊尔拉利特普尔KIST医学院教学医院新生儿出生缺陷的模式和患病率。材料和方法:这是一项基于医院的横断面描述性研究,于2018年8月至2020年8月在尼泊尔拉利特普尔KIST医学院教学医院的NICU、托儿所和产后病房进行。研究人群包括所有出生缺陷的新生儿、死胎和妊娠超过22周且有出生缺陷的IUFD。在托儿所/新生儿重症监护室(NICU)住院的早产婴儿和妊娠少于22周的流产被排除在研究之外。数据是使用基于世卫组织的监测系统收集的,并进行了临床审查。数据分析采用SPSS version 23。出生缺陷的患病率和模式以频率和百分比表示。结果:在3360例分娩中,出生缺陷发生率为3.75% (n=126)。在所有出生缺陷中,28.9% (n=112)为活产,11.1% (n=14)为死产。在活产婴儿中,2.4% (n=3)在住院期间死亡。最常见的出生缺陷为心血管缺陷(35.7%,n=45),其次为口腔-面部缺陷(23%,n=29)、泌尿生殖系统缺陷(15.9%,n=20)、肌肉骨骼缺陷(15%,n=19)、中枢神经系统缺陷(15%,n=19)、各种综合征(7.1%,n=9)、胃肠道缺陷(4.7%,n=6)和呼吸缺陷(0.8%,n=1)。结论:由于缺乏全国性的出生缺陷监测,尼泊尔出生缺陷的真实程度尚不清楚。缺乏关于出生缺陷的适当数据正在削弱其对围产期健康的影响。对出生缺陷及其患病率的认识可以显著影响预防策略和管理计划,以降低围产期死亡率和随后的新生儿和婴儿死亡率。
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16
审稿时长
12 weeks
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