Clinical profile of Congenital malformations at a Tertiary care centre

Background: Congenital malformations are one among the leading causes of mortality in the present era and contribute significantly to chronic morbidity.Objectives: To determine the incidence and clinical profile of congenital malformations at a tertiary care centre.Design: Cross sectional study.Setting: A tertiary care neonatal unit in a Medical College of Central Kerala.Subjects: All babies born during a period of one year.Methods: Detailed clinical assessment of all babies and relevant investigations in indicated cases.Congenital anomalies found out were classified system-wise.A control group of normal newborns during the same study period also was assessed and comparison was made with the study group regarding variables like gender, birth order and mode of delivery, gestational age, birth weight, birth asphyxia, maternal age, socio-economic status, maternal illnesses and antenatal problems.Chi-square test was used for statistical analysis.Results: The incidence of congenital anomalies was 7.3% in the study period.Of these 53.7% were major anomalies and the rest (46.3%) were minor anomalies.Out of the major anomalies, CVS (31.03%) and GIT (31.03%) showed highest incidence, whereas minor anomalies had maximal involvement of musculoskeletal system (48%).In the group of newborns with congenital anomalies there was a male predominance (72.2%), in contrast to the control group where male distribution was only 52%.Need for lower segment caesarean section was found higher in the congenital anomalies group (61.1% /control group 42.7%).Higher incidence of birth asphyxia was found in the study group (18.5% /7.3% in the control group).Low socio-economic status had a significant association with congenital anomalies (MKS III, IV 48.1% in the study group compared to 31% in the control group).No significant difference was found in variables like birth order, birth-weight distribution, gestational age pattern, maternal age, maternal illnesses and antenatal problems between the groups with and without congenital anomalies.Conclusions: The overall incidence of congenital malformations in the study was 7.3% which was higher compared to other Indian studies.Significantly higher incidence was seen among male babies and in those from low socio-economic status.Among major congenital anomalies, CVS and GIT anomalies predominated, whereas as a whole and among minor anomalies, musculoskeletal system was affected more.Statistically significant increase in LSCS and birth asphyxia was observed in babies with congenital anomalies.