A Case-Control Study for Assessing Risk Factors for Congenital Anomalies among Children in Sulaimani City
https://doi.org/10.24017/science.2018.2.15
Abstract views: 1154 / PDF downloads: 0Abstract
Congenital anomalies comprise a wide range of abnormalities in body structure or function that are present at birth and are of prenatal origin. These are defined as structural changes that have significant medical, social or cosmetic consequences for the affected individual, and typically require medical intervention. According to our Knowledge, research is scarce on these conditions in Sulaimaniyah city. Therefore, the current study was conducted to investigate potential risk factors for congenital anomalies. A case-control study was carried out from March to August 2017 involving 400 children (200 cases and 200 controls) aged 0-5 years. Required data were obtained on the risk factors through face to face interviews with mothers of cases and controls. The data were using descriptive statistical methods, Chi-square and Logistic Regression using STATA 11, calculating odds ratios and condensing P value less than 0.05 as statistically significant. The mean age of the children was 1.9 years and age of their mothers at the time of pregnancy was 28 years. Congenital heart anomalies were the commonest type accounting for 27.5%. Significant risk factors for congenital anomalies were family history (OR=2.24, P= 0.007), maternal obesity (OR= 2.26, P= 0.001), mothers age over 30 (OR=2.78, P= 0.002) and mothers not using folic acid during pregnancy (OR=2.12, P= 0.0007). In general, in order to control and prevent the cases of CM, it is important to provide health education and policies to reduce environmental and maternal risk factors. Further, studies with larger sample size are needed to investigate incidence and risk factors of congenital anomalies.
Keywords:
Sulaimani, Anomalies, Down syndrome, consanguinity, Microcephaly, Cleft lip.
References
[1] W. H. Organization. (Updated September 2016). Congenital anomalies Available: http://www.who.int/mediacentre/factsheets/fs370/en/
[2] F. Mashuda, A. Zuechner, P. L. Chalya, B. R. Kidenya, and M. Manyama, "Pattern and factors associated with congenital anomalies among young infants admitted at Bugando medical centre, Mwanza, Tanzania," BMC Res Notes, vol. 7, p. 195, Mar 29 2014.
https://doi.org/10.1186/1756-0500-7-195
[3] R. Sharma, "Birth defects in India: Hidden truth, need for urgent attention," Indian J Hum Genet, vol. 19, pp. 125-9, Apr-Jun 2013.
https://doi.org/10.4103/0971-6866.116101
[4] F. Behjati, S. Ghasemi Firouzabadi, K. Kahrizi, R. Kariminejad, I. Bagherizadeh, J. Ansari, et al., "Chromosome abnormality rate among Iranian patients with idiopathic mental retardation from consanguineous marriages," Arch Med Sci, vol. 7, pp. 321-5, Apr 2011.
https://doi.org/10.5114/aoms.2011.22085
[5] R. S. Kishimba, R. Mpembeni, and J. Mghamba, "Factors associated with major structural birth defects among newborns delivered at Muhimbili National Hospital and Municipal Hospitals in Dar Es Salaam, Tanzania 2011 - 2012," Pan Afr Med J, vol. 20, 2015.
https://doi.org/10.11604/pamj.2015.20.153.4492
[6] H. A. Obu, J. M. Chinawa, N. D. Uleanya, G. N. Adimora, and I. E. Obi, "Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria - a retrospective study," BMC Res Notes, vol. 5, p. 177, 2012.
https://doi.org/10.1186/1756-0500-5-177
[7] W. H. Al Bu Ali, M. H. Balaha, M. S. Al Moghannum, and I. Hashim, "Risk factors and birth prevalence of birth defects and inborn errors of metabolism in Al Ahsa, Saudi Arabia," Pan Afr Med J, vol. 8, 2011.
https://doi.org/10.4314/pamj.v8i1.71064
[8] E. A. L. Gianicolo, A. Bruni, E. Rosati, S. Sabina, R. Guarino, G. Padolecchia, et al., "Congenital anomalies among live births in a polluted area. A ten-year retrospective study," BMC Pregnancy Childbirth, vol. 12, p. 165, 2012.
https://doi.org/10.1186/1471-2393-12-165
[9] M. L. Watkins, S. A. Rasmussen, M. A. Honein, L. D. Botto, and C. A. Moore, "Maternal obesity and risk for birth defects," Pediatrics, vol. 111, pp. 1152-8, May 2003.
https://doi.org/10.1542/peds.111.S1.1152
[10] K. T. Lee, E. J. Yang, S. Y. Lim, J. K. Pyon, G. H. Mun, S. I. Bang, et al., "Association of congenital microtia with environmental risk factors in South Korea," Int J Pediatr Otorhinolaryngol, vol. 76, pp. 357-61, Mar 2012.
https://doi.org/10.1016/j.ijporl.2011.12.009
[11] M. J. Nieuwenhuijsen, P. Dadvand, J. Grellier, D. Martinez, and M. Vrijheid, "Environmental risk factors of pregnancy outcomes: a summary of recent meta-analyses of epidemiological studies," Environ Health, vol. 12, p. 6, 2013.
https://doi.org/10.1186/1476-069X-12-6
[12] K. Buckles and M. Guldi, "Worth the Wait? The Effect of Early Term Birth on Maternal and Infant Health," J Policy Anal Manage, vol. 36, pp. 748-72, 2017.
https://doi.org/10.1002/pam.22014
[13] K. Singh, K. Krishnamurthy, C. Greaves, L. Kandamaran, A. L. Nielsen, and A. Kumar, "Major congenital malformations in barbados: the prevalence, the pattern, and the resulting morbidity and mortality," ISRN Obstet Gynecol, vol. 2014, p. 651783, 2014.
https://doi.org/10.1155/2014/651783
[14] A. Dursun, A. Zenciroglu, N. Hakan, N. Karadag, B. S. Karagol, B. Aydin, et al., "Distribution of congenital anomalies in a neonatal intensive care unit in Turkey," J Matern Fetal Neonatal Med, vol. 27, pp. 1069-74, Jul 2014.
https://doi.org/10.3109/14767058.2013.847420
[15] N. Kamal, N. Othman, and A. Salih, "Incidence and Types of Congenital Heart Diseases among Children in Sulaimani Governorate," Kurdistan Journal of Applied Research, vol. 2, pp. 106-111, 2017.
https://doi.org/10.24017/science.2017.2.15
[16] M. Naghavi-Behzad, M. Alizadeh, S. Azami, S. Foroughifar, K. Ghasempour-Dabbaghi, N. Karzad, et al., "Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran," J Cardiovasc Thorac Res, vol. 5, pp. 5-9, 2013.
[17] A. H. Bui, A. Ayub, M. K. Ahmed, E. Taioli, and P. J. Taub, "Association Between Cleft Lip and/or Cleft Palate and Family History of Cancer: A Case-Control Study," Ann Plast Surg, Jan 31 2018.
https://doi.org/10.1097/SAP.0000000000001331
[18] E. B. Dupepe, D. M. Patel, B. G. Rocque, B. Hopson, A. A. Arynchyna, E. R. Bishop, et al., "Surveillance survey of family history in children with neural tube defects," J Neurosurg Pediatr, vol. 19, pp. 690-695, Jun 2017.
https://doi.org/10.3171/2016.12.PEDS1668
[19] S. Ly, M. L. Burg, U. Ihenacho, F. Brindopke, A. Auslander, K. S. Magee, et al., "Paternal Risk Factors for Oral Clefts in Northern Africans, Southeast Asians, and Central Americans," Int J Environ Res Public Health, vol. 14, Jun 19 2017.
https://doi.org/10.3390/ijerph14060657
[20] M. J. Khoury, J. D. Erickson, J. F. Cordero, and B. J. McCarthy, "Congenital malformations and intrauterine growth retardation: a population study," Pediatrics, vol. 82, pp. 83-90, Jul 1988.
https://doi.org/10.1542/peds.82.1.83
[21] U. B. Wennerholm, C. Bergh, L. Hamberger, K. Lundin, L. Nilsson, M. Wikland, et al., "Incidence of congenital malformations in children born after ICSI," Hum Reprod, vol. 15, pp. 944-8, Apr 2000.
https://doi.org/10.1093/humrep/15.4.944
[22] L. E. Frederiksen, A. Ernst, N. Brix, L. L. Braskhoj Lauridsen, L. Roos, C. H. Ramlau-Hansen, et al., "Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age," Obstet Gynecol, Feb 5 2018.
https://doi.org/10.1097/01.aoa.0000542378.64975.41
[23] K. R. Goetzinger, A. L. Shanks, A. O. Odibo, G. A. Macones, and A. G. Cahill, "Advanced Maternal Age and the Risk of Major Congenital Anomalies," Am J Perinatol, vol. 34, pp. 217-222, Feb 2017.
https://doi.org/10.1055/s-0036-1585410
[24] Y. Ingrid Goh, E. Bollano, T. R. Einarson, and G. Koren, "Prenatal multivitamin supplementation and rates of congenital anomalies: a meta-analysis," J Obstet Gynaecol Can, vol. 28, pp. 680-689, Aug 2006.
https://doi.org/10.1016/S1701-2163(16)32227-7
[25] J. Nazer Herrera, M. Garcia Huidobro, and L. Cifuentes Ovalle, "[Congenital malformations among offspring of diabetic women]," Rev Med Chil, vol. 133, pp. 547-54, May 2005.
https://doi.org/10.4067/S0034-98872005000500006
[26] J. Rankin, P. W. Tennant, K. J. Stothard, M. Bythell, C. D. Summerbell, and R. Bell, "Maternal body mass index and congenital anomaly risk: a cohort study," Int J Obes (Lond), vol. 34, pp. 1371-80, Sep 2010.
https://doi.org/10.1038/ijo.2010.66
[27] A. Garcia-Patterson, L. Erdozain, G. Ginovart, J. M. Adelantado, J. M. Cubero, G. Gallo, et al., "In human gestational diabetes mellitus congenital malformations are related to pre-pregnancy body mass index and to severity of diabetes," Diabetologia, vol. 47, pp. 509-514, Mar 2004.
https://doi.org/10.1007/s00125-004-1337-3
[28] K. J. Stothard, P. W. Tennant, R. Bell, and J. Rankin, "Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis," JAMA, vol. 301, pp. 636-50, Feb 11 2009.
https://doi.org/10.1001/jama.2009.113
[29] S. Johansson, E. Villamor, M. Altman, A. K. Bonamy, F. Granath, and S. Cnattingius, "Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden," BMJ, vol. 349, p. g6572, Dec 2 2014.
https://doi.org/10.1136/bmj.g6572
[30] Z. Mosayebi and A. H. Movahedian, "Pattern of congenital malformations in consanguineous versus nonconsanguineous marriages in Kashan, Islamic Republic of Iran," East Mediterr Health J, vol. 13, pp. 868-75, Jul-Aug 2007.
[2] F. Mashuda, A. Zuechner, P. L. Chalya, B. R. Kidenya, and M. Manyama, "Pattern and factors associated with congenital anomalies among young infants admitted at Bugando medical centre, Mwanza, Tanzania," BMC Res Notes, vol. 7, p. 195, Mar 29 2014.
https://doi.org/10.1186/1756-0500-7-195
[3] R. Sharma, "Birth defects in India: Hidden truth, need for urgent attention," Indian J Hum Genet, vol. 19, pp. 125-9, Apr-Jun 2013.
https://doi.org/10.4103/0971-6866.116101
[4] F. Behjati, S. Ghasemi Firouzabadi, K. Kahrizi, R. Kariminejad, I. Bagherizadeh, J. Ansari, et al., "Chromosome abnormality rate among Iranian patients with idiopathic mental retardation from consanguineous marriages," Arch Med Sci, vol. 7, pp. 321-5, Apr 2011.
https://doi.org/10.5114/aoms.2011.22085
[5] R. S. Kishimba, R. Mpembeni, and J. Mghamba, "Factors associated with major structural birth defects among newborns delivered at Muhimbili National Hospital and Municipal Hospitals in Dar Es Salaam, Tanzania 2011 - 2012," Pan Afr Med J, vol. 20, 2015.
https://doi.org/10.11604/pamj.2015.20.153.4492
[6] H. A. Obu, J. M. Chinawa, N. D. Uleanya, G. N. Adimora, and I. E. Obi, "Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria - a retrospective study," BMC Res Notes, vol. 5, p. 177, 2012.
https://doi.org/10.1186/1756-0500-5-177
[7] W. H. Al Bu Ali, M. H. Balaha, M. S. Al Moghannum, and I. Hashim, "Risk factors and birth prevalence of birth defects and inborn errors of metabolism in Al Ahsa, Saudi Arabia," Pan Afr Med J, vol. 8, 2011.
https://doi.org/10.4314/pamj.v8i1.71064
[8] E. A. L. Gianicolo, A. Bruni, E. Rosati, S. Sabina, R. Guarino, G. Padolecchia, et al., "Congenital anomalies among live births in a polluted area. A ten-year retrospective study," BMC Pregnancy Childbirth, vol. 12, p. 165, 2012.
https://doi.org/10.1186/1471-2393-12-165
[9] M. L. Watkins, S. A. Rasmussen, M. A. Honein, L. D. Botto, and C. A. Moore, "Maternal obesity and risk for birth defects," Pediatrics, vol. 111, pp. 1152-8, May 2003.
https://doi.org/10.1542/peds.111.S1.1152
[10] K. T. Lee, E. J. Yang, S. Y. Lim, J. K. Pyon, G. H. Mun, S. I. Bang, et al., "Association of congenital microtia with environmental risk factors in South Korea," Int J Pediatr Otorhinolaryngol, vol. 76, pp. 357-61, Mar 2012.
https://doi.org/10.1016/j.ijporl.2011.12.009
[11] M. J. Nieuwenhuijsen, P. Dadvand, J. Grellier, D. Martinez, and M. Vrijheid, "Environmental risk factors of pregnancy outcomes: a summary of recent meta-analyses of epidemiological studies," Environ Health, vol. 12, p. 6, 2013.
https://doi.org/10.1186/1476-069X-12-6
[12] K. Buckles and M. Guldi, "Worth the Wait? The Effect of Early Term Birth on Maternal and Infant Health," J Policy Anal Manage, vol. 36, pp. 748-72, 2017.
https://doi.org/10.1002/pam.22014
[13] K. Singh, K. Krishnamurthy, C. Greaves, L. Kandamaran, A. L. Nielsen, and A. Kumar, "Major congenital malformations in barbados: the prevalence, the pattern, and the resulting morbidity and mortality," ISRN Obstet Gynecol, vol. 2014, p. 651783, 2014.
https://doi.org/10.1155/2014/651783
[14] A. Dursun, A. Zenciroglu, N. Hakan, N. Karadag, B. S. Karagol, B. Aydin, et al., "Distribution of congenital anomalies in a neonatal intensive care unit in Turkey," J Matern Fetal Neonatal Med, vol. 27, pp. 1069-74, Jul 2014.
https://doi.org/10.3109/14767058.2013.847420
[15] N. Kamal, N. Othman, and A. Salih, "Incidence and Types of Congenital Heart Diseases among Children in Sulaimani Governorate," Kurdistan Journal of Applied Research, vol. 2, pp. 106-111, 2017.
https://doi.org/10.24017/science.2017.2.15
[16] M. Naghavi-Behzad, M. Alizadeh, S. Azami, S. Foroughifar, K. Ghasempour-Dabbaghi, N. Karzad, et al., "Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran," J Cardiovasc Thorac Res, vol. 5, pp. 5-9, 2013.
[17] A. H. Bui, A. Ayub, M. K. Ahmed, E. Taioli, and P. J. Taub, "Association Between Cleft Lip and/or Cleft Palate and Family History of Cancer: A Case-Control Study," Ann Plast Surg, Jan 31 2018.
https://doi.org/10.1097/SAP.0000000000001331
[18] E. B. Dupepe, D. M. Patel, B. G. Rocque, B. Hopson, A. A. Arynchyna, E. R. Bishop, et al., "Surveillance survey of family history in children with neural tube defects," J Neurosurg Pediatr, vol. 19, pp. 690-695, Jun 2017.
https://doi.org/10.3171/2016.12.PEDS1668
[19] S. Ly, M. L. Burg, U. Ihenacho, F. Brindopke, A. Auslander, K. S. Magee, et al., "Paternal Risk Factors for Oral Clefts in Northern Africans, Southeast Asians, and Central Americans," Int J Environ Res Public Health, vol. 14, Jun 19 2017.
https://doi.org/10.3390/ijerph14060657
[20] M. J. Khoury, J. D. Erickson, J. F. Cordero, and B. J. McCarthy, "Congenital malformations and intrauterine growth retardation: a population study," Pediatrics, vol. 82, pp. 83-90, Jul 1988.
https://doi.org/10.1542/peds.82.1.83
[21] U. B. Wennerholm, C. Bergh, L. Hamberger, K. Lundin, L. Nilsson, M. Wikland, et al., "Incidence of congenital malformations in children born after ICSI," Hum Reprod, vol. 15, pp. 944-8, Apr 2000.
https://doi.org/10.1093/humrep/15.4.944
[22] L. E. Frederiksen, A. Ernst, N. Brix, L. L. Braskhoj Lauridsen, L. Roos, C. H. Ramlau-Hansen, et al., "Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age," Obstet Gynecol, Feb 5 2018.
https://doi.org/10.1097/01.aoa.0000542378.64975.41
[23] K. R. Goetzinger, A. L. Shanks, A. O. Odibo, G. A. Macones, and A. G. Cahill, "Advanced Maternal Age and the Risk of Major Congenital Anomalies," Am J Perinatol, vol. 34, pp. 217-222, Feb 2017.
https://doi.org/10.1055/s-0036-1585410
[24] Y. Ingrid Goh, E. Bollano, T. R. Einarson, and G. Koren, "Prenatal multivitamin supplementation and rates of congenital anomalies: a meta-analysis," J Obstet Gynaecol Can, vol. 28, pp. 680-689, Aug 2006.
https://doi.org/10.1016/S1701-2163(16)32227-7
[25] J. Nazer Herrera, M. Garcia Huidobro, and L. Cifuentes Ovalle, "[Congenital malformations among offspring of diabetic women]," Rev Med Chil, vol. 133, pp. 547-54, May 2005.
https://doi.org/10.4067/S0034-98872005000500006
[26] J. Rankin, P. W. Tennant, K. J. Stothard, M. Bythell, C. D. Summerbell, and R. Bell, "Maternal body mass index and congenital anomaly risk: a cohort study," Int J Obes (Lond), vol. 34, pp. 1371-80, Sep 2010.
https://doi.org/10.1038/ijo.2010.66
[27] A. Garcia-Patterson, L. Erdozain, G. Ginovart, J. M. Adelantado, J. M. Cubero, G. Gallo, et al., "In human gestational diabetes mellitus congenital malformations are related to pre-pregnancy body mass index and to severity of diabetes," Diabetologia, vol. 47, pp. 509-514, Mar 2004.
https://doi.org/10.1007/s00125-004-1337-3
[28] K. J. Stothard, P. W. Tennant, R. Bell, and J. Rankin, "Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis," JAMA, vol. 301, pp. 636-50, Feb 11 2009.
https://doi.org/10.1001/jama.2009.113
[29] S. Johansson, E. Villamor, M. Altman, A. K. Bonamy, F. Granath, and S. Cnattingius, "Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden," BMJ, vol. 349, p. g6572, Dec 2 2014.
https://doi.org/10.1136/bmj.g6572
[30] Z. Mosayebi and A. H. Movahedian, "Pattern of congenital malformations in consanguineous versus nonconsanguineous marriages in Kashan, Islamic Republic of Iran," East Mediterr Health J, vol. 13, pp. 868-75, Jul-Aug 2007.
How to Cite
[1]
N. Mustafa Kamal and N. Othman, “A Case-Control Study for Assessing Risk Factors for Congenital Anomalies among Children in Sulaimani City”, KJAR, vol. 3, no. 2, pp. 90–95, Jul. 2018, doi: 10.24017/science.2018.2.15.
Article Metrics
Published
23-07-2018
Issue
Section
Pure and Applied Science
