Spectrum of Congenital Anomalies among Children Attending the Pediatric Departments of Dhaka Medical College Hospital

Abstract

Introduction: Congenital anomalies (CA), which refer to morphologic defects that occur during the process of human development in the womb usually clinically apparent at birth, are an important cause of mortality in newborns and a major cause of mortality and morbidity in children globally as well as Bangladesh, affecting not only the lives of the children but also their families, health care providers and societies. However, sufficient and up-to-date data regarding the variations of CA among children in Bangladesh especially of those who have survived after birth are largely lacking. Objective: To determine the spectrum of congenital anomalies among children attending the Departments of Pediatric Medicine and Surgery in Dhaka Medical College Hospital. Methodology: A descriptive study was conducted from April to October 2013 to explore the variations and patterns of distribution of congenital anomalies among children attending the Departments of Pediatric Medicine and Surgery in Dhaka Medical College Hospital. Detailed information was collected from mothers (respondents) and hospital files of 267 children with CAs on a predesigned pro-forma and analyzed using SPSS for frequencies and distributions. Results: Out of 267 children with CAs, digestive system accounted for majority of the cases 27% (n=72) followed by nervous system, 15.7% (n=42); genitourinary system, 15.7% (n=42); and others. Overall, congenital hydrocephalus 8.6% (n=23) was the most common followed by hypospadias 7.9% (n=21) and Hirschsprung's disease 7.5% (n=20). 71.9% (192) of the patients were treated and discharged with correction of anomaly while only 3% (n=8) of the patients died during hospital stay. Early neonates (1-7days) were the most common age group of the children (33.3%); 52.8% of the patients were males; 91.8% of the respondents were Muslims; majority (44.9%) of the mothers were between 21-25 years of age at conception; 6% of respondents had family history of birth defects; and 3.4% of the respondents had consanguineous marriages. Majority of the mothers (40.4%) and fathers (32.2%) received education up to or below 6 th grade; majority (65%) of respondents had monthly income of less than 10,000 Tk. 15 % of the mothers had regular antenatal checkups; 30.7% took iron, folic acid and vitamin B12 supplementation during pregnancy; none were found to be active smokers; and scattered cases of maternal diabetes, hypertension and epilepsy were encountered. Conclusions: A wide variety of congenital anomalies with varying patterns of distribution was recorded. Health care facilities in Dhaka Medical College Hospital were found to be relatively adequate. Socioeconomic conditions and educational levels of parents having children with congenital anomalies were found to be under par. In addition, the percentages of patients receiving regular antenatal checkups and vitamin supplementations were found to be alarmingly low. The problem of CAs can be tackled through measures of prevention and treatment which include early recognition, micronutrient supplementation, vaccination, antenatal care, affordable surgical intervention or reconstruction and heightened awareness.