Epidemiological Risk Factors and Perinatal Outcomes of Congenital Anomalies

Epidemiological Risk Factors and Perinatal Outcomes of Congenital Anomalies

Author Garcia Almeida, Lissa Fernandes Google Scholar
Araujo Junior, Edward Autor UNIFESP Google Scholar
Crott, Gerson Claudio Google Scholar
Okido, Marcos Masaru Google Scholar
Berezowski, Aderson Tadeu Google Scholar
Duarte, Geraldo Google Scholar
Marcolin, Alessandra Cristina Google Scholar
Abstract Objectives To identify the epidemiological risk factors for congenital anomalies (CAs) and the impact of these fetal malformations on the perinatal outcomes. Methods This prospective cohort study comprised 275 women whose fetuses had CAs. Maternal variables to establish potential risk factors for each group of CA and perinatal outcomes were evaluated. The primary outcome was CA. Secondary outcomes included: fetal growth restriction (FGR)

fetal distress (FD)

premature rupture of membranes (PROM)

oligohydramnios or polyhydramnios

preterm delivery (PTD)

stillbirth

cesarean section

low birth weight

Apgar score < 7 at the 1st and 5th minutes

need for assisted ventilation at birth

neonatal infection

need for surgical treatment

early neonatal death

and hospitalization time. Chi-square (chi(2)) test and multilevel regression analysis were applied to compare the groups and determine the effects of maternal characteristics on the incidence of CAs. Results The general prevalence of CAs was of 2.4%. Several maternal characteristics were associated to CAs, such as: age

skin color

level of education

parity

folic acid supplementation

tobacco use

and history of previous miscarriage. There were no significant differences among the CA groups in relation to FGR, FD, PROM, 1-minute Apgar score > 7, and need for assisted ventilation at birth. On the other hand, the prevalence of the other considered outcomes varied significantly among groups. Preterm delivery was significantly more frequent in gastrointestinal tract/abdominal wall defects. The stillbirth rate was increased in all CAs, mainly in isolated fetal hydrops (odds ratio [OR]: 27.13

95% confidence interval [95% CI]: 2.90-253.47). Hospitalization time was higher for the urinary tract and congenital heart disease groups (p < 0.01). Neonatal death was significantly less frequent in the central nervous system anomalies group. Conclusion It was possible to identify several risk factors for CAs. Adverse perinatal outcomes were presented in all CA groups, and may differ according to the type of CA considered.
Keywords pregnancy
congenital anomaly
epidemiological risk factor
ultrasound
perinatal outcome
xmlui.dri2xhtml.METS-1.0.item-coverage Rio De Janeiro Rj
Language English
Date 2016
Published in Revista Brasileira De Ginecologia E Obstetricia. Rio De Janeiro Rj, v. 38, n. 7, p. 348-355, 2016.
ISSN 0100-7203 (Sherpa/Romeo, impact factor)
Publisher Federacao Brasileira Soc Ginecologia & Obstetricia-Febrasgo
Extent 348-355
Origin http://dx.doi.org/10.1055/s-0036-1586160
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000410247300006
SciELO ID S0100-72032016000700348 (statistics in SciELO)
URI https://repositorio.unifesp.br/handle/11600/57712

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