Congenital anomalies infant death births infant mortality rate

Written by Anuradha Mascarenhas | Published:December 24, 2016 12:02 am

Researchers have stressed that the first requirement for a policy to prevent birth defects is the need to establish surveillance for such defects.

Congenital anomalies were estimated to contribute to 60,699 neonatal deaths in India in 2013, which accounted for the highest global burden of neonatal mortality due to congenital anomalies. Now, a first-of-its-kind study from India shows that congenital anomaly rates were high, affecting one in 44 births.

In 2010, congenital anomalies were estimated to be the fifth largest cause of neonatal deaths in India after preterm births (34.7 per cent), intrapartum complications (19.6 per cent), pneumonia (16.3 per cent) and neo-natal sepsis (15 per cent) .

The Global Burden of Disease Study 2013 identified congenital anomalies among the top 10 causes of mortality in children less than five years of age. However, in India, there is scant data on the number of live born children with birth defects, mainly as they are not considered to be significant public health problems in low- and middle-income countries.

Now, a new study reported in PloS journal measured the magnitude and types of congenital anomalies among over 2,000 urban women, attending antenatal clinics at government hospitals in Pune, the eighth largest city in India. The findings are significant as the data implied that one in 44 births was affected with a major congenital anomaly. This ambitious Pune Urban Birth Outcome study was undertaken among 2,107 women reporting for first antenatal checkup (ANC) at four government hospitals in Pune.

Anita Kar, professor at School of Health Sciences, Pune University, who guided PhD students Prajakta Bhide and Pooja Gund in the research, said this study was initiated as there is no national surveillance to measure the magnitude of congenital anomalies occurring in India, and earlier cross-sectional studies have shown wide differences in overall prevalence rates. The study was supported by the UGC with Potential for Excellence (UGC-UPE) Holistic area and Pune University.

One in five births were found to be low birth weight, one in nine were preterm births, one in 20 pregnancies resulted in a miscarriage and stillbirths affected one in 44 births. Data showed that congenital heart defects (CHDs) were the most prevalent anomalies (65.86 per 10 000 births), with atrial septal defects (43.91 per 1,0 000 births) and ventricular septal defects (27.44 per 10 000 births) being the most commonly present heart defects. The most frequent nervous system anomalies were neural tube defects (27.44 per 10,000 births).

Kar pointed out that the data implied that one in 44 births was affected with a major congenital anomaly, one in 152 births was affected with a congenital heart defect, one in 304 births was affected with talipes or a renal anomaly, while one in 364 births presented with a neural tube defect. Of the 22 neonatal deaths, 41 per cent (9/22) were due to prematurity, 32 per cent (7/22) was due to congenital anomalies, 9 per cent (2/22) was due to birth asphyxia and one was a case of milk inhalation. Researchers have stressed that the first requirement for a policy to prevent birth defects is the need to establish surveillance for such defects.