RELATIONSHIP OF SELECTED PRENATAL FACTORS TO PREGNANCY OUTCOME AND CONGENITAL ANOMALIES

Gulrukh Qazi

Abstract


Objective: The aim of this paper is to explore the relationship of various selected prenatal
circumstances to pregnancy outcome in particular reference to congenital anomalies. Method: It was a
cross-sectional analytical study and conducted at unit ‘A’ of the Department of Obs/Gyn, Postgraduate
Medical Institute, Lady Reading Hospital, Peshawar, from January to December 2009. The analysis
included data on all women having pregnancies with adverse outcome and various congenital
anomalies during the study period 1st January to 31st December 2009. A hospital-based maternal health
data was used from history records and direct interviewing of the patients subject to their availability
and information were recorded for all the cases on structured proformae. The data included
demographic details, social environment, consanguinity, ovulation induction, drug intake during early
pregnancy, exposure to radiation, infection during early pregnancy, complications of pregnancy,
prematurity, obstetrical variables, congenital anomalies and materno-foetal morbidity and mortality.
Findings at prenatal visits and data regarding prior pregnancies and morbidity among other children are
also abstracted from obstetrical and medical charts. In case of the newborn, the neonatal chart abstract
has proved to be a more complete source of information on congenital anomalies. The data was entered
on SPSS-10 and the analysis included simple proportions and rates. Results: Out of a total of 5,082
deliveries 163 (3.2%) were complicated by various congenital anomalies with prepondrence of neural
tube defects notably the hydrocephalous (33.4%) and Anencephaly (29.2%). Most of the mothers were
un-booked and uneducated (90%). Eighty- eight (54%) women were in there twenties, thirty (22%)
with ≥35 years of age and only 9%in the teenage group. About 36% of the deliveries in the study
population are among primigravida. Four cases (3.1%) had history of exposure to some non-specific
radiation due to the locality of there house. Almost 21% of couples had cousin marriage. Regarding
drug intake no specific link could be demonstrated as 45% took nothing while the remaining took the
multivitamins and tonics only. Only 4 cases (2.5%) had taken assisted conception in the form of
clomiphene citrate. About 34 per cent of the multigravida with antepartum bleeding reported that their
last prior pregnancy ended in a foetal death or prematurely born infant. The corresponding figure for all
multigravida women was 21 per cent. However, prior pregnancy history does not explain the more
adverse risk associated with APB. Conclusion: These results together provide information to
physicians and genetic counsellors to realise contribution of congenital abnormalities and setting
priorities of screening individual cases.
Keywords: Outcome, Prenatal, Pregnancy, Foetal, Counselling

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References


Singh R, Al-Sudani O. Major Congenital Anomalies at birth in

Benghazi, Libyan Arab Jamahiriya,1995. East Mediterr Health J

;6:65–75.

Rankin J. Congenital anomalies in the British Isles. In:

Nicolopoulou-Stamati, P; Hens, L; Howard, CV, (eds.)

Congenital Diseases and the Environment. Dordrecht, The

Netherlands: Springer; 2007. p. 359–77.

Sípek A, Gregor V, Horacek J, Masatova D, Seetnicova K. The

incidence of birth defects in Czech Republic in 2002. Ceska

Gynekol 2004;69:202–10.

P. Tootoonchi. Easily Identifiable Congenital Anomalie:

Prevalence and Risk Factors. Acta Med Iran 2003;41:15–9.

Bianchi F, Calzolari E, Ciulli L, Cordier S, Gualandi F, Pierini

A, et al. Environment and genetics in the etiology of cleft lip and

cleft palate with reference to the role of folic acid. Epidemiol

Prev 2000;24:21–7.

J Ayub Med Coll Abbottabad 2010;22(4)

http://www.ayubmed.edu.pk/JAMC/PAST/22-4/Gulrukh.pdf 45

Glinianaia SV, Rankin JM, Pless-Mulloli T, Pearce MS, Charlton

ME, Parker L. Temporal changes in key maternal and foetal

factors affecting birth outcomes: A 32-year population-based

study in an industrial city. BMC Pregnancy and Childbirth

;8:39.

Gustavson KH. Review Prevalence and aetiology of congenital

birth defects, infant mortality and mental retardation in Lahore,

Pakistan: a prospective cohort study. Acta Paediatr 2005;94:769–

Schuurman M J, Robben S G, Been JV. A congenital anomaly in

a preterm newborn. BMJ 2010;340:b5241.

Nader S, Ghasem S, Fakher R, Sohayla N. Incidence of head and

neck birth defects in Iran: A cross-sectional study from southwest

region. Pak J Med Sci 2009;25:770–5.

Behrooz A. Prevalence of neural tube defect and its relative

factors in South-West of Iran .Pak J Med Sci. 2007;23:654–6.

Khattak ST, Naheed T, Akhtar S, Jamal T. Incidence and risk

factors for neural tube decects in Peshawar. Gomal J Med Sci

;6(1):1–4.

Northrup H, Voleik KA. Spina bifida and other neural tube

defects. Curr Probl Pediatr.2000;30:313–32.

Rajabian MH, Aghaei S. Cleft lip and palate in southwestern

Iran: an epidemiologic study of live births. Ann Saudi Med

;25:385–8.

Yassaei S, Mehrgerdy Z, Zareshahi G. Prevalence of cleft lip and

palate in births from 2003 - 2006 in Iran. Community Dent

Health 2010;27:118–21.

Singhal SR, N. & Nanda S : Maternal And Perinatal Outcome In

Antepartum Hemorrhage: A Study At A Tertiary Care Referral

Institute. Internet J Gynecol Obstet 2008;9:2.

Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S.

Maternal and perinatal outcome in women with threatened

miscarriage in the first trimester: a systematic review. BJOG

;117:245–57.

Rasmussen SA, Moore CA, Paulozzi LI, Rhodenhiser EP. Risk

for birth defects among premature infants: a population-based

study. J Pediatr 2001;l38:668–73.

Nándor Á, Bánhidy F G, Czeizel A E. (Eds.) Congenital

Abnormalities and Preterm Birth Related to Maternal Illnesses

During Pregnancy 1st Edition, New York: Springer; 2010.

Sípek A, Gregor V, Horácek J. Birth defects in the Czech

Republic in the period 1994 - 2005--perinatology data .Ceska

Gynekol. 2007;72:103–9

Rankin J, Tennant PWG, Stothard KJ, Bythell M, Summerbell C,

Bell R. Maternal body mass index and congenital anomaly risk; a

cohort study. Int J Obesity 2010:10;60–6.

Stothard KJ; Tennant PWG; Bell R; Rankin J. Maternal

Overweight and Obesity and the Risk of Congenital Anomalies

A Systematic Review and Meta-analysis. J Am Med Asso

;301:636–50.

Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang

R, at al. The impact of maternal BMI status on pregnancy

outcomes with immediate short-term obstetric resource

implications: a meta analysis. Obesity Rev 2008;9:635–83.

Frias AE Jr, Luikenaar RA, Sullivan AE, Lee RM, Porter TF,

Branch DW, at al. Poor obstetric outcome in subsequent

pregnancies in women with prior foetal death. Obstet Gynecol

;104:521–6

Movafagh A, Pear Zadeh Z, Javadi MH, Mohammed FM,

Ghaderian SMH, Heidari MH, et al. Occurrence of Congenital

Anomalies and Genetic Diseases in a Population of Ghazvin

Province, Iran: A study of 33380 cases. Pak J Med

Sci2008;24:80–5.

Rankin JM, Chadwick TJ, Natarajan M, Howel DM, Pearce MS,

Pless-Mulloli T. Maternal exposure to ambient air pollutants and

risk of congenital anomalies. Environmental Research

;109:181–7.

Walden RV, Taylor SC , Hansen NI, Poole WK, Stoll B, Abuelo

D, at al. Major Congenital Anomalies Place Extremely Low

Birth Weight Infants at Higher Risk for Poor Growth and

Developmental outcomes. Pediatrics 2007;120:e1512–9.

Rankin JM, Silf K, Pearce MS, Parker L, Ward Platt MP.

Congenital anomaly and childhood cancer: A population-based,

record linkage study. Pediatr Blood and Cancer 2008;51:608–12.

Forrester M B, Merz R D. First-year mortality rates for selected

birth defects, Hawaii, 1986–1999. Am J Med Genetics Part A

;119:311–8.

Agha MM, Williams JI, Marrett L, To T, Dodds L. Determinants

of survival in children with congenital abnormalities: A longterm population-based cohort study. Birth Defect Research Part

A: Clin Molecul Teratol 2006;76:46–54.


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