Journal Article

Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

Sunny, Avinash K., Malla, Honey, Gurung, Rejina, Rana, Netra B., Gurung, Abhishek, KC, Nawaraj, Chaudhary, Ram Narayan, KC, Ashish, Paudel, Prajwal

2021

Overview

Background Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal. Method This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age < 20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18–2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46–2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41–2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12–2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93–4.69). Conclusion Maternal age younger than 20 years and advantaged ethnicity were risk factors of birth defects. Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted. Funding Swedish Research Council (VR).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Age / Birth defects / Birth weight / Cardiovascular disease / Case-Control Studies / Childrens health / Cleft Lip / Cleft Palate / Clinical Medicine / Cohort analysis / Complications and side effects / Congenital diseases / Data collection / epidemiology / Ethics / Ethnicity / Female / Global and public health and healthcare / Heart / Hospitals / Humans / Infant / Infant mortality / Internal Medicine / Klinisk medicin / Maternal & child health / Medicine / Medicine & Public Health / Mortality / Mothers / Nepal / Newborn / Obstetrics / Pediatric research / Pediatrics / Pediatrik / Pregnancy / Prenatal care / Prevalence / Prospective Studies / Research Article / Risk factor / Risk Factors / Social aspects / Sociodemographics / Surgery / Surveillance / Variables / Womens health / Young Adult