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Prevalence of congenital anomalies and factors associated with their development at a national referral hospital in Quito, Ecuador

Abstract:

Introduction: Congenital anomalies (CA) have a significant impact on health and quality of life. Therefore, knowing their prevalence and the factors associated with their development is essential for designing and implementing educational and preventive programs. Objectives: To determine the prevalence of CAs in a national referral hospital in Ecuador between 2009 and 2022 and to explore the factors associated with their development. Materials and methods: Cross-sectional study conducted using 2 data sets for the period 2009 and 2022: 105 385 live births delivered at the HGOIA (estimation of prevalence) and 26 236 neonates hospitalized in the hospital's neonatology service (exploration of factors associated with the presence of CA). The Chi-square test was used to evaluate differences between groups (neonates with and without congenital defects), and binary logistic regression models, both simple (crude Odds ratio [OR]) and multiple (adjusted OR), were utilized to assess associations between the perinatal conditions considered and the presentation of CAs (overall and per anomaly category). Results: The prevalence of CA was 2.92% (n=3 075). Anomalies of the nervous system (25.6%), cardiovascular and respiratory systems (21.1%), and musculoskeletal (16.1%) were the most frequent CAs. Maternal age >35 years (OR: 1.20, 95%CI: 1.07-1.33) was positively associated with the presentation of CAs, whereas planned pregnancy (OR: 0.88, 95%CI: 0.81-0.96) and multiple pregnancy (OR: 0.50, 95%CI: 0.42-0.60) were negatively associated. Folic acid supplementation, being male, and several maternal-related factors, among other variables, showed an association with the presence of specific types of CA. Conclusions: The prevalence of CAs at the HGOIA between 2009 and 2022 is slightly higher than what has been reported in the region, with neurological, cardiovascular and respiratory system anomalies being the most frequent. A positive association was found between maternal age >35 years and the occurrence of CAs, whereas planned pregnancy and multiple pregnancy showed negative associations.