To Determine The Prevalence, Pattern, Risk Factors Of Congenital Anomalies, And Their Impact On Neonatal Mortality At Georgetown Public Hospital Corporation (Gphc) From January 1st, 2019, To December 31st, 2021..
Keywords:
Congenital anomalies, neonatal mortality, prevalence, risk factors, cardiovascular defectsAbstract
Objective: To determine the prevalence, patterns, risk factors, and impact of congenital anomalies (CAs) on neonatal mortality at Georgetown Public Hospital Corporation (GPHC) between January 1st, 2019, and December 31st, 2021.
Design: A facility-based, retrospective, cross-sectional study.
Setting: Georgetown Public Hospital Corporation, the largest and only tertiary hospital in Guyana.
Patients: A total of 17,719 live births over the study period, with 87 neonates diagnosed with congenital anomalies. A control group of 300 neonates without CAs was also included, with 100 neonates selected from each year (2019, 2020, and 2021).
Interventions: Data were collected from neonatal and maternal records, including demographic information, medical history, and outcomes. Data analysis included descriptive statistics, chi-square tests, and logistic regression.
Main Outcome Measures: Prevalence of congenital anomalies, identified patterns of anomalies, risk factors (maternal age, ethnicity, hypertension, infection, folic acid use), and neonatal mortality rates.
Results: The prevalence of CAs was 0.44% in 2019, 0.46% in 2020, and 0.58% in 2021. The most common anomalies were cardiovascular (29.3%), with Patent Ductus Arteriosus being the most frequent condition (16.0%). Maternal risk factors included age >35 years (OR 2.4, 95% CI: 1.4–4.1), East Indian ethnicity (OR 1.8, 95% CI: 1.1–3.0), hypertension (OR 2.1, 95% CI: 1.2–3.7), and no folic acid use (OR 3.2, 95% CI: 1.9–5.4). Preterm birth (OR 5.3, 95% CI: 3.1–9.0) and low birth weight (OR 3.8, 95% CI: 2.3–6.3) were significant neonatal risk factors. Neonatal mortality from CAs decreased from 8% in 2019 to 6% in 2021, but the reduction was not statistically significant (p = 0.35).
Conclusions: Congenital anomalies are prevalent at GPHC, with cardiovascular defects being the most common. Maternal age, ethnicity, hypertension, and lack of folic acid use were significant risk factors. Although neonatal mortality due to CAs decreased slightly, further studies with larger sample sizes are needed to confirm these trends. Public health initiatives focusing on prenatal care and folic acid fortification are recommended to reduce the burden of congenital anomalies in Guyana..
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