Neonatal Characteristics Associated with Congenital Anomalies and Mortality in a Tertiary Neonatal Unit: A Three-Year Retrospective Study.
DOI:
https://doi.org/10.63682/jns.v15i1s.10451Keywords:
congenital anomalies; neonatal mortality; neonatal surgery; antenatal ultrasound; neonatal unit; logistic regressionAbstract
Background: In tertiary neonatal centres congenital anomaly (CA) forms part of the causes of neonatal morbidity and mortality when it is combined with other factors such as premature birth, respiratory failure, sepsis, birth asphyxia and/or surgical referral.
Methods: 1200 neonatal admissions to neonatal unit were included as an analytical cohort in this 3-year retrospective study. Neonatal characteristics, maternal factors, congenital anomaly status, clinical morbidities, interventions and mortality were analysed using descriptive statistics, bivariate tests, crude odds ratios and multivariable logistic regression. Each variable for the regression was considered a priori and not entered by a stepwise method.
Results: Congenital anomalies were recorded in 89 (7.4%) of 1,200 neonates. Overall mortality was 171/1,200 (14.2%). The mortality rate in neonates with anomalies was higher than in neonates without anomalies (21.3% vs 13.7%). Antenatal ultrasound was documented in 60/89 anomaly cases (67.4%), but when records were available a confirmed antenatal detection rate could not be computed. In adjusted analysis, mortality was associated with congenital anomaly status, low birth weight, low five-minute Apgar score, birth asphyxia, respiratory distress and mechanical ventilation.
Conclusion: Congenital anomalies were found to be more clinically complex and associated with higher mortality. Small sample sizes of anomaly subgroups are only presented descriptively. Results suggest the need for better documentation during pregnancy, more complete diagnostics, neonate to surgery referrals, and a structured mortality review
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