Pattern and outcome of congenital malformations in newborn babies in a Nigerian teaching hospital

Several types of congenital malformations have been seen in our settings, but the frequencies and pattern are not known.

To review the prevalence and pattern of congenital malformation in the Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital, Maiduguri, over a 10-year period.

This was a retrospective study carried out in a semi-urban Nigerian Teaching Hospital. All admissions into SCBU from 1991 to 2000 were reviewed, using both the admission and discharge records. The information extracted from the case note of each patient included sex, age and weight on presentation, maternal age and parity, gestational age, presence of associated neonatal illnesses such as jaundice, sepsis and the type of malformation on physical examination only.

Three hundred and ten (13.9%) of 2233 admissions had major congenital malformation. Thirty one (10%) gave a history of antenatal care while 279(90%) had no record of receiving antenatal care. Of the 310 babies, 140 (45.2%) abnormalities were of the gastro-intestinal system and 75 (24.2%) of central nervous system. Anterior abdominal wall defect 77(24.8%) was the commonest type of malformation seen followed by neural tube defect 63(20.3%) and imperforate anus 31(10.0%). Gastro-intestinal malformations were associated with a mortality rate of 60.9% as compared with 21.1% in those with central nervous system malformations.

The high prevalence of malformation seen in this study could be associated with the fact that majority (75.4%) of the mothers delivered their babies outside the teaching hospital, whose antenatal care are unknown. The occurrence of congenital malformations is very high in North Eastern Nigeria, Environmental factors may have a role.