Magnitude, pattern, birth outcome, and determinants of congenital anomalies among newborns in Ethiopia

Congenital anomalies, encompassing structural or functional defects present at birth, pose a significant global health challenge. Addressing congenital anomalies can contribute significantly to further reducing neonatal mortality and advancing overall child health in Ethiopia.

This study aimed to assess the magnitude, pattern, birth outcome, and determinants of congenital anomalies among newborns in Ethiopia.

Employing a facility-based cross-sectional design over one month, the study enrolled 813 deliveries attending two public and private maternal and child health centers. We used consecutive sampling of all eligible deliveries who fulfils the inclusion criteria during the study period and meticulously screened for congenital anomalies using a well-designed pictorialized data collection tool by training pediatricians and midwives. To determine the strength of the association and identify independent predictors of birth defects, the adjusted odds ratio (AOR) and 95% confidence interval were computed using binary logistic regression analysis.

Forty-six neonates (5.66%, 95% CI: 4.17%-7.47%) had one or more congenital anomalies detected on physical examination. Of these, 36 had a single anomaly, while 10 had multiple malformations. There were a combined 60 anomalies among the 46 newborn babies. The majority of the patients had central nervous system anomalies (31.7%), followed by genitourinary system (25.4%) and musculoskeletal system (22.2%) anomalies. The odds of birth defects increased by 3.73 for women attending a private hospital compared to those attending a public hospital (AOR 3.73, 95% CI 1.67, 8.32). The odds of birth defects were 1.97 times greater for males than for females (AOR 1.97, 95% CI 0.99, 3.91; p = 0.051), which is clinically or practically significant even if the p value is slightly above the cutoff point, 0.05. The odds of birth defects were found to be 9.3 times greater among neonates with very low birth weight and low birth weight than among neonates with appropriate birth weight (AOR 9.29, 95% CI 3.41, 25.31). Primipara women had 3.64 times greater odds of delivering babies with birth defects than did multipara women (AOR 3.64, 95% CI 1.45, 9.13). In this study, perinatal mortality was markedly higher among newborns with congenital anomalies (37%) compared to those without anomalies (1%), and this difference was statistically significant (p < 0.001).

In conclusion, this study provides important insights into the prevalence, patterns, birth outcomes, and predictors of congenital anomalies. The high anomaly rates highlight the need for comprehensive prenatal care, including early diagnosis, risk factor monitoring, and targeted interventions for private MCH clinics, male neonates, low birth weight infants, and primipara women. Further longitudinal research and collaboration with the Ministry of Health to establish a congenital anomaly surveillance system can improve the understanding and management of these conditions.