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Congenital malformations: a review of 672 autopsies in Ibadan, Nigeria
E E Akang1, K O Osinusi, H U Pindiga
1Department of Pathology, University College Hospital, Ibadan, Nigeria.
Insights
This study reviewed 672 Nigerian children with lethal congenital malformations. Alimentary tract issues were most common, followed by cardiovascular and craniospinal defects.
Area of Science:
- Pediatric Pathology
- Medical Genetics
- Public Health
Background:
- Congenital malformations represent a significant cause of infant mortality worldwide.
- Understanding the spectrum and patterns of lethal congenital anomalies is crucial for public health interventions.
- Nigeria, a populous African nation, requires specific data on congenital malformations.
Purpose of the Study:
- To analyze the postmortem findings of lethal congenital malformations in Nigerian children.
- To identify the most common affected organ systems and specific malformations.
- To determine the demographic characteristics of affected infants.
Main Methods:
- Retrospective review of postmortem records.
- Analysis of 672 cases of lethal congenital malformations in Nigerian children.
- Categorization of malformations by anatomical site and type.
Main Results:
- The alimentary tract was the most frequent site (30%), with intestinal and biliary atresia being common.
- Cardiovascular malformations occurred in 26% of cases, including ventricular septal defect and tetralogy of Fallot.
- Craniospinal axis anomalies (hydrocephalus, spina bifida, anencephaly) and urogenital malformations (with male predominance) were also significant.
- Complex malformations involving multiple systems were observed in 20% of cases, some linked to chromosomal anomalies or infections like rubella.
Conclusions:
- Congenital malformations in Nigerian children predominantly affect infants under one year, with a male predominance.
- Alimentary tract, cardiovascular, and craniospinal axis defects are the leading causes of lethal congenital malformations in this population.
- Further research into etiological factors and preventative strategies is warranted.
Abstract:
The postmortem findings in 672 Nigerian children with lethal congenital malformations are reviewed. Eighty-six percent of the patients were less than 1 year of age and the male-to-female sex ratio was 1.3:1. The alimentary tract was the most common anatomic site involved (30%), intestinal and biliary atresia being the two lesions most frequently identified in this location. Twenty-six percent of the children had cardiovascular malformations, of which ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot were most important. There was an accentuated male predominance among cases with urogenital malformations due to the high frequency of posterior urethral valve. Hydrocephalus, spina bifida, and anencephaly were the most common lesions observed in the craniospinal axis. One-fifth of the children had complex malformations of multiple organ systems, 20% of which were associated with chromosomal anomalies, rubella, and other malformation syndromes.