Congenital abnormalities at a tertiary center in Jamaica: an 18-month maternal-fetal medicine experience

J Matern Fetal Neonatal Med. 2012 Jun;25(6):687-91. doi: 10.3109/14767058.2011.594921. Epub 2011 Jul 20.

Abstract

Objective: The objective of this study was to compare outcomes of patients with prenatally versus postnatally diagnosed congenital abnormalities seen during the first 18 months of a recently established MFM unit.

Methods: Hospital charts of all congenital abnormalities diagnosed between July 2008 and December 2009 were reviewed. Data collected included: maternal demographics, perinatal outcome, neonatal mortality and morbidity as defined in the Radius trial.

Results: Fifty-five pregnancies with 57 anomalous fetuses were identified: 13 (23%) postnatally and 44 (77%) prenatally. Most frequent postnatally diagnosed anomalies were gastrointestinal (33%), central nervous system (CNS) (16%) and cardiac (16%); whereas prenatally diagnosed were CNS (29%) and genitourinary (23%). Mothers postnatally diagnosed had a 12 kg (17%) greater mean weight; 12 (92%) had anomaly scans reported as normal; birth weight and moderate neonatal morbidity were statistically greater (2.8 vs. 2.13 kg, p < 0.02) and (9/12 vs. 11/29, p < 0.03), respectively. Neonatal morbidity was 6.2 times more likely in the postnatally diagnosed group adjusting for birth weight, gestational age and route of delivery [OR (95% CI) 6.2, (1.2-32.4), p = 0.03].

Conclusions: Most abnormalities were diagnosed prenatally; however, the majority of postnatally diagnosed had false negative anomaly scans and experienced significantly more moderate neonatal morbidity.

MeSH terms

  • Adult
  • Congenital Abnormalities / diagnosis
  • Congenital Abnormalities / epidemiology*
  • Female
  • Gestational Age
  • Humans
  • Jamaica / epidemiology
  • Maternal-Child Health Centers / statistics & numerical data
  • Maternal-Fetal Relations
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Prenatal Diagnosis / statistics & numerical data
  • Retrospective Studies
  • Time Factors
  • Young Adult