Epidemiological Aspects of Congenital Anomalies and Associated Risk Factors in Latvia. Summary of the Doctoral Thesis

Abstract

The paper consists of 118 pages, 22 pictures, 12 tables, 172 literature references and 7 attachments. The thesis is completed in Latvian. Aim of Study: to assess the prevalence of congenital anomalies in live births and perinatal and infant mortality due to congenital anomalies in Latvian and find correlations with some antenatal care, maternal and newborn health related factors, as well as to assess prenatal diagnosis rates for birth defects and completeness of registration system. Methods and Materials: a retrospective case - control study design. The study included all live newborns from Medical Birth Register, which were born (2000-2010) and were diagnosed congenital anomalies (CA) (ICD-10: Q00-Q99) at birth. As control group was used data about live newborns without any pathologies at birth in the same time period. Diagnoses of CA were recorded according to European Surveillance of Congenital anomalies (EUROCAT) major CA diagnoses codes. Analysis also include data from: National Death Cause database, Congenital Anomaly Register, as well as medical record analysis of infants with CA who were treated in the Children's Clinical University Hospital. Main Results: during the period (2000 - 2010) live birth prevalence of major congenital anomalies statistically significantly decreased in Latvia, per year by 5.2/10, 000 births. As well as the decrease in both the perinatal and infant mortality due to congenital anomalies. Prevalence data affect: the quality of medical records, including confirmation or change of final CA diagnoses, insufficient information about the diagnosed CA cases in postneonatal period and termination of pregnancy for fetal anomaly. The survey results also indicated higher odds ratio for newborn CA in relation with the following mother health related factors: maternal age (OR = 1.2), late antenatal care (OR = 1.1), maternal diseases (OR = 1.6), including diabetes mellitus (OR = 6.3), history of abortion (OR = 1.3), maternal alcohol (OR = 1.9), and substance use (OR = 3.6). Findings from the study suggests that need to develop public health programs related to congenital anomalies avoidable risk factors. In clinical practice ultrasound screening in pregnancy for early detection of anomalies should be improved.