Types, Management and Factors associated to the Outcome of Congenital Anomalies among Neonates in the Neonatal Intensive Care Unit of the Limbe Regional Hospital

Background: Congenital abnormalities are a major contributor to perinatal and infant morbidity and mortality. The impact is more severe in countries of low socio-economic status with majority of infants who die from congenital anomalies. Epidemiologists have reported numerous investigations of the prevalence and etiology of congenital anomalies, but analyses of mortality have focus on the contribution of these disorders to perinatal and infant death rates rather than to the survival of affected infants. The aim or objectives was to determine the prevalence, associated factors to outcomes of congenital anomalies among neonates in the Neonatal unit of the Limbe Regional Hospital from 2017 to 2022.

Method: This was a hospital-based retrospective study conducted from November 2022 to July 2023. A data extraction form was used to collect data from 2815 complete neonatal files admitted between 2017 and 2022 using an exhaustive sampling technique. Incomplete files were excluded. Ethical clearance was obtained from the University of Buea, faculty of health sciences Institutional review board, administrative clearances were obtained from the South West Regional Delegation of Public Health, and Limbe Regional Hospital. Data was entered using MS Excel, and exported to SPSS version 25 for analysis. Univariate analysis was done using descriptive statistics. Chi square test was used to test for association between variables while Logistic and cox regression models were used to test for significant determinants and outcome of congenital abnormalities (α=0.05).

Results: Congenital anomalies accounted for (3.5%) neonatal hospital admissions in the Limbe Regional Hospital. As for the management (34.7%) of the neonates with congenital anomaly were on medical treatment while (22.4%) underwent surgical procedures. The average period of hospital stay was 6.450±9.324 days. From 2017 to 2022, majority of the neonates 76.5% got discharged while (18.4%) died. Congenital abnormalities accounted for 5.8% of the total neonatal deaths with majority of the birth defect fatalities occurring during the neonatal period. The highest rate of mortality in this study was found in post-surgical cases (61.1%). Babies with nervous system abnormalities were found to have the poorest prognosis compared to other groups of anomalies (X²: 8.375, df:1, P: 0.004). Primiparity, male sex, forceps delivery, low birth weight and surgical management were significant risk factors for mortality.

Conclusion: Congenital anomaly is a major indication for neonatal admissions and mortality in the Limbe Regional Hospital. The highest rate of mortality in this study was found in post-surgical cases. Babies with nervous system abnormalities were found to have the poorest prognosis There is the need to establish a surveillance system for congenital anomaly and efforts should be made to raise awareness of the occurrence and risk factors of congenital anomaly in Cameroon to improve on the outcome.