Measuring Risk Factors, Maternal and Neonatal Outcome of Pregnancies Complicated by Foetal Anomalies, HEND SHALABY, MOHAMMED IBRAHIM and EMAD FYALA
Abstract
Objective: To investigate the prevalence, the associated risk factors, maternal and neonatal outcome in pregnancies complicated by fetal anomalies among Egyptian women.
Methods: A case-control study involving 119 pregnant cases with fetal anomaly (ies) compared to an equal number with no anomaly conducted from January 2015 through May 2016 at Mansoura University Hospitals and a private clinic centre 'The future fetal centre 'Mansoura, Egypt. All cases were diagnosed by US (2D, 3D/4D types). Multiple logistic regression models were used to control for confounders.
Results: Multivariable analysis indicated the risk factors are independently associated with fetal anomalies. There were no significant differences between women with fetal anomaly and controls as regard gravidity, parity, body mass index, living status, occupation, utilization of antenatal care and level of education (p>0.05). Women with malformation were significantly younger at marriage and more likely to marry their relatives (20.8±3.4 vs. 22.3±4.07, p<0.001) and (38.4% vs. 22.9%, p=0.001) respectively compared to controls. Also they found to have a higher rate of induced pregnancy (41.08 vs. 15.1%, p=0.001), less likely had hypertension (7.5% vs. 17%, p=0.03), commonly had anaemia (28.5 vs. 18.4, p=0.01) and most likely delivered by caesarean section (43.6% vs. 30.2%, p=0.03). Women with malformations and controls were similar in other medical disorders like diabetes mellitus, hypo-hyperthyroidism (p>0.05) while family history of mal-formation showed borderline significance (p=0.05). The most frequent anomalies were GIT types (33 cases) while the least were skeletal (6 cases). Cas was mostly in females (54.6 vs. 45.4, p=0.002). Conservative or no treatments was the rule in 59 cases while medical and surgical interventions were used in the rest (4 and 56 cases respectively). No significant difference as regard post-partum maternal complications between cases or control; PPH was found 1.9 vs. 1.7 (p=0.2), retained placenta was 9.2 vs. 6.7 (p=0.06) while infection rate was 5.04 vs. 3.3 (p=0.76).