Prevalence of congenital malformations at the "Les Orangers" Maternity and Reproductive Health Hospital of Rabat: Descriptive study of 470 anomalies

Abstract Congenital malformations are described in about 3% of live births and 20% of stillbirths. In the industrialized countries, they represent one of the main causes of infant mortality, morbidity and handicap. In our country, as in all developing countries, the prevalence of congenital anomalies is not well known at the national level, besides, causes and risk factors are not always identified. The aim of our work is to conducta the first large descriptive exploratory analysis of congenital malformations cases diagnosed at the "Les Orangers" maternity and reproductive health hospital in Rabat. METHODS We have collected all the cases of congenital malformations diagnosed at the "Les Orangers" maternity and reproductive health hospital in Rabat for a period of five and a half years from January 1st, 2011 to June 30th, 2016. Data were collected on pre-established sheets and on a registry of malformations. Total and specific prevalences were calculated for each malformation then a principal component analysis was conducted followed by a Varimax rotation in order to identify the different associations of malformations in our series. RESULTS During the study period, a total of 43923 births were recorded. We have registred 245 cases of congenital malformations with a prevalence of 5.58 per thousand births of which 19.2% were fetal deaths in utero. The most representative anomalies were malformations of the osteoarticular system and muscles with a rate of 33%, followed by neurological abnormalities representing 18%, of whom 31% were hydrocephalus, 26.2% anencephaly, and 20.24% spina bifida. Malformations of the eye, ear, face and neck were described in 12% of the cases, while genetic abnormalities were observed in 8,5% of which 87.5% represented Trisomy 21. The antenatal diagnosis of congenital malformations was performed in 28.6% of cases. We observed a slight male predominance with a sex ratio of 1.19. CONCLUSIONS Congenital malformations are a real public health problem as they represent a major cause of stillbirth and neonatal mortality. Identifying and studying the causes and risk factors is a priorityin order to adapt a primary prevention strategy, especially folic acid supplementation to prevent neural tube closure defects.