A Silent Epidemic of Gross Congenital malformations in Tigray, Northern Ethiopia: Hospital-Based Study

Abstract Background Congenital malformations are defects of the morphogenesis of organs or body during the pregnancy period and are identifiable at pre- or postnatal. It is identified as the major cause of child mortality worldwide. There is a need to understand the prevalence of congenital malformations in Tigray in particular and Ethiopia in general as surveillance data are lacking. Hence, this study was designed to investigate the burden of gross congenital malformations in the Tigray Region, Northern Ethiopia. Methods This cross-sectional study was conducted of birth outcomes diagnosed with structural malformations in the labor ward admitted to Ayder comprehensive specialized university hospital and five general hospitals namely Alamata, Lemlem Karl, Adwa, St Mary and Shul Hospitals from Tigray region between January 2018 and January 2019. Data on demographic and clinical findings of the mothers and their pregnancy outcomes were collected using a standard data collection tool. Simple descriptive statistics were used to characterize the study subjects. Statistical analysis was done using chi-square analysis and P value < 0.05 was considered significant. Results A total of 12225 births were recorded in the six hospitals during the study period. Of these, 383 births had gross congenital malformations of different degrees of severity and 12 of them were stillbirths. The overall occurrence of congenital malformations was 3.1 % of the total births (live births and stillbirths) examined. Central nervous system anomaly mainly Neural tube defect were found the commonest anomalies observed in this study. The maternal factors (maternal age, gravidity, abortion history, parity) and fetal factors (birth weight and gestational ages were significantly associated with the occurrence of the gross congenital malformations (p < 0.05). Conclusion This study has shown a high prevalence of gross congenital anomalies exists in the study communities. High prevalence of central nervous system-related malformations was observed in the Tigray region, given the high prevalence of nutritional deficiency and lack of periconceptional care that can impact the formation of the nervous system in the current study population. Hence, there should be an immediate food fortification with folic acid and periconceptional folic acid supplementation for all reproductive-age women in the region and the country at large.