Determinants of Congenital Anomalies in Central India: A Case-Control Study on Modifiable Maternal Risk Factors

Background:  A Congenital anomaly represents defects in morphogenesis during early foetal life. The majority have multifactorial inheritance. Some congenital anomalies can be prevented. This study assessed risk factors associated with congenital anomalies among children aged 0–6 years attending a tertiary care centre in Bhopal, Madhya Pradesh, India. Methods: This was a case-control study conducted at Samarpan Kendra, Bhopal, for the duration of one year. Data of 124 cases and 124 controls were collected by interviewing the mothers. Odds ratio and adjusted Odds ratio were calculated for the risk assessment. Results: Ten independent risk factors were statistically significant, namely duration of pregnancy, type of pregnancy, birth weight, place of delivery, order of pregnancy, irregular iron and folic Acid tablets, maternal illness, neonatal loss, and family history. These were then selected and included in the multivariate logistic regression model and adjusted odds ratios were calculated. The risk of birth defect was six times higher among preterm births (AOR= 6.001; CI= 2.524-14.264), multiple pregnancy had 12.25 times higher risk (AOR= 12.250; CI= 2.482-60.448) and low birth weight infants had 2.6 times increased risk of developing the anomaly in comparison to normal weighed infant (AOR= 2.623; CI= 1.180-5.831). Conclusion: Public awareness should be raised on the importance of iron and folic acid intake, regular antenatal checkups, maintaining hygienic conditions to avoid infections, nutritional care of the mother antenatally and postnatally, for the preparation for next pregnancy.