Exploring prenatal risk factors associated with congenital anomalies among newborns in national referral hospital, Indonesia.

Abstract

Introduction: Congenital anomalies (CAs) account for approximately 8 to 15% of perinatal deaths and 13 to 16% of neonatal deaths. Congenital anomalies are a significant public health issue in Indonesia, affecting approximately 59.3 per 1,000 live births. The three most frequent malformations were hydrocephalus (21%), cleft lip and cleft palate (9.2%) and Down Syndrome (9.2%).

Materials and methods: A retrospective case-control study was conducted at Dr. Cipto Mangunkusumo General Hospital, Jakarta, between September 2023 and October 2024. Data from 552 births were analysed, including 97 cases of congenital anomalies (CAs). Maternal, fetal, and environmental factors were assessed using medical records and documented clinical histories. Statistical analyses included descriptive statistics, cross-tabulations, binary logistic regression, and multivariable logistic regression.

Results: The prevalence of CAs was 17.6%. Significant maternal risk factors included a history of congenital anomalies (OR = 3.7, 95% CI: 0.88-16.00) and severe anemia (OR = 4.37, 95% CI: 2.48-7.69). Environmental risks, such as drug use in the first trimester (OR = 3.43, 95% CI: 2.01-5.86), passive smoking (OR = 4.10, 95% CI: 1.89-8.90), and pesticide exposure (OR = 3.92, 95% CI: 1.26-12.17), were also significant. Folic acid supplementation showed a significant protective effect against congenital anomalies (OR = 0.56, p = 0.001), although the usage rate remained low (35.5%).

Conclusion: This study found a significant association between congenital anomalies and risk factors such as passive smoking, exposure to pesticides, and chemicals. It highlights the importance of ongoing community health education to prevent and manage these predisposing risk factors.