Burden of Fetal Anomalies among Antenatal Mothers Attending a Public Referral Hospital: A Mixed Cohort Study.

Abstract

Background and objective: Fetal anomalies or birth defects are structural or functional abnormalities that occur before birth, often leading to significant health issues. The burden of fetal anomalies among antenatal mothers attending a public referral hospital in urban Bangalore is a critical public health concern, reflecting broader issues of maternal and child health in India. Factors such as consanguinity, genetic disorders, and delayed access to healthcare contribute to the high prevalence of anomalies in the country. This study aimed to determine the magnitude and types of fetal anomalies detected through routine ultrasound in an urban referral hospital in Bangalore and to explore associations with maternal demographic and socioeconomic factors.

Methods: This ambispective study analyzed data from 1432 antenatal mothers who underwent ultrasound screening from July 2021 to June 2022. It included a retrospective review of medical records and a prospective follow-up for pregnancies with detected anomalies. Data on maternal age, consanguinity, parity, and other maternal risk factors were collected using logistic regression to explore associations with congenital anomalies.

Results: Fetal anomalies were detected in 2.9% of pregnancies (n = 42), with renal system anomalies being the most prevalent (59.5%). Consanguinity was present in 9.9% of cases and showed a significant association with congenital anomalies (odds ratio [OR] = 2.14, p = 0.05). Preterm birth was significantly associated with anomalies (OR = 4.47, p = 0.001). Most anomalies were detected after 30 weeks of gestation, limiting the scope for early intervention.

Conclusions and global health implications: The study highlights congenital anomalies, particularly renal anomalies, that are prevalent in a public hospital in urban Bangalore. It emphasizes the importance of early antenatal care, targeted-screening, and genetic counseling for at-risk population due to consanguinity. Timely detection and intervention could improve maternal and neonatal outcomes.