Clinical Profile and Outcomes of Congenital Gastrointestinal Malformations: A Single Hospital Study

Abstract

Aims: To determine the prevalence, clinical profile and outcomes of gastrointestinal (GI) malformations in neonates in a tertiary care hospital. Settings and Design: A prospective observational case-control study was conducted at a tertiary care hospital in New Delhi. Methods: The study was conducted on live neonates from October 2014 to November 2015. Cases of neonates with GI malformations were compared against healthy babies. Outcome measures assessed were prevalence, associated risk factors, clinical profile, and mortality of GI malformation. Statistical analysis: Qualitative variables were compared using Chi-Square test/Fisher’s exact test. Multivariate logistic regression was used to assess the significant risk factors after adjusting for confounding variables. A P-value <0.05 was considered statistically significant. Results: Among the 25,116 live births, 41 cases were diagnosed with GI malformations. To compare, 82 controls (healthy babies) were taken. The prevalence of GI malformations was 0.163 or 1.63/1,000 live births with a male to female ratio of 1.1:1. The tracheoesophageal fistula was the most frequent anomaly (39.02%). Multivariate analysis revealed a lack of periconceptional iron and folic acid supplementation and baby birth weight <2.5 kg as independent significant factors related to the occurrence of congenital GI defects (when compared to controls). Among 41 cases, 20 neonates died (48.78% mortality rate). Causes of mortality were prematurity, sepsis, asphyxia, and shock. Conclusion: In a developing country like ours, the association of GI malformations (0.163%) with lack of periconceptional iron and folic acid supplementation and low birth weight shows that increased counseling and implementation of the supplements during the pregnancy can help decrease the prevalence. Mortality remains high among such children and thus they demand urgent necessary surgery and management.