Prevalence and factors associated with congenital malformations in live births

Gonçalves, Milena Kelry da Silva; Cardoso, Mirian Domingos; Lima, Rosário Antunes Fonseca; Oliveira, Conceição Maria de; Bonfim, Cristine Vieira do

doi:10.37689/acta-ape/2021AO00852

Brasil

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Original Article • Acta Paul Enferm. 34 • 2021 • https://doi.org/10.37689/acta-ape/2021AO00852 linkcopy

Prevalence and factors associated with congenital malformations in live births

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective: To estimate the prevalence of congenital malformations and to identify associated factors in live births.

Methods: Cross-sectional study, population-based, with data from the Live Births Information System. A bivariate statistical analysis (Chi-square test) and a multivariate statistical analysis (multiple logistic regression) were performed to evaluate the association between the variables and the outcome (live-births with or without congenital malformations).

Results: A total of 346,874 live births were registered, of which 3,473 presented some type of congenital malformation, with an average prevalence of 1.0%. In the multiple analysis, the factors positively associated with prevalence were: duration of pregnancy less than 37 weeks (OR = 1.17), maternal age between 20 and 29 years (OR = 0.893), singleton pregnancy (OR = 1.775), type of delivery (OR – 0.827), and number of prenatal consultations inferior to six (OR = 1.214).

Conclusion: The variables pointed out in the study integrated a predictive model that can help in the planning of health services, suggest hypotheses regarding etiological factors, and finance prenatal care actions with attention to the identified factors.

Year	Number of live births	Number of live births with CMF	Prevalence of live births with CMF (%)
2001	25,294ᵃ	296	1.2
2002	24,307^b	207	0.9
2003	24,676^c	275	1.1
2004	22,898^d	250	1.1
2005	23,207^e	227	1.0
2006	22,646^f	240	1.1
2007	22,046^g	204	0.9
2008	22,261^h	184	0.8
2009	22,546ⁱ	215	1.0
2010	21,796^j	225	1.0
2011	22,218^k	178	0.8
2012	22,633^l	151	0.7
2013	23,176^m	224	1.0
2014	23,506ⁿ	262	1.1
2015	23,664^o	335	1.4
Total	346,874	3,473	1.0
Δ%	-6.4	13.2	21

Characteristics		Malformation		p-value
Characteristics		Yes No. (%)	No No. (%)	p-value
Sexᵃ				< 0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	Female	1310(39.9)	160296(48.9)
	Male	1974(60.1)	167694(51.1)
Birth weight (grams)^b				< 0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	<2.500	745(22.7)	28204(8.6)
	≥2.500	2539(77.3)	299786(91.4)
Apgar 1st minute^c				<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	<7	1039(31.6)	44221(13.5)
	≥7	2245(68.4)	283769(86.5)
Apgar 5th minute^d				<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	<7	439(13.4)	7257(2.2)
	≥7	2845(86.6)	320733(97.8)
Maternal age^e (in complete years)				0.003^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	< 20	663(20.2)	62962(19.2)
	20-29	1611(46.0)	170666(52.0)
	≥ 30	1010(30.8)	9436(28.8)
Educational level (years)^f				0.011^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	<8 years	1140(34.7)	106991(32.6)
	≥8 years	2144(65.3)	220999(67.4)
Type of pregnancy^g				0.085
	Singleton	3201(97.5)	321167(97.9)
	Multiple	83(2.5)	6823(2.1)
Prenatal consultation^h				< 0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	<6	1736(52.9)	146588(44.7)
	≥6	1548(47.1)	181402(55.3)
Pregnancy duration (in weeks)ⁱ				< 0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	<37	693(21.1)	29950(9.1)
	≥37	2591(78.9)	298040(90.9)
Type of delivery^j				0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%). Proportion of live births with information ignored: a) 0.04%; b) 0.02%; c) 0.8%; d) 0.5%; e) 0.06%; f) 1.2%; g) 0.04%; h) 1.4%; i) 0.5%; j) 0.05%
	Vaginal	1459(44.4)	155571(47.4)
	Cesarean	1825(55.5)	172419(52.6)

Variable		Odds ratio (adjusted)	Confidence interval (95%)	p-value
Sex				-
	Female	0.70	(0.65-0.75)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	Male	1	-	-
Birth weight (grams)
	< 2,500	2.09	(1.86-2.36)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	≥ 2,500	1	-	-
Apgar 1^st minute
	<7	1.82	(1.67-2.00)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	≥7	1	-	-
Apgar 5t^h minute
	<7	3	(2.64-3.41)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	≥7	1	-	-
Maternal age (in complete years)
	< 20	0.92	(0.83-1.02)	0.115
	20-29	0.89	(0.82-0.97)	0.006^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	≥30	1	-	-
Educational level (years)
	<8 years	1.05	(0.98-1.14)	0.181
	≥8 years	1	-	-
Type of pregnancy
	Singleton	1.77	(1.41-2.23)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	Multiple	1	-	-
Prenatal consultation
	<6	1.21	(1.13-1.31)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	≥6	1	-
Pregnancy duration (in weeks)
	<37	1.17	(1.04-1.32)	0.012^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	≥37	1	-	-
Type of delivery
	Vaginal	0.82	(0.77-0.89)	<0.001^* * The Null Hypothesis was rejected, because the p-value is smaller than the significance level of 0.05 (5%).
	Cesarean	1	-	-

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Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
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[TFN4] CMF - congenital malformation; LB - live births. Proportion of live births with the information regarding congenital malformation ignored: a) 0.18%; b) 0.10%; c) 0.09%; d) 0.21%; e) 0.05%; f) 0.07%; g) 0.03%; h) 0.01%; i) 0.08%; j) 0.03%; k) 0.14%; l) 0.15%; m) 0.03%; n) 0.05%; o) 0.08%