The differences between the cases and the controls were statistically significant with an Odds ratio of 2.461; 99% CI: 1.8063.299, P-value < 0.001, revealing that cases are more likely to have a premature birth. A total of 3301 HRP women (20112014) were enrolled. Thus, the present study was carried out to investigate risk factors associated with CAs in southwestern Ethiopia. As a result, unidentified drug usage in the first three months of pregnancy (AOR = 3.435; 99% CI: 2. Besides, 16(6.4%) mothers of the cases and 52(5.9%) of the control had hypertension before and during pregnancy. 
No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0245915. In our findings, unidentified medicinal use during early pregnancy had a strong association with the occurrence of CAs. Lastly, about 3.6% of both mothers of the cases and controls were 36 years old (Table 2). Newborns, either fresh stillbirth or live birth in the selected hospitals during the study period were evaluated for the presence of any CAs by trained health professionals. The data were coded, stored in a safe and secure location. As shown in Table 3, 39.8% and 8.2% of the cases and controls were born with low birth weight (<2500 g), respectively. From existing hospitals in the study regions, only six selected hospitals were used for the study, although cases of CAs were expected in the remaining hospitals and health stations, which may limit generalizability to the wider population of Ethiopia. In our findings, more live births were observed in controls than in cases. There is a need to continuously provide health information for the community on how to prevent and control predisposing risk factors. Formal analysis, Of these, smoking cigarettes during pregnancy (COR = 5.317; 99% CI: 0.50356.242, P- value = 0.068), passive smoking (COR = 3.852; 99% CI: 1.8847.875, P-value = <0.001), exposure to radiation (Xrays) in the early pregnancy (COR = 3.586; 99% CI: 0.6968.482, P- value = 0.045), exposure to pesticides (COR = 4.012; 99% CI: 1.40611.446, Pvalue <0.001), diabetic mellitus (COR = 14.341; 99% CI: 0.800256.981, P- value = 0.017), use of unidentified medication and drugs in the first three months of pregnancy (COR = 3.091; 99% CI: 1.8845.070, Pvalue < 0.001) were associated with CAs in the crude Odds ratio analysis and may be responsible for the occurrences of CAs. Methodology, Other environmental factors such as radiation also contribute to the formation of abnormal development. However, most of the risk factors of CAs are uncertain (4060%) genetic factors, environmental factors, and multifactorial inheritance are among risk factors that lead to abnormal prenatal development [4]. The COR and AOR with their 99% confidence intervals and the P-value as well as the results of the findings were presented in the form of text and table. Software, Several studies described that the human embryo is well protected in the uterus by the extra-embryonic membranes, although teratogens may cause developmental disruptions after maternal exposure to them in a specific period of organogenesis during the critical period in early pregnancy [10]. 471; P-Value = 0.017) (Table 4). Project administration, Furthermore, pre-gestational diabetes was identified to be an important risk factor for structural anomalies due to the teratogenic effect of poorly controlled diabetes and is considered to be the most important risk factor during early period of pregnancy, especial during the first 8 weeks, at which active differentiation of organ systems could occur [24,27]. In other words, mothers of the newborns who did not get folic acid supplementation during their early pregnancy were twice as likely to have a baby with CAs. No, Is the Subject Area "Medical risk factors" applicable to this article? About 26.0% and 21.0% of mothers of the cases and controls were below 20 years old, respectively.
The participants did not write their names on the questionnaires for confidentiality and no identifying information was recorded by participants.
We used trained health professional data collectors, including gynecologists who evaluated the presence of CAs (the cases). Eleven percent pregnant women were carrying fetuses with CAs in the present pregnancy. Is the Subject Area "Pregnancy" applicable to this article? Then data collections were started after permissions were obtained from the medical directors of each hospital. Maternal age (25years, OR=1.42, p=0.002), paternal age (<30years, OR=1.51, p<0.001), consanguinity (OR=1.39, p=0.012) and primi gravida (OR=3.40, p<0.001) were identified as risk factors for HRP women with fetal CAs in present pregnancy.
Data curation, A similar report showed that the overall CA-specific stillbirth risk was increased among affected fetuses over the occurrence of stillbirth in the general population in the United State [32,33]. We use cookies to help provide and enhance our service and tailor content and ads. First, we used hospitals with high caseloads in southwestern Ethiopia where most cases of CAs were expected. Passive smokers were observed in 28(11.2%) mothers of the cases and 28 (3.2%) of the controls. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Finally, the data analysis was based on all maternal, neonatal, and other associated factors that may contribute to the occurrence of CAs. The funders had no role in the study design, data analysis and decision to publish for preparation of the manuscript.
Overall data were calculated using frequency, cross-tabulation, binary and multiple logistic regressions. High prevalence of CAs was found in HRP women compared to general population. A standard pretested checklist was used to assess every live and fresh stillbirth at selected hospitals. Correa (2016) [28] reported that the embryopathy associated with pre-gestational diabetes mellitus is nonspecific underlying metabolic disorders disturbing morhogenetic process. 005/16, dated May 2016.
In the present study, there were maternal illnesses in 113 (45.0%) mothers of the cases and 373 (42.2%) of controls. The outcome of fetal birth disorder was determined to intermesh with the mode of deliveries. Besides, a single gene mutation also contributes to genetic related birth defects [2]. Written and signed consent was obtained from all study participants before administering the questionnaires and facetoface interviews. e0245915. This might be because chemicals and pesticides added to the surface water through several routes/sources can contaminate the surface water. Although exposure to radiation, especially Xrays, during early pregnancy seems to have an association with the occurrence of CAs in its crude risk estimate, multivariable logistic regression shows no association with the occurrence of the CAs. Supervision, All the study participants were informed that participation is voluntary and can be withdrawn at any time. Ethical approval was obtained from the Addis Ababa University, College of Health Sciences, Institutional Review Board, meeting Ref. The major CAs observed were Central Nervous System (CNS) followed by renal anomalies. Two hundred fifty-one cases and 887 controls were used with a total sample size of 1138. Visualization, Maternal chromosomal abnormalities which can be defined as numerical and structural abnormalities of the chromosomes cause a genetic disorder. The difference between the cases and the controls was statistically significant indicating that the mothers who had not received antenatal care during their pregnancy were strongly associated with having a baby with CAs. Secondly, it was a hospital-based study design and might have missed cases of CAs for deliveries that occurred outside the study hospitals within the community. Hence, more stillbirths occurred in cases than controls. The difference might be due to the cultural difference in practicing cigarette smoking or staying with a smoker of a country with a geographically different location. Serum was analyzed for IgG & IgM against TORCH (Toxoplasma, Rubella, CMV and HSV) agents by ELISA. Similarly, parity, gravidity, the onset of labor, mode of delivery, and types of birth outcome and birth order of the newborns showed no significant association with the occurrence of CAs. In line with the present study, studies done in Iraq and Egypt show that maternal smoking either actual or passive smoking in the first three months of pregnancy was strongly associated with the occurrence of birth defects specifically cleft lip with or without cleft palate [14,15]. For example, X-rays can cause problems with fetal development, such as spina bifida, cleft palate, blindness, abnormalities of the arms and legs, or microcephaly. Competing interests: The authors have declared that no competing interests exist. 128 (51.0%) and 123 (49.0%) of the cases were male and female, respectively. About 7.2% of the mothers of the cases and 2.9% of mothers of controls had no antenatal care visit. According to our findings, the use of surface water as a source of drinking had a significant association with the occurrence CAs. We have purposively included all except one in the study after reviewing the hospital record for CAs and capacity to assess the defects among the newborns. 162(64.5%) mothers of the cases and 449(50.8%) of controls were not used folic acid supplementation during the index pregnancy, respectively. Among the mothers of both cases and controls, 59.9% were housewives, 11.8% were farmers, 18.9% were governmental employees, 7.6 were merchants and 1.7% were unemployed.
ScienceDirect is a registered trademark of Elsevier B.V. ScienceDirect is a registered trademark of Elsevier B.V. Risk factors for congenital anomalies in high risk pregnant women: A large study from South India, Toxoplasmosis Rubella Cyto Megalo Virus Herpes Simplex Virus. However, the difference between mothers of the cases and controls were not statistically significant. The collected data were cleaned, coded and entered into Epi Data manager computer software and transferred to SPSS Version 25.0 for analysis. The present study was aimed to determine the prevalence, types and distribution of various CAs and also to find out the exact risk factors for different obstetric histories.
Maternal age, socioeconomic status, educational background, maternal health status (medical disorder such diabetes mellitus), maternal exposure to drugs, maternal exposure to infection, maternal exposure to pesticides, medications, alcohol, tobacco, khat and waste disposal areas and sources of drinking water, mode of deliveries, gestational age, sex and birth weight of the neonate were considered as associated risk factors for the CAs (malformation) and were the focus of the study. The socio-demographic characteristics of the study participants of cases and controls are shown in Table 2. Regarding the birth order of a case, 37.2%, 21.1%, 14.2%, and 27.0% were the first, the second, the third, the fourth, and above (4+) babies to their family, respectively. Multifactorial inheritances linked to the causation of CAs in humans include gene-gene and gene-environment interactions and have been demonstrated in mouse models of neural tube defects [11].
This might increase the efficiency of the study result in providing predictors or associated factors. On the contrary, 40.8% of the cases and 58.1% of the controls attained their full-term gestational age (Table 3). Mothers of the newborn who did get folic acid supplementation during their early pregnancy were strongly protected against having neonates with CAs, specifically neural tube defects. 57(22.7%) and 77(8.7%) of mothers of the cases and mothers of the controls had experiences of using unidentified medicine and drugs during the first three months of their pregnancy, respectively. Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia, Roles Yes No, Is the Subject Area "Birth" applicable to this article? The organs or parts of an embryo are most sensitive to environmental factors during periods of rapid differentiation leading to abnormal development or malformation of those organs [10,11]. The mean age for case and control mothers was 26 years old. High Risk Pregnancy (HRP) is a condition where mother or developing fetus or both are at increased risk of complications during or after pregnancy and birth.