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Types ,Frequency,Clinical Presentation of Congenital Central Nervous System Anomalies in Al- Kadmayhia Teaching Hospital

Author: Lamyaa Abdul Kareem Hamoodi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 524-531
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The central nervous system (CNS)anomalies are the most severe, difficult to detect its etiology, and predict its clinical presentation and course. OBJECTIVE:To find out the common types of congenital malformations in central nervous system.,determine the frequency and the clinical features of these malformations.And to study the risk factors associated with congenital central nervous system malformations.PATIENTS AND METHODS:This cross-sectional study was performed at Al-Kadhimiyia Teaching Hospital (Neonatal care unit) from the 1st of January to the 1st of July, 2011.One hundred newborn infants were proved to have congenital abnormalities by physical examination alone. Fifty five neonates were diagnosed as having CNS congenital anomalies.neonatal evaluation include: gestational age, sex, body weight, type of CNS congenital anomaly.Maternal age, parity, antenatal care, any history of abortion, previous baby with CNS congenital abnormality, still births, or drug intake during pregnancy.the residency of the family and consanguinity .RESULTS:The number of neonates delivered alive was 2700 neonates, one hundred of them (3.7% of total deliveries) were delivered with congenital anomalies, and 55 cases from those (2% from total deliveries / 55% from congenitally abnormal deliveries) have had CNS congenital anomalies,the most frequent anomalies aremeningocele 25( 45.5%),the second and third in frequency were hydrocephaly 12 (21.8%), and myelomeningocele 10 (18.2%) respectively.There were 34(61.8%) male and 21 (38.2%) female. There were 30(54.5%) full term and 25(45.5%) preterm.Thirty cases out of the total 55 cases (54.5%) with body weight 3-3.5 kg.Most of the affected neonates to mothers with an age range of 20-40 years where 34 mothers (61.8%) aged between 20-30 years .Most of the mothers were multipara (45 cases / 81.8%) .The majority of the neonates were the product of a consanguineous marriage 39 (70.9%).Maternal peri-conceptional folic acid supplementation was not taken in the vast majority of cases (43 cases / 78.2%).Positive family history of CNS congenital anomalies was reported in 4 cases only (7.3%) .Familial residence was documented as urban in 30 cases (54.5%), and rural in 25 cases (45.5%).CONCLUSION:The most common type of CNS anomalies is meningocele with relatively higher male to female ratio.These anomalies occur in full term multipara mothers. Occur more frequent in infants with larger body weight and to younger multipara mothers. Consanguinity is a major risk. There was a low utilization of maternal peri-conceptional folic acid supplementation

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