Analysis of Observable Congenital Malformations Surveillance System data at the José Domingo de Obaldía Maternal and Child Hospital, Panama, 2013 - 2020

Abstract

Background

Birth defects have a worldwide prevalence of 3%. They are the second leading cause of mortality among children under five. Panama does not have up-to-date data at the national level on observable congenital malformations (OCM). We aimed to characterize OCM registered in a hospital surveillance system at the José Domingo de Obaldía Maternal and Child Hospital to contribute to the national surveillance system and the prevention of OCM.

Population and Methods

Descriptive study. OCM definition: all hospital births and stillbirths, gestational age ≥22 weeks, weight ≥500 g with one or more OCM, up to seven days postpartum. The variables were sex, gestational age, birth weight, condition, maternal age, schooling, origin, occupation, history of maternal diseases and infections, intake of folic acid and vitamins. We calculate summary measures, proportions, rates, and ratios.

Results

In 2013-2020, 67,693 births were recorded, and 467 (0.7%) had a total of 606 OCM. The mortality rate was 1.0 per 1,000 births. Nearly one third (126 or 27.0%) of women who had OCM did not take vitamins during pregnancy. Of the 606 OCM, the most frequent were musculoskeletal with 290 (47.9%), followed by the central nervous system, with 116 (19.1%) and of these, the most frequent were microcephaly (38/116 or 32.8%), followed by spina bifida (27/116 or 23.3%).

Conclusions

Births with OCM were approximately 1%, lower than expected. We recommend improving surveillance and evaluating the delivery and intake of vitamin supplements in women of childbearing age to reduce preventable OCM.