Introduction
In Oman, LBW was 10.2% out of a total live birth of over 66,000 live birth during 2013. The worldwide prevalence of low birth weight (LBW) is 15.5%, which amounts to about 20 million LBW infants born each year, 96.5% of them in the developing countries (1). For example, in Oman, the prevalence of LBW was 4.2% in 1980, which doubled (8.1%) in 2000 and has shown a slow but steady increase reaching 10.2% in 2013. This also causes an increase in the rate of LBW infants, and subsequently an increased rate of long-term medical sequalae.
LBW has been increasing globally and regionally with various advancement in medical care; including that of obstetric and neonatal care and technological development with restricted growth, and pregnancy complications are taking place as live births.
Recently, over the last few decades, devotion has been steered toward the contribution of the intrauterine environment to the development of chronic and noncommunicable diseases (NCD). Epidemiological studies have demonstrated that a poor intrauterine environment is associated with an increased risk of various non-communicable diseases such as chronic kidney disease, and diabetes (1-5). Many of these diseases may be associated with birth anomalies. Birth defects are an important cause of infant mortality and disproportionately occur among LBW infants.
Congenital anomalies, also commonly referred to as birth defects, are conditions of prenatal origin that are present at birth. Congenital anomalies have a lifelong impact on children’s health and survival (6). It is estimated that 1 in 33 newborns have birth defects and it leads to 300 000 yearly deaths of neonates (1) and linked to 3.2 million birth related disabilities (7). Congenital anomalies encompass a wide array of structural and functional abnormalities that can occur in isolation (i.e., single defect) or as a group of defects (i.e., multiple defects). Multiple defects may occur as part of well-described associations, such as the non-random co-occurrence of vertebral anomalies, anal atresia, cardiac defects, trachea-esophageal fistula, and/or esophageal atresia, renal and radial anomalies, and limb defects (VACTERL) (8, 9). Such disabilities can impose social stigma and economic burden on poor families, society and health care organizations (6). Cardiac system, neural tube defects and Down syndrome are most common type of anomalies seen (6).
In 2013 the Global Burden of Disease reported that congenital anomalies are one of the top ten causes of mortality in children under five years old (10). Globally, the trend of childhood mortality due to infection and malnutrition is decreasing. This is likely due to the wide availability of vaccination, infection control and improvement in nutrition supply (11). Besides, the availability of standard pediatric and maternal health services, the contribution of congenital anomalies upon mortality and morbidity of neonates is on the rise (12). Early diagnosis of congenital anomalies in antenatal period is important for effective counseling, fetal or neonatal timely intervention and termination of pregnancy if needed, planning delivery and future prevention (13, 14). The world health Assembly has highlighted the importance of taking actions in prevention diagnosis and timely intervention (15, 16).
To deal with the problem efficiently, accurate data is crucial to establish the appropriate methods of surveillance of congenital anomalies (17-20). Accurate estimate on the prevalence and mortality linked to birth defects are limited in low- and middle-income countries in contrast with high-income countries. For instance, in UK, the prevalence of congenital anomalies estimated to be 2-3 % and the 20-year survival rate is about 85.55% (21). In United State it is estimated to be 2-3% (17), 1.07% in Japan (22), in India 2.5 % (17) and in KSA 52.17 per 1000 pregnancies (7, 23). However, government actions and efforts on improving risk factors and primary prevention is more effective when based on accurate data and information gathered about the causes, patterns and outcomes of congenital anomalies (7, 23). In this study, we gathered data from the only tertiary hospital for obstetric cases that seen in the Obstetric Ultrasound and Fetal Medicine units, of fetuses with major congenital anomalies, for a duration of 10 years. Main aim was to identify the prevalence, patterns, maternal characteristics and perinatal outcomes.