Prevalence and Spectrum of Congenital Anomalies in Multiple Births with Analysis of Demographic and Obstetric Risk Factors

Abstract

Introduction: Recently, there is an increase in incidence of Congenital Anomalies (CA) more so in case of multiple births. But literature regarding the prevalence of congenital anomalies in combination with multiple births, the association of maternal and demographic risk factors and exact typing and proportion of congenital anomalies are few. Aim: The present study was done to compare the prevalence of CA in singleton and multiple births, document major anomaly subtypes, analyse demographic and maternal risk factors. Materials and Methods: Study was conducted in a referral care centre from September 2015 to August 2016. Total number of the live births, still births, and abortions> 20 weeks were collected. Consecutive cases of multiple births with CA and similar number of multiple births without CA during this period (taken as control) were included in the study. Type of anomalies were classified according to World Health Organisation (WHO). Different maternal risk factors and demographic factors were collected and analysed. Results: There were total 278 multiple births out of 10817 total births and 15 congenitally anomalous babies among multiple births. The prevalence of CAs in multiple births was 4 to 5 times higher than that of singleton births and was statistically significant. Commonest malformation among multiple births was twin-associated anomalies and was found to be more among same sex twins, especially female pairs. Association of occurrence of birth defects was observed with increased paternal age, lower socioeconomic status, rural habitat, history of addiction, fever in first trimester. Conclusion: The incidence of anomalies is more in multiple births and especially in monozygotic twins. Early screening of birth defects by biochemical and level two anomaly scan should be emphasised, which can help the normal infant in cases of the co-occurrence of multiple births and birth defects.

Keywords

• dizygotic
• fetal dysmorphology
• fetus papiraceous
• monozygotic
• singletons
• twins