Abstract:

 BACKGROUND

Although, birth defects are one of the leading causes of infant deaths and long term disabilities and have contributed significantly to the global burden of diseases, extensive researches have not been carried out in Guyana.

METHODS

A retrospective study, of 138 patients, diagnosed with Congenital Malformations at Georgetown Public Hospital Cooperation, between January 2007- December 2007was carried out. These patients’ medical records; inclusive of infant, neonatal intensive care and postnatal; were located and information was recorded in the form of a questionnaire which had structured and detailed parameters. Exclusion criteria were records for all stillborns, pregnanciesterminated at or after 20 weeks of gestation, out- patients and or patients in specialized clinics / institutions. Analysis on various variables (demographic distribution, clinical outcomes, clinical presentation, Apgar score, birth weight, maternal age, sex, ethnicity, previous infant with a birth defect, family history of a birth defect, known teratogenic exposure, maternal medical history, lack of folic acid supplementation and average length of hospital stay) was done using Microsoft Office Excel version 2003 for information on the epidemiology, management and clinical outcomes of the condition in the Guyanese population.

RESULTS

I found an estimate incidence 2240 cases of birth defects occurring annually in Guyana. The majority of cases were from Regions 4 (46.8%) and 3 (10.9%). The majority (73.9 %) of cases was seen in the age group birth-5 months, followed by (9.4%) > 50 months (>12 years old), 6-10 month (5 %) and 21-25 month (4.4 %). There was a male to female ratio of 1.3: 1 of having a birth defect. Afro-Guyanese accounted for almost one half (48%) of the cases followed by Indo-Guyanese, Mixed and Amerindians. The most common types of birth defects were congenital heart disease, Hirshsprung disease, hypospadia, cryptorchidism, accessory breast, club feet and syndactyl. The average length of stay was 6.5 days. One mother used alcohol and another used an abortificient during the current pregnancy. 82% of patients underwent surgery while 18% had medical interventions. Few patients had laboratory testing done. Patients generally had excellent clinical outcomes given a mortality rate of 0 %.

CONCLUSION

My findings highlight the clinical and public health importance that should be placed on Congenital Malformations in Guyana and to re-evaluate our approach to the condition and to introduce nation-wide screening practices.

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