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.
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.
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 %.
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
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