Epidemiology of congenital anomalies: Malta, 1993 to 1995, with comparison to other European centres

Abstract

Congenital anomalies are a major cause of mortality and morbidity. The aims of this study were to identify and describe congenital anomalies in Malta during 1993-1995 and compare the results to those obtained by other European Centres. Multiple sources of information were employed to ensure complete coverage. 485 infants were identified. The prevalence of infants/fetuses with congenital anomalies was found to be 33 per 1000 total births. The largest group of anomalies was cardiovascular anomalies (17.8/1000 births), followed by limb defects (8.811000 births) and disorders of the nervous system (3.211000 births). A relationship between high maternal and paternal ages was found for chromosomal anomalies and a lower maternal age was associated with non-chromosomal anomalies. Congenital anomalies were also associated with increased fetal mortality, lower birth weight and multiple pregnancies. No significant differences in prevalence of congenital anomalies were noted by region or paternal occupational category. The prevalence rates of specific anomalies for livebirths, fetal deaths and induced abortions were similar to those in other European Centres, apart from cleft palate which had a higher prevalence than the mean. When livebirth prevalence was compared, Malta showed significantly higher prevalence of certain anomalies. This is explained by the absence of prenatal diagnosis and termination of pregnancy in Malta. Knowledge of the epidemiology of congenital anomalies is important m quantifying the impact such conditions have on a country and in guiding government policy decisions in order to cater for these individuals. Accurate description of the epidemiology of congenital anomalies is only possible in the presence of an ongoing surveillance system and it is suggested that such a system be encouraged and utilised in Malta.