Características maternas e perinatais associadas a anomalias congênitas: um estudo caso-controle

Abstract

Congenital Anomalies (CA) are the second leading cause of infant mortality in Brazil, significantly impacting public health, particularly in low- and middle-income countries. The main risk factors associated with CA include a family history of congenital malformations, maternal alcohol consumption, gestational diabetes, and previous miscarriages.This study aimed to identify the patterns and factors associated with CA in newborns at a tertiary hospital maternity ward. A case-control study was conducted at the Hospital Regional do Sudoeste Walter Alberto Pecóits in Francisco Beltrão, Paraná, between December 1, 2023, and September 30, 2024. Among 1,400 live births, 40 cases of CA were identified 2.9% (CI:95%: 2.1–3.8). After excluding women who gave birth before 24 weeks of gestation (n=3), 37 cases remained. The control group included 120 women with infants without CA. Data were collected through in-person interviews and medical record analysis. Women who delivered before 24 weeks of gestation were excluded (n=3 cases). Isolated anomalies accounted for 78.1% of cases, with cardiovascular malformations being the most prevalent (16.9%). Recognized syndromes comprised 13.6% of cases, while multiple malformations represented 10.2%. Bivariate analysis revealed significant associations between CA and a family history of CA (p = 0.02), low Apgar scores at the 1st and 5th minutes (p < 0.01), and fetal condition at birth (p < 0.01). Model 1, which incorporated family history of CA, Apgar score at 5 minutes, and fetal condition, demonstrated the best predictive fit, aligning with previous findings. Bayesian logistic regression identified this model as the most robust, with the lowest AIC (295.98) and BIC (326.22) values and an accuracy of 89%. The findings underscore the critical role of family history and neonatal vitality in the context of CA, highlighting the need for further studies to confirm these associations and develop more effective strategies for prevention and neonatal monitoring.