Profile of the congenital malformations in a Neonatal Intensive Care Unit (NICU) at a tertiary care reference University Hospital in Brazil

Abstract

OBJECTIVE: To describe the incidence and type of congenital malformation (CM), hospital mortality and amount of time in hospital of newborn babies (NB) with CM admitted to a neonatal intensive care unit (NICU) in a tertiary care reference university hospital in Brazil. METHODS: Observational retrospective and prospective study of a cohort of NB with CM. We studied all NB with CM in the period of one year (2007-2008) borned in the Berçário Anexo à Maternidade do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. The data was collected from clinical records and NB avaliation. Results were described by relative and absolute frequency of the classes of each qualitative variable and measures of central tendency and dispersion (quantitative variables). Chi-square and the Fisher’s exact tests were used to compare the variables. RESULTS: There were 1628 NB in the period, 93 (5.71%) of which had CM. The most prevalent CM were neurological 31 (33%), genitourinary 30 (32%) and craniofacial 29 (31%). Among NB with CM, 46 (49.5%) were term and 47 (50.5%) were preterm. Low birth weight was observed in 41 (44.09%) of NB. Major and minor malformations were diagnosed in 86 (92%) and 7 (8%) of NB, respectively. The average time of hospitalization was 43.8 days and 21 (22.6%) of NB with CM died. There was a significant association between mortality and CM (p<0.0001), specially cardiac malformations (p=0.014) CONCLUSION: The prevalence of CM was higher than found in literature, major malformation being more prevalent. The majority of CM was neurological, as found by others authors. Compared to literature, the NB with CM studied had higher mortality and longer period of hospitalization, what can be explained by the gravity of the cases. There was significant association between CM and mortality, mainly due to cardiac malformations.