Birth Defect Surveillance in the Main Government Referral Hospital of Maldives from 2016 to 2024

Abstract

We studied birth defects in the main tertiary government hospital, Indira Gandhi Memorial Hospital (IGMH) of Maldives from 2016 to 2024. All inborn live births in the 9-year period were included. Still births and miscarriages were excluded. ICD 10 was used for coding. There were 17188 live births, and 729 babies (4.24%) had birth defects described under Q code of ICD-10. A total of 1215 defects were noted. The number of females was 313 (43%) and there were 16 from twin deliveries. 312 defects (26% of all defects) were in preterm babies. Out of 710 mothers who delivered babies with birth defects, 107 (15%) had gestational diabetes. Median birth weight was 2,862 gm (range from 630gm to 5,000gm), and median gestational age was 37.5 weeks (range from 25 to 41 weeks) for neonates with birth defects. Looking at neonatal outcomes, 24 had hypoglycaemia (3.3%), 21 had hypothermia (2.9%), 27 babies died before discharge (3.7%). The most common cause for neonatal deaths with birth defects was lung hypoplasia (total 6 patients, 22% of deaths). Two deaths were due to diaphragmatic hernia and another 2 had Potter’s syndrome. 82 (11.2%) babies required bag and mask ventilation. The overall incidence of total birth defects in our study was 42.4 per 1000 live births. This includes significant and non-significant birth defects under the ICD code Q. The most common were congenital malformations of the circulatory system, which consists of 28.7% of defects with an incidence of 20 per 1000 live births. Birth defects were common in our study. Respiratory system defects were the cause for highest mortality.