Profile of Prenatally Diagnosed Major Congenital Malformations in a Teaching Hospital in Nigeria


Background: Prenatal diagnosis of major congenital abnormality is one of the main goals of antenatal care, because of its contribution to perinatal morbidity and mortality. Awareness of the profile in terms of rates and spectrum could aid management and prevention strategies. This study aims to determine the profile of congenital malformations, and the relationship between the rates and some maternal socio-demographic and obstetric variables.

Methods: A retrospective cross-sectional study of prenatally diagnosed congenital malformations in singleton pregnancies over a four-year period. The ultrasound scan findings and the findings of fetal ultrasonography, together with maternal socio-demographic and obstetric variables, were collected from the ultrasound scan reports or medical records of each pregnancy. Data were analyzed using Microsoft Excel 2010.

Results: Among the 968 singleton pregnancies, 78 had major congenital malformation, giving an antenatal rate of 8.04/1000 (0.8%). The first trimester prevalence was comparable with other trimesters. Malformation mostly involved single systems (93.6%), which are mainly central nervous (48.7%) and gastrointestinal/abdominal systems (21.8%). The rate was statistically significant (< 0.0018) in women aged > 35 years. The mean maternal age and parity were 31.4 + 4.7 and 2.8 + 0.4, respectively. The rates of congenital malformation in spontaneously or assisted conceptions were not statistically significant (p = 0.073 and p = 0.085).

Conclusion: Maternal age > 35 years and multiparity are important risk factors for congenital malformation. The commonly involved systems are the central nervous and gastrointestinal systems.

 Keywords: congenital malformations, prevalence, spectrum, antenatal ultrasound scan, Nigeria 

[1] World Health Organization. (2015). Congenital anomalies, fact sheet no. 370. Available at

[2] Ekwunife, O. H., Okoli, C. C., Ugwu, J. O., et al. (2017). Congenital anomalies: prospective study of pattern and associated risk factors in infants presenting to a tertiary hospital in Anambra State, South East Nigeria. Nigeria Journal of Pediatrics, vol. 44, no. 20, pp.76–80.

[3] Irvine, B., Luo, W., and León, J. A. (2015). Congenital anomalies in Canada 2013: a perinatal health surveillance report by the Public Health Agency of Canada’s Canadian Perinatal Surveillance System. Health Promotion and Chronic Disease Prevention in Canada, vol. 35, no. 1, pp. 21–22.

[4] Bahauddin, I. S., Manal, S. A., Reham, A. A., et al. (2008). Antenatal diagnosis, prevalence and outcome of major congenital anomalies in Saudi Arabia: a hospital-based study. Annals of Saudi Medical, vol. 28, no. 4, pp. 272–276.

[5] Lamina, M. A., Oloyede, O. A. O., Adefuye, P. O. (2004). Should ultrasonography be done routinely for all pregnant women? Tropical Journal of Obstetrics and Gynaecology, vol. 21, no. 1, pp. 11–14.

[6] Al-Dalla Ali, F. J., Mahmood, N. S., Al-Obaidi, B. K. (2013). Incidence of birth defects at birth among babies delivered at Maternity and Children Teaching Hospital in Ramadi. Al-Anbar Medical Journal, vol. 11, no. 1, pp. 1–10.

[7] Singh, K., Krishnamurthy, K., Greaves, C., et al. (2014). Major congenital malformations in Barbados: the prevalence, the pattern, and the resulting morbidity and mortality, ISRN Obstetrics and Gynecology. DOI: 10.1155/2014/65178

[8] Dolk, H., Loane, M., and Garne, E. (2010). The prevalence of congenital anomalies in Europe. Advances in Experimental Medicine & Biology, vol. 686, pp. 349–364.

[9] Akinmoladun, J. A., Ogbole, G. I., and Oluwasola, T. A. O. (2018). Pattern and outcome of prenatally diagnosed major congenital anomalies at a Nigerian Tertiary Hospital. Nigerian Journal of Clinical Practice, vol. 21, no. 5, pp. 560–565.

[10] Abbey, M., Oloyede, O. A., Bassey G., et al. (2017). Prevalence and pattern of birth defects in a tertiary health facility in the Niger Delta area of Nigeria. International Journal of Women’s Health, vol. 9, pp. 115–121.

[11] Kiran, P. S. (2005). Profile of major congenital malformations at Nizwa Hospital, Oman: 10-Year review. Journal of Paediatrics and Child Health, vol. 41, no. 7, pp. 323–330.

[12] AbouEl-Ella, S. S., Tawfik, M. A., AboEl-Fotoh, W. M., et al.(2018). Study of congenital malformations in infants and children in Menoufia governorate, Egypt. Egyptian Journal of Medical Human Genetics, vol. 19, no. 4, pp. 359–365.

[13] Benavides-Lara, A., Faerron Angel, J. E., UmanaSolis, L., et al. (2011). Epidemiology and registry of congenital heart disease in Costa Rica. Revista Panamericana de Salud Pública, vol. 30, pp. 31–38.

[14] Goetzinger, K. R., Shanks, A. L., Odibo, A. O., et al. (2017) Advanced maternal age and the risk of major congenital anomalies. American Journal of Perinatology, vol. 34, no. 3, pp. 217–222.