رسائل دكتوراة
English
2025
The Epidemiology of Major Congenital Anomalies in the United Arab Emirates: The Mutaba'ah Study
Hiba Mahdi Hassan Adam, Prof Luai A Ahmed
كلية الطب والعلوم الصحية-جامعة الإمارات العربية المتحدة · الامارات
Major Congenital Anomalies (MCAs) are significant contributors to perinatal morbidity and mortality. The absence of clear baseline prevalence data for MCAs hinders the development of targeted interventions to mitigate their burden. Furthermore, studies on adverse obstetric and birth outcomes in pregnancies complicated by MCAs are scarce, emphasizing the need for research to enhance management strategies. This dissertation aimed to: (1) estimate the live birth prevalence of perinatally diagnosed MCAs and describe study population characteristics by MCA status, (2) investigate the impact of MCAs on fetal presentation and delivery mode, and (3) investigate the impact of MCAs on preterm and low birth weight births. The analysis was based on a cohort of singleton live births from the Mutaba'ah Study. Minor anomalies were excluded based on the EUROCAT and the CDC guidelines. The live birth prevalence of MCAs was estimated as the number of affected births per 1000 live births. Univariable and multivariable regression models were employed to assess the impact of MCAs on obstetric and birth outcomes, with stratification and adjustment for various maternal and neonatal characteristics. Among 4,034 singleton live births, 284 neonates were diagnosed with at least one MCA, corresponding to a live birth prevalence of 70.4/1000 live births (95% Confidence Interval (CI): 62.7–78.7). Of the 284 neonates, 86% presented with single-system anomalies, while 14% had multi-system involvement. Mothers of neonates with MCAs had a significantly higher BMI compared to those without, and male neonates exhibited a significantly higher proportion of MCAs compared to female neonates. For any and single MCAs, significant associations with breech presentation were detected in women below 35 years (Adjusted Odds Ratio (AOR) = 2.7, 95% CI: 1.5-5.0; AOR = 2.5, 95% CI: 1.3-4.8) and among term deliveries (AOR = 2.5, 95% CI: 1.4-4.3; AOR = 2.4, 95% CI: 1.3-4.3). These associations remained significant in young (