EPIDEMIOLOGY OF CONGENITAL ANOMALIES IN LIVEBORNS IN FIJI; OVER FIVE YEARS: 2014-2018 Research

Introduction: Congenital Anomalies are a major cause of neonatal morbidity and mortality, more so in developing, or low and middle-income countries. Outside of Australia, and New Zealand, there is no available published data concerning Congenital Anomalies in the South Pacific. The aim of this study is to provide a descriptive overview of congenital anomalies in liveborn born at CWM Hospital, Suva, Fiji, over 5 years (2014-2018).
Method(s): This was a descriptive and retrospective study of all records of newborns born with congenital anomalies at CWM Hospital, between 2014-2018 and registered at CWM Hospital. All Live Born Babies who were identified to have a Congenital Anomaly,and registered in the Congenital Anomaly Register were included in this study. Stillbirths and Products of Termination of Pregnancies (T.O.P) due to Fetal Anomalies were excluded.
Results: This study showed a Cumulative Incidence (Number of new cases) of 6 cases of Congenital Anomalies per 1000 Livebirths or 0.6% of total live births. By world standards, this is similar and comparable to the more developed and high-income countries, where the prevalence of Congenital Anomalies is as low as 1% of Total Live Births. However, this finding is more likely due to under-reporting, lack of documentation, and exclusion of Stillbirths and Termination of Pregnancies due to Fetal Anomalies. The Neonatal Mortality rate in this study was 0.2% of total Livebirths, comprising 1/5 of Fiji’s current Neonatal Mortality Rate. This study identified significant associations between Increasing Maternal Age and Syndromic Cases (24 % of Mothers >35 years); Organ System and Surgery ( Gastrointestinal, Urogenital, Respiratory and Central Nervous System Defects more likely to require surgery); and Surgical Rate and Antenatal Detection (56% of cases detected antenatally had surgery)
Conclusion: This study has outlined that Fiji is comparable to the rest of the world in terms of Neonatal Mortality, with Congenital Anomalies contributing to 1/5 of Fiji’s current Neonatal Mortality Rate. Our Low Cumulative Incidence Rate is most likely an Under-Estimation because of under-reporting, poor documentation and due to our study limitations. Further studies including other Major Divisional Hospitals, inclusive of Stillbirths and Products of Termination of Pregnancies are recommended.