Epidemiology of Congenital Anomalies in Iran

Authors

1 Professor, Department of Pediatric Surgery, Shahid Beheshti University of Medical Sciences, Pediatric Surgery Research Center, Child Health Research Institute, Mofid Children's Hospital

2 Professor of Epidemiology, Tabriz University of Medical Sciences

3 Professor, Department of Epidemiology, Cyprus International University

4 Professor, Department of Epidemiology, Zahedan University of Medical Sciences

5 Associate Professor, Department of Epidemiology, Shiraz University of Medical Sciences

6 Professor, Department of Epidemiology, Ahvaz Jundishapur University of Medical Sciences

7 Professor, Department of Epidemiology, Isfahan University of Medical Sciences

8 Professor, Department of Pediatric Surgery, Tabriz University of Medical Sciences, Mardani Azar Children's Hospital

9 Assistant Professor, Department of Pediatric Surgery, Shahid Beheshti University of Medical Sciences, Pediatric Surgery Research Center, Child Health Research Institute, Mofid Children's Hospital

10 Professor, Department of Pediatric Surgery, Shiraz University of Medical Sciences, Namazi Hospital

11 Associate Professor, Department of Pediatric Surgery, Ahvaz Jundishapur University of Medical Sciences, Abouzar Hospital, Ahvaz

12 Associate Professor, Department of Pediatric Surgery, Isfahan University of Medical Sciences, Imam Hussein Children's Hospital

13 General Surgeon, Shahid Beheshti University of Medical Sciences, Pediatric Surgery Research Center, Child Health Research Institute, Mofid Children's Hospital

14 Research Expert, Shahid Beheshti University of Medical Sciences, Pediatric Surgery Research Center, Child Health Research Institute, Mofid Children's Hospital

15 Assistant Professor, Department of Social Medicine, Iran University of Medical Sciences

16 Epidemiologist, Department of Family and Social Medicine, Tabriz University of Medical Sciences

Abstract
Introduction & Objective: Congenital abnormalities are of the main causes of death and disability in children, infants and neonates in most countries in the world where a remarkable part of these disorders can be prevented with timely measures. The aim of this study was to provide the epidemiological characteristics of congenital anomalies in Iran. Materials & Methods: This cross sectional investigation was conducted on neonates of the birth year of 2016 in six major geographical regions in Iran including Tehran (capital), East Azerbaijan (northwest), Isfahan (center), Khuzestan (southwest), Sistan and Baluchistan (southeast) and Fars (south) Iran. Congenital defects were classified according to the coding system of the International Classification of Diseases (ICD_10). The sources of ascertainment of congenital defects were records of the cases diagnosed with birth defects, and hospital discharge forms. Fully trained and supervised data officers including midwives, nurses and medical coders were assigned to collect and management of the data for this investigation. Results: The prevalence of congenital anomalies in Tehran was estimated at 163.2, East Azerbaijan 356.4, Isfahan 326.0, Khuzestan 94.3, Sistan and Baluchistan 264.1, and Fars 376.0 per 10,000 births. The prevalence of major defect groups of genital organs, limb anomalies and heart defects were ranked the first, second and third, respectively, in the country. Hydrocele, undescended testicle and club-foot were the most common anomalies diagnosed in the organs in the study regions. Conclusions: Congenital anomalies are considerably prevalent in Iran, and it is estimated more than 100.000 cases of birth defects occur annually in the country. It seems, therefore, necessary to develop and implement new methods of screening procedures before, during and after birth to avoid occurring congenital anomalies in the country.

Keywords


1. World Health Organization, (Feb. 2023). Congenital anomalies fact sheet [Online].  Available https://www. who. int/news-room/fact-sheets/detail/birth-defects.
2. International Clearinghouse for Birth Defects Surveillance Research (ICBDSR) (Feb. 2023). Birth Defects Prevalence [Online]. Available: http://www.icbdsr.org/resources/annual-report.
3. European network of registries for the
epidemiologic surveillance of congenital anomalies (EUROCAT) (Feb. 2023). Available:
https://eu-rd-platform.jrc.ec.europa.eu/euroc at/eurocat-data/prevalence_en.
4. Kouame BD, N’guetta-Brou IA, Kouame GSY, Sounkere M, Koffi, M, Yaokreh JB,
Odehouri-Koudou T, Tembely S, Dieth GA, Ouattara O. Epidemiology of congenital abnormalities in West Africa: results of a descriptive study in teaching hospitals in Abidjan: Cote d’Ivoire. African Journal of Paediatric Surgery. 2015; 12(1): 51-55.
5. Christianson A, Howson CP, Modell B. March of Dimes global report on birth defects: the hidden toll of dying and disabled children. March of Dimes Birth Defects Foundation; 2006. Available from: https://dev.marchofdimes.org/materials/
global-report-on-birth-defects-the-hidden-toll-of-d2unzZI5_VWOaLZnw6iHcx7hbpMWtWzTuIOU3DabcVY.pdf.
6. Vatankhah S, Jalilvand M, Sarkhosh S, Azarmi M, Mohseni M. Prevalence of Congenital Anomalies in Iran: A Review Article. Iran J Public Health. 2017; 46(6): 733-743.
7. Zahed Pasha Y, Vahedi A, Zamani M,
Alizadeh-Navaei R, Zahed Pasha E. Prevalence of Birth Defects in Iran: A Systematic Review and Meta-Analysis. Arch Iran Med. 2017; 20(6):
376-385.
8. Tarighat F, Golshan E, Dastgiri S. Prevalence of congenital anomalies in the northwest of Iran. Depiction of Health. 2021; 12(4): 417-425.
9. Stone DH, Dastgiri S, Heidarzadeh M, Abdollahi HM, Imani S, Maher MH. Uses, limitations, and validity of a registry of congenital anomalies in Iran: a critical review. Journal of environmental and public health. 2017; 6972617.
10.    Mekonnen D, MollaTaye, Worku W. Congenital anomalies among newborn babies in Felege-Hiwot comprehensive specialized referral hospital,
Bahir Dar, Ethiopia. Scientific Reports. 2021; 11(1): 11027.
11.    Obu HA, Chinawa JM, Uleanya ND, Adimora GN, Obi IE. Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria-a retrospective study. 2012; 10(5): 177.
12.    Kancherla V, Sundar M, Tandaki L, Lux A, Bakker MK, Bergman JE, Bermejo-Sánchez E, Canfield MA, Dastgiri S, Feldkamp ML, Gatt M, Groisman B, Hurtado-Villa P, Kallen K, Landau D, Lelong N, Lopez-Camelo J, Martinez LE, Mastroiacovo P, Morgan M, Mutchinick OM, Nance AE, Nembhard WN, Pierini A, Sipek A, Stallings EB, Szabova E, Tagliabue G, Wertelecki W, Zarante I, Rissmann A. Prevalence and mortality among children with anorectal malformation: A multi-country analysis. Birth defects research. 2023; 115(3): 390-404.
13.    Gili JA, López-Camelo JS, Nembhard WN, Bakker M, de Walle HE, Stallings EB, Kancherla V, Group EP, Contiero P, Dastgiri S, Feldkamp ML, Nance A, Gatt M, Martínez L, Canessa MA, Groisman B, Hurtado-Villa P, Källén K, Landau D, Lelong N, Morgan M, Arteaga-Vázquez J, Pierini A, Rissmann A, Sipek A, Szabova E, Wertelecki W, Zarante I, Canfield MA, Mastroiacovo P. Analysis of early neonatal case fatality rate among newborns with congenital hydrocephalus, a 2000–2014 multi-country registry-based study. Birth defects research. 2022; 114(12): 631-644.
14.    Bell JC, Baynam G, Bergman JE, Bermejo-Sánchez E, Botto LD, Canfield MA, Dastgiri S, Gatt M, Groisman B, Hurtado-Villa P, Kallen K, Khoshnood B, Konrad V, Landau D, Lopez-Camelo JS, Martinez L, Morgan M, Mutchinick OM, Nance AE, Nembhard W, Pierini A, Rissmann A, Shan X, Sipek A, Szabova E, Tagliabue G, Yevtushok LS, Zarante I, Nassar N. Survival of infants born with esophageal atresia among 24 international birth defects surveillance programs. Birth defects research. 2021; 113(12): 945-957.
15.    Politis MD, Bermejo-Sánchez E, Canfield MA, Contiero P, Cragan JD, Dastgiri S, de Walle HE, Feldkamp ML, Nance A, Groisman B, Gatt M, Benavides-Lara A, Hurtado-Villa P, Kallén K, Landau D, Lelong N, Lopez-Camelo J, Martinez L, Morgan M, Mutchinick OM, Pierini A, Rissmann A, Šípek A, Szabova E, Wertelecki W, Zarante I, Bakker MK, Kancherla V, Mastroiacovo P, Nembhard WN. Prevalence and mortality in children with congenital diaphragmatic hernia: a multicountry study. Annals of epidemiology. 2021; 56: 61-69. e63.
16.    Nembhard WN, Bergman JE, Politis MD,
Arteaga-Vázquez J, Bermejo-Sánchez E, Canfield MA, Cragan JD, Dastgiri S, de Walle HE, Feldkamp ML, Nance A, Gatt M, Groisman B, Hurtado-Villa P, Kallén K, Landau D, Lelong N, Lopez-Camelo J, Martinez L, Morgan M, Pierini A, Rissmann A, Šípek A, Szabova E, Tagliabue G, Wertelecki W, Zarante I, Bakker MK, Kancherla V, Mastroiacovo P. A
multi-country study of prevalence and early childhood mortality among children with omphalocele. Birth defects research. 2020; 112(20): 1787-1801.
17.    Bakker MK, Kancherla V, Canfield MA,
Bermejo-Sanchez E, Cragan JD, Dastgiri S, De Walle HE, Feldkamp ML, Groisman B, Gatt M,
Hurtado-Villa P, Kallen K, Landau D, Lelong N, Lopez Camelo JS, Martínez L, Morgan M, Mutchinick OM, Nembhard WN, Pierini A, Rissmann A, Sipek A, Szabova E, Tagliabue G, Wertelecki W, Zarante I, Mastroiacovo P. Analysis of mortality among neonates and children with spina bifida: an international registry-based study, 2001-2012. Paediatric and perinatal epidemiology. 2019; 33(6): 436-448.
18.    Goel N, Morris JK, Tucker D, de Walle HE, Bakker MK, Kancherla V, Marengo L, Canfield MA, Kallen K, Lelong N, Camelo JL, Stallings EB, Jones AM, Nance A, Huynh MP, Martínez-Fernández ML, Sipek A, Pierini A, Nembhard WN, Goetz D, Rissmann A, Groisman B, Luna-Muñoz L, Szabova E, Lapchenko S, Zarante I, Hurtado-Villa P, Martinez LE, Tagliabue G, Landau D, Gatt M, Dastgiri S, Morgan M. Trisomy 13 and 18-Prevalence and mortality-A multi-registry population based analysis. American journal of medical genetics Part A. 2019; 179(12): 2382-2392.
19.    Yu X, Nassar N, Mastroiacovo P, Canfield M, Groisman B, Bermejo-Sánchez E, Ritvanen A,
Kiuru-Kuhlefelt S, Benavides A, Sipek A, Pierini A, Bianchi F, Källén K, Gatt M, Morgan M, Tucker D, Canessa MA, Gajardo R, Mutchinick OM, Szabova E, Csáky-Szunyogh M, Tagliabue G, Cragan JD, Nembhard WN, Rissmann A, Goetz D, Bower C, Baynam G, Lowry RB, Leon JA, Luo W, Rouleau J, Zarante I, Fernandez N, Amar E, Dastgiri S, Contiero P, Martínez-de-Villarreal LE, Borman B, Bergman JEH, de Walle HEK, Hobbs CA, Nance AE, Agopian AJ. Hypospadias prevalence and trends in international birth defect surveillance systems,
1980-2010. European urology. 2019; 76(4): 482-490.
20.    Mc Goldrick N, Revie G, Groisman B,
Hurtado-Villa P, Sipek A, Khoshnood B, Rissmann A, Dastgiri S, Landau D, Tagliabue G, Pierini A, Gatt M, Mutchinick OM, Martínez L, de Walle HEK, Szabova E, Lopez Camelo J; ECEMC Peripheral Group; Källén K, Morgan M, Wertelecki W, Nance A, Stallings EB, Nembhard WN, Mossey P. A
multi-program analysis of cleft lip with cleft palate prevalence and mortality using data from 22 International Clearinghouse for Birth Defects Surveillance and Research programs, 1974-2014. Birth defects research. 2023; 115(10): 980-997.
21.    Al-Dewik N, Samara M, Younes S, Al-Jurf R, Nasrallah G, Al-Obaidly S, Salama H, Olukade T, Hammuda S, Marlow N. Prevalence, predictors, and outcomes of major congenital anomalies: A population-based register study. Scientific Reports. 2023; 13(1): 2198.
22.    Asemi-Rad A, Heidari Z, Mahmoudzadeh-Sagheb H, Mehdipour Y, Moudi B, Sheibak N, Ebrahimi S. Prevalence of congenital anomalies and related factors in live births in Zahedan, Southeast of Iran: A cross-sectional study. International Journal of Reproductive BioMedicine. 2023; 21(21): 647-656.