Journal of Medical Society

SHORT COMMUNICATION
Year
: 2017  |  Volume : 31  |  Issue : 3  |  Page : 217--218

Strengthening primary prevention interventions to tackle the problem of congenital anomalies


SR Shrivastava, PS Shrivastava, J Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Correspondence Address:
S R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur-Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India

Abstract

Worldwide, childbirth has been acknowledged as a significant and a delightful event for the families and the society. However, the birth of a congenitally malformed child poses a major challenge for the parents, their families, society, and the health system. The current global estimates suggest that almost 0.27 million newborns die within the neonatal period due to congenital anomalies each year. If not all, some of the anomalies can be prevented through appropriate primary prevention interventions. Moreover, the early detection of the condition through screening will offer multiple benefits and can be done before the conception, during conception, and through neonatal screening. To conclude, congenital anomalies tend to cast a significant burden on the families, communities, and the health sector. The need of the hour is to strengthen the primary prevention interventions and expand the reach of care and supportive services to ensure the welfare of the affected people.



How to cite this article:
Shrivastava S R, Shrivastava P S, Ramasamy J. Strengthening primary prevention interventions to tackle the problem of congenital anomalies.J Med Soc 2017;31:217-218


How to cite this URL:
Shrivastava S R, Shrivastava P S, Ramasamy J. Strengthening primary prevention interventions to tackle the problem of congenital anomalies. J Med Soc [serial online] 2017 [cited 2022 Jan 25 ];31:217-218
Available from: https://www.jmedsoc.org/text.asp?2017/31/3/217/207673


Full Text



 Introduction



Worldwide, childbirth has been acknowledged as a significant and a delightful event for the families and the society.[1] However, the birth of a congenitally malformed (structural or functional defects occurring during intrauterine life and detected during gestational period, at birth or afterwards in life) child pose a major challenge for the parents, their families, society, and the health system.[1],[2] The current global estimates suggest that almost 0.27 million newborns die within the neonatal period due to congenital anomalies each year.[2]

Implications of the birth of a congenitally malformed child

Not only the parents consider it as a reproductive failure and feel being isolated from their community, but also subsequently even the child has to deal with a dubious life in the future.[1],[2] In fact, most of the children with severe anomalies are left abandoned, neglected, or even killed by the parents themselves, especially in developing nations.[1],[3] Moreover, it might result in adverse consequences on the health or development, hospital admissions or prolonged stay in intensive care units, long-term disabilities, and impairment in the quality of life.[3]

Potential risk factors

More often than not, the causes for these anomalies are multifactorial, and includes socioeconomic and demographic factors (like poor financial status resulting in limited access to nutritious food or facilitating exposure to environmental risk factors, maternal age); genetic factors such as consanguinity or ethnicity; maternal infections with rubella or syphilis; poor nutritional status of mother such as deficient iodine or folate, excessive vitamin A, obesity, diabetes; exposure to specific pesticides-teratogenic drugs-alcohol-tobacco-radiation during pregnancy.[1],[2],[3],[4],[5]

Prevention and control

If not all, some of the anomalies can be prevented through appropriate primary prevention interventions such as avoiding consanguineous marriages, improving the dietary intake of females in their entire reproductive age group, including adequate consumptions of vitamins and folic acid; restricting exposure of pregnant women to the predisposing causative factors; ensuring adequate control of preconceptional and gestational diabetes; upscaling vaccination coverage against rubella among children and women; and organizing sensitization sessions for the health staffs to ensure prevention of congenital anomalies.[2],[3],[5] In addition, measures like establishing and strengthening registration and surveillance systems, developing expertise and building capacity, and expanding research work in areas of etiology, diagnosis, and prevention, is expected to reduce the incidence or improve the prognosis.[1],[3]

Moreover, early detection of the condition through screening will offer multiple benefits and can be done before the conception (through obtaining family history and screening for carrier state), during conception (through radiological tools or screening for age or other environmental risk factors), and neonatal screening with the help of complete clinical assessment and biochemical investigations.[2],[3],[4],[5] Even though some of the congenital anomalies cannot be cured, nevertheless, structural defects or functional anomalies can be managed through specific interventions.[1],[2] Realizing the importance and the magnitude of the problem, a resolution has been developed at the global level to initiate a national program for the surveillance, prevention, and care of congenital anomalies before and after birth, and to enhance international cooperation to ensure implementation of high-impact and cost-effective interventions to improve neonatal and child health through both medical and social support.[2]

 Conclusion



Congenital anomalies tend to cast a significant burden on the families, communities, and the health sector. The need of the hour is to strengthen the primary prevention interventions and expand the reach of care and supportive services to ensure the welfare of the affected people.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Singh S, Chukwunyere DN, Omembelede J, Onankpa B. Foetal congenital anomalies: An experience from a tertiary health institution in North-West Nigeria (2011-2013). Niger Postgrad Med J 2015;22:174-8.
2World Health Organization. Congenital anomalies – Fact sheet No. 370; 2015. Available from: http://www.who.int/mediacentre/factsheets/fs370/en/. [Last accessed on 2016 May 27].
3Shrivastava SR, Shrivastava PS, Ramasamy J. Congenital anomalies: Public health interventions to ensure its prevention and expansion of care to the patients. Cukurova Med J 2015;40:135-7.
4dos Reis LV, Araujo Júnior E, Guazzelli CA, Cernach MC, Torloni MR, Moron AF. Congenital anomalies detected at birth in newborns of adolescent women. Acta Med Port 2015;28:708-14.
5Taruscio D, Mantovani A, Carbone P, Barisic I, Bianchi F, Garne E, et al. Primary prevention of congenital anomalies: Recommendable, feasible and achievable. Public Health Genomics 2015;18:184-91.