title: Incidence, types, geographical distribution, and risk factors of congenital anomalies in Al-Ramadi Maternity and Children's Teaching Hospital, Western Iraq.
abstract: OBJECTIVE
  To study the incidence, types, geographical distribution, and risk factors of congenital anomalies (CAs) in a teaching hospital.
  
  
  METHODS
  A total of 5864 neonates were examined for CAs between October 2010 and October 2011 in Al-Ramadi Maternity and Children's Teaching Hospital, Al-Ramadi, Western Iraq. Data include: neonate's name, gender, weight, and type of CAs, mother's age, residence, education, parity, consanguinity, smoking, illness, drugs, and ultrasound (U/S) results, father's age and smoking, and family recurrence of CAs. For every case, 2 controls were selected. Types and incidence of CAs was calculated. Odds ratio and confidence interval was utilized for risk factors evaluation.
  
  
  RESULTS
  Overall CA incidences were 40.5/1000 for total births, 40.8/1000 live births, and 270.0/1000 for stillbirths. Twenty percent of CAs was found as multiple, 80% single, 63.8% major, and 36.2% minor. The cardiovascular system was found most affected, followed by genito-urinary system. Low birth weight, male gender, maternal smoking, consanguinity, parity, and CAs family recurrence were found to be significant risk factors, and oligohydramnios, polyhydramnios, and positive CAs by U/S, found as significant co-factors associated with CAs, while parental age, and maternal education were not considered risk factors.
  
  
  CONCLUSIONS
  Although the incidence of CAs was lower than the Al-Fallujah rate, it is still higher than many developed and developing countries. Amniotic fluid volume changes in U/S may hide an ominous CA, and maternal smoking exposure during pregnancy and consanguinity may expose the family to  a congenitally anomalous delivery.
authors.affiliation: Department of Pediatrics, Medical College, Al-Anbar University, Al-Anbar Governorate, Iraq. zaidrasheedalani@yahoo.com
authors.forename: Zaid R
authors.initials: ZR
authors.lastname: Al-Ani
authors.forename: Shaker A
authors.initials: SA
authors.lastname: Al-Haj
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Al-Ani
authors.forename: Khamees M
authors.initials: KM
authors.lastname: Al-Dulaimy
authors.forename: Ayad Kh
authors.initials: AKh
authors.lastname: Al-Maraie
authors.forename: Belal Kh
authors.initials: BKh
authors.lastname: Al-Ubaidi
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D005843:Geography; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007493:Iraq / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D012307:Risk Factors