Korean J Perinatol.  2013 Mar;24(1):11-19. 10.14734/kjp.2013.24.1.11.

Changing Patterns of Congenital Anomalies over Ten Years in a Single Neonatal Intensive Care Unit

• Chung SH
• Kim HY
• Kim JH
• Choi YS
• Lee BS
• Kim KS
• Kim EA

• KMID: 1427067
• DOI: http://doi.org/10.14734/kjp.2013.24.1.11

Abstract

PURPOSE
To investigate incidence, changing patterns, and mortality associated with congenital anomalies experienced in a single neonatal intensive care unit (NICU).
METHODS
Retrospective chart review of 29,026 neonates admitted to NICU and nursery of Asan Medical Center from January 2001 to December 2010 was done. The congenital anomalies were classified according to 76 anomalies in 8 systems registered by Korean Ministry of Health and Welfare in 2009.
RESULTS
A total of 3,122 neonates had at least 1 anomaly. Mean gestational age and birth weight were 38(+2)+/-2.3 weeks and 2,030+/-541 g respectively. The proportion of male is 61%. The incidence of congenital anomalies and the proportion of mothers older than 35 years increased from 8.3% to 23.0% and 6.4% to 16.4% in 2001 compared to 2010 respectively. The percentage of neonates who have multiple anomalies was almost equal from 24.0% in 2001 to 23.7% in 2010. The most common anomalies, by system, included atrial septal defect, hydronephrosis, anorectal atresia/stenosis, cystic adenomatoid malformation, cleft lip and/or palate, CATCH 22 syndrome, polydactyly, and hydrocephalus. The overall mortality at 2 years old decreased from 11.1% to 8.0% in 2001 and 2010. Most common etiologies resulting in highest mortality, by system, were hypoplastic left heart syndrome, renal agenesis, congenital diaphragmatic hernia, pulmonary hypoplasia, 18 trisomy, and anancephaly.
CONCLUSION
Our data have shown that the incidence of congenital anomaly included in this study is increasing. A detailed epidemiologic study based on larger population is required in order to investigate preventive measures.

Keyword

Congenital anomalies; Single Neonatal Intensive Care Unit; Incidence; Mortality

MeSH Terms

Birth Weight
Cleft Lip
Congenital Abnormalities
Epidemiologic Studies
Gestational Age
Heart Septal Defects, Atrial
Hernia, Diaphragmatic
Humans
Hydrocephalus
Hydronephrosis
Hypoplastic Left Heart Syndrome
Incidence
Infant, Newborn
Intensive Care, Neonatal
Kidney
Kidney Diseases
Male
Mothers
Nurseries
Palate
Polydactyly
Retrospective Studies
Trisomy
Congenital Abnormalities
Hernia, Diaphragmatic
Kidney
Kidney Diseases

Figure

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  Fig. 1 The Annual incidence of congenital anomalies.

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  Fig. 2 Changes in annual percentage of mother older than 35, prematurity, and birth weight under 2,500 g.

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  Fig. 3 Changes in the proportion of major anatomical system, 2001-2010.

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  Fig. 4 Changes in mortality rate by two ages of congenital anomaly from 2001 to 2010. CA, congenital anomaly; CHD, congenital heart disease.

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