Customized birthweight standard for an Iranian population

Objective: To produce a customized birthweight standard for Iran.Method: Retrospective study of a pregnancy database collected from five hospitals across Iran. The cohort consisted of 4994 consecutive term births with complete data, delivered between July 2013 and November 2014. Coefficients were derived using a backwards stepwise multiple regression technique.Results: Maternal height, weight in early pregnancy and parity as well as the baby's sex were identified as significant physiological variables affecting birthweight. Paternal height and weight were also significant although weaker factors. The expected 280-day birthweight, free from pathological influences, of a standard size mother (height 163 cm, weight 64 kg) in her first pregnancy was 3390 g. Pathological factors found to affect birthweight in this cohort included village housing, anemia, preexisting and gestational diabetes and preeclampsia.Conclusion: The analysis confirmed the main physiological variables that affect birthweight in other countries and shows paternal factors also to be significant variables. Development of a country-specific customized birthweight standard will aid clinicians in Iran to distinguish between fetuses that are either constitutionally or pathologically small, thereby avoiding unnecessary interventions, and improving identification of at-risk pregnancies and perinatal outcome.

Congenital anomalies in Tunisia: Frequency and risk factors

BACKGROUND

Despite the high risk of recurrence of congenital malformations, there are no well-accepted preventive measures in developing countries like Tunisia. It is recommended that thorough epidemiological studies of congenital anomalies in this country are needed. The aim of this study is to assess the frequency and types of congenital anomalies in Tunisia and research some risk factors associated with occurrence of these anomalies.

METHODS

In this retrospective study, all the fetuses who were autopsied during 21years period from February 1991 to December 2011 (n=9678) at Service of embryofetopathology in the Center of Maternity and Neonatology of Tunis (CMNT) were studied. The classification of malformations was based upon the anatomical system affected. The differences in fetal/maternal characteristics between cases with or without congenital malformations were assessed using Chi² test.

RESULTS

Of the all 9678 autopsied fetuses, 4498 (46.47%) were diagnosed as being malformed fetuses. Anomalies of limbs (22.71%) and digestive and abdominal wall defects (14.76%) were mostly detected, followed by congenital brain defects (13.41%) and nephrourologic abnormalities (11.23%). A marked association of parental consanguinity with increased congenital anomalies rates was found (P<10^-6, OR=1.89, CI=1.69-2.13).

CONCLUSION

In Tunisia, surveillance and epidemiological evaluation of congenital anomalies underline the high frequency of these events. This will help to better target congenital anomalies prevention and screening policies in our population.