A ten-year review of neonatal congenital abnormalities and parental perceptions at a tertiary hospital in Ghana

Anane-Fenin, Betty Akua Oparebea
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Prevalence of congenital abnormalities (CA) is highest in developing countries. For the first time in Ghana, the prevalence and spectrum of neonatal CA and their admission outcomes over a ten-year period, and the perceptions of parents on their acceptability of prenatal testing and termination of pregnancy for fetal anomaly (TOPFA) were determined in a tertiary hospital. Demographic, obstetric and clinical data were collected for all babies admitted to the Special Care Baby Unit between 1st January 2010 and 31st December 2019. Parents of new-borns diagnosed with CA in the hospital between 13th April and 13th October 2021 were also recruited to assess their perceptions on prenatal testing and TOPFA. A total of 236 admissions occurred over the decade, accounting for 2.8% of neonatal admissions and 8.6 per 1000 births. Mortality occurred in 31.4%, responsible for 4.6% of total neonatal deaths. Gravidity of >5 and place of delivery were statistically associated with mortality. Central nervous system anomalies were the most prevalent, followed by suspected chromosomal abnormalities, then cardiac defects. Neonates with cardiac defects were more likely to demise. There is a high acceptance rate for prenatal testing and TOPFA among parents of new-borns with CA. However, there is a significant lack of knowledge on prenatal testing. Strategies for the prevention and early detection of CA, including the creation of a CA register, are required. Education and introduction of prenatal testing in routine antenatal care is essential. Parental support is also key to the management of parents with affected foetuses or new-borns.
A dissertation submitted in fulfilment of the requirements for the degree of Master of Science (Obstetrics and Gynaecology) to the Faculty of Health Sciences, School of Clinical Medicine, University ofthe Witwatersrand, Johannesburg,2022