Possible determinants of birth defects responsible for perinatal mortality in Yerevan

Abstract

Background. Birth defects are genetic or developed anomalies of the human organism present at birth. The clinical appearances of them vary from minor undetectable defects with minor clinical symptoms to major defects that require medical interventions. Birth defects are among the leading causes of infant mortality and the first leading cause of perinatal mortality in Armenia. During the last five years, infant mortality from birth defects has increased in Armenia. To determine the leading type of birth defects a preliminary survey was conducted in Yerevan during June - September 2003. The leading type of birth defects causing perinatal mortality was identified to be central nervous system anomalies, while in the case of infant mortality there were different anomalies. Moreover, it was found that mortality from birth defects in perinatal period was higher than that in infant mortality. To find possible determinants of birth defects from which newborns die during the perinatal period, it is proposed to conduct a case control research requiring total budget of 3685 USD. Objectives. The objectives of the proposed research are: · To determine the prevalence of selected characteristics of mothers of children who died from birth defect during the perinatal period. Those include demographic characteristics: mother’s date of birth and/or mother’s age, residency area, occupation, number of previous pregnancies, abortions, deliveries, number of alive children, and pregnancy history related to maternal health during pregnancy, diet and substance use during it. · To identify the association of above mentioned characteristics and their interactions with the occurrence of birth defect causing perinatal mortality. Methods/Study Instrument. As the initial step, it is planned to review the autopsy reports in Republican Children Pathology Anatomy and Republican Perinatal Centers to determine the hospitals where deaths occurred. From the medical records the necessary data will be obtained and filled into abstract forms. The abstract forms will comprise the questions on above mentioned selected characteristics. After that an interaction of those characteristics with occurrence of birth defect development causing perinatal mortality will be determined through the case-control study. Sample size. The estimated sample size for detecting the possible association of the selected factors and presence of birth defects causing perinatal death is 150 for cases and 150 for controls; thus, from the total autopsy reports there is a need to extract 300 for the study. Analyses. In order to identify an association of dependent and independent variables of the study, the Chi-square, t-test, and Logistic Regression will be used. The results of this study will help to initiate educational programs for women willing to become pregnant in order to increase their knowledge in the prevention of birth defects development.