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Pediatría (Asunción)

On-line version ISSN 1683-9803


OJEDA, Limpia Concepción  and  BENITEZ LEITE, Stela. Prenatal risk factors and their association with congenital malformations at a university referral hospital. Pediatr. (Asunción) [online]. 2018, vol.45, n.1, pp.8-16. ISSN 1683-9803.


Congenital malformations are the second- leading cause of infant mortality in South America, according to World Health Organization (WHO) data.


To determine the association between prenatal risk factors and congenital malformations in patients hospitalized at a reference hospital.

Materials and Methods:

This was a retrospective, analytical, cross- sectional case-control study in inpatients from October 2014 to October 2015, who met inclusion and exclusion criteria definitions for a case; we also included outpatients who met the inclusion and exclusion criteria as controls. We performed 1:1 matching using age and sex. Instrument: we used a structured survey. We used a qualitative variable sample with a Z value of 1.9, and P value of 4% (Percentage in general population 2 to 5%) of the main variable, with a confidence interval of 95% and a p-value of 0.05, resulting in a needed N of 60 per group.


Sixty-six cases and 66 controls, matched by age and sex, were evaluated; the ages ranged from 1 month to 15 years, with an average age of 2 years (SD: + 2,63); males were 61%. 41% (27) of the cases and 11% (7) of the controls came from the interior of the country. The most frequent malformations were those of the central nervous system 29% (19/66) followed by cardiac, 23% (15/66). Prenatal diagnosis by obstetric ultrasound was made in 33% of cases (21/66). When performing multivariate logistic regression, an association was found between congenital malformations and a history of malformations in the family (OR 20.8, 95% CI, 2.66-162.2), a history of a previous child with a genetic syndrome (OR 8.84, 95% CI, 1.35- 73.86), lack of folic acid supplementation before or during pregnancy (OR 3.44, 95% CI, 1.49- 8.33), a distance from the house of fumigated fields less than 1 km (OR 3.75, 95% CI, 0.98- 14.31) and direct maternal exposure to pesticides (OR 4.51, 95% CI, 1.77- 11.46).


The lack of folic acid supplementation, a history of congenital malformation in the family and maternal exposure to agrochemicals had significant statistical associations. There is a probable bias in the findings due to the lack of matching by provenance.

Keywords : Risk factors; congenital malformation; pesticides.

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