Patterns of Congenital Malformations in a Tertiary Newborn Care Unit in Central India: Implications for Prenatal Care.

Background:  Congenital malformations pose emotional strains for expecting parents and are linked to stillbirths, newborn deaths, and post-neonatal deaths. This understanding is crucial for prenatal counseling and risk assessment in maternal and child healthcare. This study provides an overview of congenital malformation patterns in a tertiary care neonatal unit in central India. Understanding the burden and pattern of congenital malformation is key in monitoring the trend and prevention of stillbirths, especially those in low-income countries.  Methods: This was a prospective, observational study that recruited all neonatal unit admissions with major congenital malformations, with the exceptions of newborns without known biological mothers and those whose parents refused consent, during a one-year span from May 2024 to April 2025. Parental demographics, newborn traits, and outcome measures such as prior stillbirth, birth weight, gestational age, and viral infections were analysed.

Results: Among 4407 admissions, 200 newborns had congenital malformations (4.5%), which included gastrointestinal (45%; n=90), CNS (25%; n=50), cardiovascular (10%; n=20), and musculoskeletal (7%; n=14) malformations. Of the cohort, 56% were male and 44% female; 154 (76%) were full term, 44 (22%) were preterm, and 4 (2%) were post-term births, with 130 (65%) being low birth weight. A total of 70 infants died in the neonatal period, with a case fatality ratio of 32% (n=16) from CNS, 25% (n=5) from cardiovascular, and 18.88% (n=17) from gastrointestinal malformations. Previous history of abortion and stillbirth was associated with 30% (n=60) and 9% (n=18) of congenital malformation, respectively.  Conclusion: The study highlights the burden of congenital malformation in a tertiary care sick newborn care unit in central India. Antenatal care, including screening for congenital malformation, counselling, and management, will help to decrease the burden of congenital malformation. Further research is essential to refine interventions and support families affected by these challenges.