Congenital Anomalies at a Nigerian Teaching Hospital: A Retrospective Study, 2016–2018

Before a baby is born, the body is building itself from the inside out. Between the third and eighth week of pregnancy, the organs take their shape, a critical window where even a small disruption can lead to a birth defect. These defects, known as congenital anomalies, are structural or functional differences present at birth. They can affect almost any part of the body, from the heart and brain to the limbs and skin. While some are mild, others are life-threatening or can cause severe, lifelong disabilities. In many parts of the world, these conditions remain a silent challenge, often going undetected until a child is born. Understanding how often they happen and what they look like in specific communities is the first step toward preventing them or managing them better.

In Southern Nigeria, researchers at the University of Calabar Teaching Hospital decided to look closely at this reality. They conducted a study reviewing the medical records of newborns over a three-year period, from 2016 to 2018. Their goal was simple but vital: to count and categorize the different types of birth defects seen in their hospital. They examined the files of 438 babies who had been diagnosed with at least one anomaly. The team sorted these cases into groups based on which part of the body was affected, using a standard international system for classifying diseases. This method allowed them to see patterns that might otherwise be hidden in a pile of individual case files.

The results revealed a total of 129 distinct types of anomalies among the babies studied. The most common group of defects involved the musculoskeletal system, which includes the bones, muscles, and joints. This category made up nearly a third of all the cases. Within this group, a condition called talipes equinovarus, commonly known as clubfoot, was the single most frequent finding. This is a deformity where a baby's foot is twisted inward and downward. The second most common group involved the eye, ear, face, and neck, with congenital cataracts—a clouding of the eye's lens present at birth—being a notable example. The third most frequent category was defects of the circulatory system, specifically malformations of the heart.

The study also highlighted a concerning pattern regarding how these babies came to be treated. The majority of the cases were found in mothers who had not received adequate care during their pregnancy. These women often visited the hospital only for the delivery itself, missing out on the regular checkups that happen during antenatal care. During those checkups, doctors can use ultrasound scans to see the developing baby and spot many defects early. Because these mothers missed those opportunities, the defects were only discovered after the babies were born. The medical records also pointed to a strong genetic link for several conditions, including heart defects and cataracts, suggesting that family history plays a significant role in these cases.

While the researchers noted that environmental factors like pollution or exposure to hazardous waste could contribute to birth defects, their data strongly emphasized the role of genetics and the lack of prenatal screening. The study concluded that there is a significant number of congenital anomalies in this region, with clubfoot, heart defects, and cataracts being the most prevalent. The authors suggest that the solution lies in strengthening antenatal care services. If more mothers attend regular checkups, doctors could detect these issues earlier, potentially offering genetic testing or ultrasound scans to identify problems before birth. They also recommended setting up a formal registry to track these conditions over time, which would help hospitals and health officials better understand the scope of the problem and improve how they manage it.