2025/09/05 by Alemu Birara Zemariam1*, Tegene Atamenta Kitaw2
paper · doi:10.20372/nadre:17289
Abstract<br> Introduction: Congenital anomalies (CAs) are a major cause of newborn mortality and long-term disabilities,<br> especially in developing countries. Research on CAs is limited and inconclusive. This umbrella review evaluates the<br> pooled prevalence, patterns, and determinants of CAs among newborns in low- and middle-income countries.<br> Methods: We conducted a comprehensive search across databases, including PubMed and Cochrane Library, until<br> 31 December, 2024. Study quality was assessed using the AMSTAR checklist. Heterogeneity was measured with<br> the I² test and Cochrane Q test, while publication bias was evaluated through funnel plots, Egger's, and Begg's<br> tests. The pooled prevalence of CAs and determinants were calculated using the DerSimonian and Laird randomeffects model.<br> Results: Seven studies revealed a pooled prevalence of CAs at 15 per 1,000 births (95% CI: 9.00, 21.00), with the<br> highest rate in low-income countries at 18 per 1,000 (95% CI: 8.00, 27.00). Musculoskeletal and urogenital<br> anomalies were the most prevalent, at 8 and 4 per 1,000 births, respectively. Key predictors includes lack of folic<br> acid supplementation (AOR 4.18, 95% CI: 2.35, 6.02), kchat chewing (AOR 3.5, 95% CI: 2.97, 4.03), maternal illness<br> (AOR 3.55, 95% CI: 3.37, 4.73), and drug use during pregnancy (AOR 4.37, 95% CI: 1.21, 7.54).<br> Conclusion: The pooled prevalence of CAs is significantly higher than WHO reports, with musculoskeletal and<br> urogenital defects being the most common. Key risk factors include maternal illness, unidentified drug use, kchat<br> chewing, and lack of folic acid supplementation. Enhancing folic acid intake and targeting these risk factors are<br> essential for policymakers.<br>