بررسی وضعیت شیوع ناهنجاری‌های مادرزادی در ایران: مطالعه مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکتری تخصصی بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار روان‌شناسی و آموزش کودکان استثنایی، گروه علوم تربیتی، دانشگاه فردوسی مشهد، مشهد، ایران.

4 داﻧﺸﯿﺎر گروه ﻣﺪﯾﺮﯾﺖ ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﯽ، داﻧﺸﮑﺪه ﺑﻬﺪاﺷﺖ، داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﻣﺸﻬﺪ، ﻣﺸﻬﺪ، اﯾﺮان.

5 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: ناهنجاری‌های مادرزادی از مهم‌ترین علل بستری در بیمارستان و معلولیت و مرگ نوزادان به شمار می­روند و هزینه بستری و اقدامات درمانی این کودکان، بار سنگینی را به سیستم بهداشتی و خانواده‌های آنها وارد می­کند. از این رو مطالعه حاضر با هدف بررسی وضعیت ناهنجاری‌های مادرزادی در ایران به روش مرور سیستماتیک و متاآنالیز انجام شد.
روش­کار: در این مطالعه مروری جهت یافتن مطالعات مرتبط، پایگاه­های اطلاعاتی SID،Iranmedex ، IranDoc،Magiran ، Scopus و Pubmed و همچنین موتور جستجوی  Google Scholarبا استفاده از کلید واژه­های شیوع، ایران، ناهنجاری‌های مادرزادی و معادل انگلیسی آنها در مجلات فارسی و انگلیسی زبان در فاصله سال‌های 1365 تا اردیبهشت 1397 جستجو شدند. داده­ها با روش متاآنالیز و با استفاده از مدل اثرات تصادفی مورد تجزیه و تحلیل قرار گرفت و ناهمگنی مطالعات با استفاده از شاخص I2محاسبه شد.
یافته­ها: از مجموع 2306 مطالعه بعد از اعمال معیارهای ورود و خروج، در نهایت 35 مطالعه از فاصله سال‌های 1986 تا 2017 وارد متاآنالیز شدند. نتایج این مطالعه متاآنالیز نشان داد شیوع کلی ناهنجاری مادرزادی در ایران 6/2% می­باشد. شیوع ناهنجاری در پسران 8/2% و در دختران 2% می­باشد. شایع‌ترین ناهنجاری مادرزادی گزارش شده در متولدین ناهنجاری اسکلتی (1/29%) و سپس ناهنجاری سیستم ادراری تناسلی (2/23%) می­باشد.
نتیجه­گیری: نتایج مطالعه حاضر حاکی از میزان بالای ناهنجاری مادرزادی در ایران می­باشد، لذا مطالعات بیشتری جهت شناخت بیشتر این مسأله و برنامه‌ریزی در جهت پیشگیری از بروز ناهنجاری مادرزادی توصیه می­شود.

کلیدواژه‌ها


عنوان مقاله [English]

The prevalence of congenital anomalies in Iran: A Systematic Review and Meta-analysis

نویسندگان [English]

  • Morvarid Irani 1
  • Talat Khadivzadeh 2
  • Seyyed Mohsen Asghari Nekah 3
  • Hosein Ebrahimipour 4
  • Fatemeh Tara 5
1 PhD Student of Reproductive Health, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Reproductive Health, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Education and Psychology of Exceptional Children, Department of Educational Sciences, Ferdowsi University of Mashhad, Mashhad, Iran.
4 Associate Professor, Department of Health Services Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Congenital anomalies is one of most important causes of hospitalization, disability and neonatal death; the cost of admission and treatment of these children imposes a heavy burden on the health system and their families. Therefore, the present study was performed with aim to investigate the status of congenital anomalies in Iran through systematic review and meta-analysis.
Methods: In this review for finding the related articles, the databases of SID, Iranmedx , Irandoc, Magiran ,Scopus, Pubmed and Google scholar were searched using the keywords such as Prevalence, Iran, Congenital anomalies in Persian and English journals from 1986 to 2018. Data were analyzed by meta-analysis method using random effects model. The heterogeneity of the studies was calculated by I2 Index.
Results: Of 2306 studies, 35 studies which met the inclusion criteria from 1986 to 2018 entered to the meta-analysis. The results of this meta-analysis showed that the total prevalence of congenital anomalies in Iran is 2.6%. The prevalence of abnormalities in boys is 2.8% and in girls is 2%. Also, the most common congenital anomalies were skeletal abnormalities (29.1%) and genitourinary system abnormalities (23.2%), respectively.
Conclusion: The results of this study indicate a high prevalence of congenital anomalies in Iran. Further studies are needed to more identify this issue and plan to prevent congenital anomalies.

کلیدواژه‌ها [English]

  • Congenital anomalies
  • Iran
  • Meta-analysis
  • Prevalence
  • Systematic review
  1. Crowley LV. An introduction to human disease: pathology and pathophysiology correlations. Massachusetts: Jones & Bartlett Publishers; 2012.
  2. Kurinczuk JJ, Hollowell J, Boyd PA, Oakley L, Brocklehurst P, Gary R. The contribution of congenital anomalies to infant mortality. Oxford: National Prenatal Epidemiology Unit, University of Oxford; 2010.
  3. Abdi-Rad I, Khoshkalam M, Farrokh-Islamlou HR. The prevalence at birth of overt congenital anomalies in uremia, northwestern Iran. Arch Iran Med 2008; 11(2):148-51. (Persian).
  4. Shawky RM, Sadik DI. Congenital malformations prevalent among Egyptian children and associated risk factors. Egypt Med Hum Genet 2011; 12(1):69-78.
  5. Al-Sadoon I, Hassan GG, Yacoub AA. Depleted Uranium and health of people in Basrah: epidemiological evidence. Incidence and pattern of congenital anomalies among births in Basrah during the period 1990-1998. Med J Basrah Univ 1999; 17:27-33.
  6. Garry VF, Harkins ME, Erickson LL, Long-Simpson LK, Holland SE, Burroughs BL. Birth defects, season of conception, and sex of children born to pesticide applicators living in the red River valley of Minnesota, USA. Environ Health Perspect 2002; 110(3):441-9.
  7. Shokohi M, Kashani KH. Prevalence and risk factors of congenital malformations in Hamadan. J Mazandaran Univ Med Sci 2001; 12(35):42-5. (Persian).
  8. Abbasi M, Shamsi Gooshki E, Allahbedashti N. Abortion in Iranian legal system: a review. Iran J Allergy Asthma and Immunol 2014; 13(1):71-84.
  9. Figo Committee for Ethical Aspects of Human Reproduction and Women's Health. Ethical issues in the management of severe congenital anomalies. Int J Gynecol Obstet 2013; 3(120):307-8.
  10. Karbasi SA, Golestan M, Fallah R, Mirnaseri F, Barkhordari K, Bafghee MS. Prevalence of congenital malformations. Acta Med Iran 2009; 47(2):149-53
  11. Longman J. Medical embryology. Human development normal and abnormal. 9th ed. Baltimore: Williams and Wilkins Company; 2005.
  12. Dastgiri S, Stone DH, Le-Ha C, Gilmour WH. Prevalence and secular trend of congenital anomalies in Glasgow, UK. Arch Dis Child 2002; 86(4):257-63.
  13. Kermani RM, Nedaeifard L, Nateghi MR, Fazeli AS, Osia MA, Jafarzadehpour E, et al. Congenital anomalies in infants conceived by assisted re-productive techniques. Arch Iran Med 2012; 15(4): 228-31.
  14. Zarante I, Lopez MA, Caro A, Garcia-Reyes JC, Ospina JC. Impact and risk factors of craniofacial malformations in a Colombian population. Int J Pediatr Otorhinolaryngol 2009; 73(10):1434-7.
  15. Tomatir AG, Demirhan H, Sorkun HC, Koksal A, Ozerdem F, Cilengir N. Major congenital anomalies: a five year retrospective regional study in turkey. Genet Mol Res 2009; 8(1):19-27
  16. Linhart Y, Bashiri A, Maymon E, Shoham-Vardi I, Furman B, Vardi H, et al. Congenital anomalies are an independent risk factor for neonatal morbidity and perinatal mortality in preterm birth. Eur J Obstet Gynecol Reprod Biol 2000; 90(1):43-9.
  17. Carmichael SL, Nelson V, Shaw GM, Wasserman CR, Croen LA. Socio-economic status and risk of conotruncal heart defects and or facial clefts. Paediatr Perinat Epidemiol 2003; 17(3):264-71.
  18. Vrijheid M, Dolk H, Stone D, Abramsky L, Alberman E, Scott JE. Socioeconomic inequalities in risk of congenital anomaly. Arch Dis Child 2000; 82(5):349-52.
  19. Mosayebi Z, Movahedian AH. Pattern of congenital malformations in consanguineous versus nonconsanguineous marriages in Kashan, Islamic Republic of Iran. Eastern Mediterranean health journal. 2007;13(4):868-75..
  20. Schmidt FL, Hunter JE. Methods of meta-analysis: correcting error and bias in research findings. London, UK: Sage Publications; 2014.
  21. Hossein MA, Kargar Maher MH, Afsharnia F, Dastgiri S. Prevalence of congenital anomalies: a community-based study in the Northwest of Iran. ISRN Pediatr 2014; 2014:1-6.
  22. Mohammadzadeh I, Sorkh H, Alizadeh-Navaei R. Prevalence of external congenital malformations in neonates born in Mehregan Hospital, North of Iran. Genet 3rd Millennium 2013; 11(1):2990-5.
  23. Khoshhal-Rahdar F, Saadati H, Mohammadian M, Hafar-Rangchi M, Mohazzab-Torabi S, Khabazkhoob M. The prevalence of congenital malformations in Dezful-2012. Genet 3rd Millennium 2014; 12(2):3622-31.
  24. Khatami F, Mamuri GA. Survey of congenital major malformation in 10,000 newborns. Iran J Pediatr 2005; 15(4):315-20.
  25. Golalipour MJ, Ahmadpour-Kacho M, Vakili MA. Congenital malformations at a referral hospital in Gorgan, Islamic Republic of Iran. East Mediterr Health J 2005; 11(4):707-15.
  26. Karbasi SA, Golestan M, Fallah R, Mirnaseri F, Barkhordari K, Bafghee MS. Prevalence of congenital malformations. Acta Med Iran 2009; 47(2):149-53.
  27. Aliakbarzadeh R, Rahnama F, Hashemian M, Akaberi A. The incidence of apparent congenital anomalies in neonates in mobini maternity hospital in Sabzevar, Iran in 2005-6. J Sabzevar Univ Med Sci 2008; 15(4):231-6.
  28. Shokoohi M. Prevalence of obvious congenital anomalies and some related factors in newborns in Fatemieh hospital of Hamedan during March to September 1999. J Mazandaran Univ Med Sci 2002; 12(35):42-7.
  29. Ghahramani M, Moshki M, Ebadi A. A survey of causes and prevalence of congenital anomalies in live Bornneonates in Gonabad 22 Bahman Hospital (1994-2001). Horizon Med Sci 2002; 8(1):1-6. (Persian).
  30. Alijahan R, Mirzarahimi M, Ahmadi-Hadi P, Hazrati S. Prevalence of congenital abnormalities and its related risk factors in Ardabil, Iran, 2011. Iran J Obstet Gynecol Infertil 2013; 16(54):16-25. (Persian).
  31. Sedighi YH. Prevalence of congenital anomalies associated with multi congenital anomalies and their effective factors in children under the age of three months referred to Amir Kabir surgical clinic in the first half of the year 1998. [PhD Dissertation]. Tehran: School of Medicine, Tehran University of Medical Sciences; 1999. (Persian)
  32. Khalesi N, Narouee M, Dashi pour A.Prevalence of congenital anomalies in newborns born in Ghods' maternity ward in Zahedan, Iran,2002 ( Dissertation).Zahedan University of Medical Sciences,2003) Thesis number 892) (persian)
  33. Shajari H, Mohammadi N, Aghai MK. Prevalence of congenital malformations observed in neonates in Shariati Hospital (2002-2004). Iran J Pediatr 2007; 16(3):308-12.
  34. Hosseini S, Nikravesh A, Hashemi Z, Rakhshi N. Race of apparent abnormalities in neonates born in Amiralmomenin hospital of Sistan. J North Khorasan Univ Med Sci 2014; 6(3):580-9. (Persian).
  35. Ali A, Zahad S, Masoumeh A, Azar A. Congenital malformations among live births at Arvand Hospital, Ahwaz, Iran-a prospective study. Pakistan J Med Sci 2008; 24(1):33.
  36. Masoodpoor N, Arab-Baniasad F, Jafari A. Prevalence and pattern of congenital malformations in newborn in Rafsanjan, Iran (2007-08). J Gorgan Univ Med Sci 2013; 15(3):109-12. (Persian).
  37. Farhud DD, Walizadeh GR, Kamali MS. Congenital malformations and genetic diseases in Iranian infants. Hum Genet 1986; 74(4):382-5.
  38. Khosravei S. The investigation of gross congenital anomalies incidence in newborns in Taleghani and Ghods Hospitals-Arak. Arak Med Univ J 2001; 4(1):5-9. (Persian).
  39. Zamani A, Amini E, Kaveh M, Aminzadeh V. Prevalence of congenital malformations in infants born in Imam Khomeini and Shariati hospital. Sci J Forensic Med 2000; 6(20):19-25.
  40. Hajian K, Sharifi FS, Sharifzadeh-Baii M, Shareapour M. Prevalence of major abnormality and some of its related factors in the newborns in Shahid Yahyanejad hospital in Babol (2001). Med J Guilan Univ Med Sci 2005; 14(55):70-5. (Persian).
  41. Tayebi N, Yazdani K, Naghshin N. The prevalence of congenital malformations and its correlation with consanguineous marriages. Oman Med J 2010; 25(1):37-40.
  42. Kavianyn N, Mirfazeli A, Aryaie M, Hosseinpour K, Golalipour MJ. Incidence of birth defects in Golestan province. J Gorgan Univ Med Sci 2016; 17(4):73-6. (Persian).
  43. Abdi-Rad I, Khoshkalam M, Farrokh-Islamlou HR. The prevalence at birth of overt congenital anomalies in Urmia, Northwestern Iran. Arch Iran Med 2008; 11(2):148-51.
  44. Hematyar M, Khajoi P. Prevalence of congenital anomalies in 1000 live births in Javaheri Hospital, Tehran, 2004. Med Sci J Islamic Azad Univ Tehran Med Branch 2005; 15(2):75-8.
  45. Gheshmi AN, Nikuei P, Khezri M. The frequency of congenital anomalies in newborns in two maternity hospitals in Bandar Abbas: 2007-2008. Genet 3rd Millennium 2012; 9(4):2554-9.
  46. Ahmadi M, Shah-Mohammadi F. Statistical investigation of the gross congenital anomalies in alive newborns in Taleghani hospital, Arak. J Arak Univ Med Sci 1997; 1(4):23-9.
  47. Jalali S, Fakhraie S, Afjaei S, Kazemian M. The incidence of obvious congenital abnormalities among the neonates born in Rasht hospitals in 2011. J Kermanshah Univ Med Sci 2011; 19(2):109-17.
  48. Sarrafan N, Mahdinasab SA, Arastoo L. Evaluation of prevalence of congenital upper and lower extremity abnormalies in neonatal live births in Imam and Razi hospital of Ahvaz. Jundishapur Sci Med J 2011; 10(70):13-9.
  49. Marzban A, Sadeghzadeh M, Nasab NM. Incidence of gross congenital anomalies in newborns in Zanjan. J Zanjan Univ Med Sci 2001; 9(37):33-8.
  50. Ebrahimi S. Birth defects: prevalence and associated factors. Armaghane-Danesh 1999; 4(13-14):9-15.
  51. 51- Tootoonchi P. Easily identifiable congenital anomalies: prevalence and risk factors. Acta Med Iran 2003; 41(1):15-9.
  52. Amini Nasab Z, Aminshokravi F, Moodi M, Eghbali B, Fatemimogadam F. Demographical condition of neonates with congenital abnormalities under Birjand city health centers during 2007-2012. J Birjand Univ Med Sci 2014; 21(1):96-103. (Persian).
  53. Dastgiri S, Imani S, Kalankesh L, Barzegar M, Heidarzadeh M. Congenital anomalies in Iran: a cross-sectional study on 1574 cases in the North-West of country. Child Care Health Dev 2007; 33(3):257-61.
  54. Pouladfar G, Malahzadeh A. The prevalence of minor congenital anomalies and normal variations in neonates in Bushehr port. Iran South Med J 2005; 8(1):43-52.
  55. Rostamizadeh L, Bahavarnia SR, Gholami R. Alteration in incidence and pattern of congenital anomalies among newborns during one decade in Azarshahr, Northwest of Iran. Int J Epidemiol Res 2017; 4(1):37-43.
  56. Critical appraisal tools. The University of Adelaide. Available at: URL: http://joannabriggs.org/research/critical-appraisal-tools.html; 2018.
  57. Sarkar S, Patra C, Dasgupta MK, Nayek K, Karmakar PR. Prevalence of congenital anomalies in neonates and associated risk factors in a tertiary care hospital in eastern India. J Clin Neonatol 2013; 2(3):131.
  58. Francine R, Pascale S, Alineia H. Congenital anomalies: prevalence and risk factors. Univ J Public Health 2014; 2(2):58-63.
  59. Costa CM, Gama SG, Leal MD. Congenital malformations in Rio de Janeiro, Brazil: prevalence and associated factors. Cadernos Saude Publ 2006; 22(11):2423-31.
  60. Hussain S, Asghar I, Sabir MU, Chattha MN, Tarar SH, Mushtaq R. Prevalence and pattern of congenital malformations among neonates in the neonatal unit of a teaching hospital. JPMA 2014; 64(6):629-34.
  61. Mashuda F, Zuechner A, Chalya PL, Kidenya BR, Manyama M. Pattern and factors associated with congenital anomalies among young infants admitted at Bugando medical Centre, Mwanza, Tanzania. BMC Res Notes 2014; 7(1):195.
  62. Evans PR, Polani N. Congenital malformation in a post-mortem series. Teratology, 1980; 22 (2): 207-16
  63. Lisi A, Botto LD, Rittler M, Castilla E, Bianchi F, Botting B, De Walle H, Erickson JD, Gatt M, De Vigan C, Irgens L. Sex and congenital malformations: an international perspective. American Journal of Medical Genetics Part A. 2005 Apr 1;134(1):49-57.
  64. Shapiro L. Human genetics. In: Behrman R, editor. Nelson textbook of pediatrics. 16th ed. Philadelphia: Saunders; 2000. P. 313-7.
  65. Kirke PN, Daly LE, Elwood JH. A randomised trial of low dose folic acid to prevent neural tube defects. The Irish Vitamin Study Group. Arch Dis Childhood 1992; 67(12):1442-6.
  66. Al Arrayed SS. Epidemiology of congenital abnormalities in Bahrain. East Meditter Health J 1995; 1(2):248-52.
  67.  Bittar Z. Major congenital malformations  presenting in the first 24 hours of life in 3865 consecutive births in south of Beirut. Incidence and pattern. Le Journal medical libanais. The Lebanese medical journal. 1998;46(5):256-60
  68. Afshar M, Golalipour MJ, Farhud D. Epidemiologic aspects of neural tube defects in South East Iran. Neurosciences 2006; 11(4):289-92.