MATERNAL PERSPECTIVES ABOUT BIRTH DEFECTS AND ANORECTAL MALFORMATIONS IN IBADAN, NIGERIA

Abstract

Birth defects are structural congenital malformations that are almost always seen at birth. In countries lacking guidelines on screening for birth defects, additional responsibility is placed on parents in the early detection of these defects. Moreover, the major cause of morbidity and mortality in the treatment of children with these malformations in our environment is delayed presentation. Furthermore, there is absence of published data on the knowledge of Nigerian parents regarding birth defects and there is no information in the literature on the awareness, knowledge and attitude of parents towards early detection of birth defects and anorectal malformations. The objectives of this study included assessing the awareness and knowledge of mothers about birth defects and anorectal malformations, ascertaining the adequacy of counselling at antenatal clinics concerning birth defects, evaluating the influence of sociodemographic factors on awareness or birth defects, and determining the relationship between maternal obstetric factors and awareness of birth defects. This was a descriptive cross-sectional study of 365 mothers consecutively selected at the immunisation clinics affiliated to the University College Hospital, Ibadan and Adeoyo Maternity Hospital, Yemetu, Ibadan, conducted between May and July, 2012 following ethical approval. Data were collected with the use of structured interviewer administered questionnaires and information obtained on the socio-demographic characteristics, maternal obstetric history, details of antenatal care for the index pregnancy and items testing the awareness of mothers about birth defects and anorectal malformations. Descriptive and inferential statistics were performed using SPSS, version 19. Tests of association were performed using chi square statistics and p-value set at <0.05. Multinomial logistic regression was done to identify independent predictors of awareness of birth defects. The participants were aged 17 to 42 years. The majority (98.4%) was married; 52.6% were Christians and 60.8% were unskilled workers. The participants have had between one and seven pregnancies each and the majority (99.5%) attended antenatal care during the index pregnancy. The study found that only 35.9% and 19.5% of them were aware of birth defects and anorectal malformations respectively. During the antenatal care visit for the index pregnancy, 5.8% of the respondents received counselling about birth defects. Factors that were found to be associated with greater awareness and improved knowledge scores of birth defects were age, religion, highest level of education, occupational class, booking at an early phase in pregnancy for antenatal care and registration in a tertiary care facility. Religion, educational status and the facility where antenatal care was received were found to be independent predictors of awareness of birth defects. In conclusion, the study has shown that mothers in Ibadan, Nigeria have a poor level of awareness of birth defects and anorectal malformations.