Environmental Pollution and Risk of Congenital Anomalies in Al-Diwaniya Governorate

Abstract

Analytic study, conducted on 15 cases of congenital deformity of the newborn babies in the maternity and children's teaching hospital in Diwaniya for the period from the first of January until the end of December 2014 (6 males and 9 females) , were recorded cases include cardiac defects , urinary system anomalies , neural tube defects , cleft lip 'and Down syndrom. The largest percentage is cardiac malformations and abnormalities of the urinary system,the proportion of malformations among females were more than in males , for the place of residence was a al- Jumhoory locality in the top of the other 'as to the nature of the environment there were no any strange environmental phenomenon or different from other regions environment' except al- Jumhoory locality had seen very violent military conflicts.Key words:Environmental pollution, Congenital defects .Background: Although environmental pollution suggested to play a great role in occurrence of certain bad outcome , evidence of health consequences to populations is sparse.Aim of the study: To investigate whether there is an association between risk of congenital anomaly and level of environmental pollution in Diwaniya during the last years .Methodology: Case series for each age-sex defected born baby in the region for 15 disorders represented births from January 2014 –December 2014 , were calculated, based on the estimates of cases by cause, type of disorder , incidence, age of the mother, duration, and disability severity. Estimates of the burden and prevalence of exposure in different localities of disorders attributable to malnutrition, poor water supply, poor sanitation, personal and domestic hygiene, , tobacco use by mother, occupation, hypertension, physical inactivity, and use of illicit drugs during pregnancy . We asked also about history of feeding , rash appearance , x-ray exposure , history of previous baby with congenital anomaly , also asking about antenatal care during the whole period of gestation and also about the duration of residence of mothers .Results : From the total 15 congenital anomalies recorded during the whole year , 6 males and 9 females , non-chromosomal anomalies combined, raised risks were found for Tetralogy of Fallot 5 cases ( 33.3% ) , urinary system anomalies 4 cases ( 26.6% ) , while those with cleft lip 2 cases and those with neural tube anomalies 2 cases represents only 13.3% for each , also cases with chromosomal anomalies ( Down syndrome ) 2 cases represents only 13.3% from the total cases . According to the locality , it was found that al- Jumhoory locality is the highest ( 5 ) cases i.e. 33.3% of the total , followed by al-wihda locality ( 4 ) cases which represents 26.6% of the anomalies recorded . Other localities { al- asry , al-oroba , al- askary , al-hakim , al- taqia and al- sanniah } registered only one case for each . According to other variables , age of the mother , smoking , presence of associated diseases like hypertension or D M , level of education , we don’t find any significance . Conclusions: Although both environmental exposure and multiple genetic factors may plausibly explain some of the excess risks of birth defects observed, several alternative explanations, including exposure misclassification, ascertainment bias, and residual confounding cannot be excluded. Some of the effects observed, if real, might be therapeutic drugs , radioactive substance from weapons , cigarette smoking during pregnancy and maternal infection with rubella or cytomegalovirus .