DISTRIBUTION OF CONGENITAL MALFORMATIONS IN RORAIMA

Ano: 2018 | Volume: 2 | Número: Especial

Autores: Victor Hugo Araujo Moraes; Marcelo Eduardo Rauber; Geovanna Ferreira Silva; Yasmin de Freitas Santos; Larissa Soares Cardoso; Ana Iara Costa Ferreira

Palavras-chave: Embryology; congenital abnormalities;teratology

Resumo Inglês:

ntroduction: Congenital malformations may be due to genetic, environmental or multifactorial factors. Congenital defects caused by genetic factors may be originated from numerical or structural chromosomal anomalies and through mutant genes. Teratogens are inserted within environmental factors, however, most of the malformations resulting from teratogenic agents can be avoided aslong as there is no maternal exposure to teratogens during the gestational period.
Objective: The primary objective of this study was to investigate the main congenital malformations in children in the state of Roraima. The specific objectives were: survey of medical records between the period from 2015 to 2017; analyze the main congenital malformations presented by children attending public health services in the state of Roraima and verify the association of genetic, environmental and multifactorial factors with the congenital malformations presented.
Methods: This study was approved by the Ethics Committee on Human Research of the Federal University of Roraima (CAAE: 70051417.6.0000.5302/Number: 2,366,062). The first stage of the study involved consulting medical records ofthe Hospital Materno Infantil Nossa Senhora de Nazaré (HMI) and the Centro de Referência Saúde da Mulher (CRSM) from the 2015-2018 period. Between November 2017 and June 2018, pregnant women attended at the CRSM fetal medicine service who had fetuses withdevelopmental abnormalities, observed by ultrasonography, were selected.
Results and discussion:Among the data from the medical records and the information obtained from the application of the epidemiological record among the pregnant women of the CRSM andHMI, a total of 88 congenital malformations were observed. Among the children withmalformation, 64 (72.72%) had isolated malformation, ten (11.36%) associated malformation, eight (9.09%) multiple malformations and six (6.83%) genetic syndromes. The distribution of congenital malformations was as follows (with associated malformations and multiple malformations being inserted into more than one category of malformation): 35 neurological malformations, among them the presence of microcephaly, hydrocephalus, and others; 22 were malformations of the cardiovascular system, patients presented mainly cardiomegaly and arterial stenosis; 13 craniofacial, identified primarily cleft palate and unilateral and bilateralcleft lip. In addition, eleven patients with abdominal wall alterations, eight genitourinary, five genetic syndromes, five gastrointestinal, five musculoskeletal, two pulmonary syndromes and two presenting abdominal cyst were observed.Compared with studies conducted in other Brazilian states, the prevalence of neurological malformation has been broad across the national territory. A study carried out in the nursery of newborns in the state of SãoPaulo, shows that neurological malformation is prevalent,affecting 33.33% of its study population. In 2011, Pante et al. Carried out a study in Rio Grande do Sul, at the General Hospital of Caxias do Sul, where there was an increase in cesarean deliveries, lower average neonatal weight, need for admission to a neonatal intensive care unit and related early neonatal mortality with neurological malformations. In addition, the researchers observed a relationship between these malformations and the use of anticonvulsant drugs during pregnancy, especially valproic acid and other drugs that interfere with folic acid metabolism. They also reported the role of glycemic control in preconception and first trimester gestation in patients with type 1 and type2 diabetes mellitus. Regarding the care that pregnant women must have in the first trimester, Kondo et al. (2009) bring maternal hyperthermia as a risk for the development of neurological malformation. A study carried out in Ceará, in three referral centers of tertiary level, one of them, classified as maternity and the others as general hospitals with maternity, also showed a prevalence of neurological malformations, affecting 21.1% of its analysis group. All these studies converge withthe results found in the state of Roraima.
Conclusion: It can be observed that the main malformations found in children in the state of Roraima involve the central nervous, cardiovascular, gastrointestinal and genitourinary systems