Epidémiologie des Malformations Congénitales Visibles à la Naissance à Yaoundé

ABSTRACT Introduction. Congenital malformations are one of the main causes of neonatal morbidity and mortality. Epidemiological data on this topic are largely unknown in the Cameroon population. This prospective multicentre study aimed at bringing more data on the qualitative and quantitative aspects of congenital malformations in Yaounde. Methods. This was a cross sectional descriptive prospective study. We studied all newborns presenting one or more malformations detectable at birth in 10 selected and representative maternities for one year. Data of interest were type of malformation, newborn anthropometric parameters, sociodemographic records of parents, obstetrical data, past medical history of the mother, history of previous malformations, abortion or still birth, irradiation, fetal toxic drugs including folic acid around the conception. Results. The prevalence was 9 per 1000 births. The most common types of malformations were (per 1.000 births) polydactyly 2.1; clubfeet 1.1, Neural tube defects 1.4; Hydrocephalus 1.1; oro-facial clefts 0.9; and abdominal parietal defects 0.7. The pair myelomeningocele and hydrocephalus was common polymalformation. The sex ratio was 1.1. Mothers of malformed babies were mostly found in the age group 26 to 35 years (49.6%), single, housewives with a secondary education level. Suspected risk factors were maternal fever during the first trimester (31.4 %), past history of spontaneous abortions (23.4 %), primiparous mothers (36.6 %), and absence folic acid supplementation in periconceptional period (100 %). Conclusion. Congenital malformations are relatively frequent in Yaounde. There is no national prevention strategy. RESUME Introduction. Les malformations congenitales representent l’une des principales causes de morbidite et de mortalite neonatale. Les donnees epidemiologiques sur ce sujet sont rares au Cameroun et non representatives de la population d’ou cette etude prospective visant a contribuer a l’analyse des aspects qualitatifs et quantitatifs de ces malformations a Yaounde. Methodologie. Nous avons recense pendant un an tous nouveau-nes presentant une ou plusieurs malformations decelables a la naissance dans 10 maternites selectionnees et representatives. Resultats. La prevalence etait de 9 cas pour 1000 naissances. Les types de malformations les plus frequentes etaient (pour 1000 naissances) la polydactylie (2,1) ; les pieds bots (1,1), les anomalies de fermeture du tube neural (1,4) ; l’hydrocephalie (1,1) ; les fentes orofaciales (0,9) ; et le defect parietal abdominal (0,7). L’association myelomeningocele et hydrocephalie etait la polymalformation la plus frequente. Le sexe ratio etait de 1,1. Les nouveau-nes malformes etaient issus pour la plupart des meres âgees entre 26 et 35 ans (49,5 %), celibataires (61,7 %), menageres (28,7 %), avec un niveau d’etude secondaire (56,4 %). Les facteurs de risques suspectes sont la fievre maternelle au premier trimestre (31,4 %), les antecedents d’avortement spontane (23,4 %), la primiparite (36,6 %) et l’absence de supplementation periconceptionnelle en acide folique (100 %). Conclusion. Les malformations congenitales sont des pathologies frequentes a Yaounde. Il n’existe pas de strategie nationale de prevention.