Anorectal malformations in neonates.

BACKGROUND: Anorectal malformations (ARM) are associated with congenital anomalies and other risk factors, yielding a poor prognosis, especially in neonatal life.

OBJECTIVES: This study was performed to identify the congenital anomalies as a factor of poor prognosis (mortality) in such patients.

SETTINGS: Department of Pediatric surgery, The Children's Hospital and The Institute of Child Health, Lahore.

DESIGN: Prospective observational study, with statistical support.

MATERIALS AND METHODS: The information on the demography, clinical features, investigations, management performed, and outcome was entered in the designed proforma and analysed with the help of statistical software EpiInfo version 3.5.1. Statistical test: Chi-square test was used to determine statistical significance of the results.

RESULTS: Of 100 neonates with ARM, 77 were male and 23, female (3.4:1). The mean age at presentation was 3.4 days (range, 12 hrs to 28 days). In 60 patients (60%), the presentation was imperforate anus without a clinically identified fistula. In 28 patients (28%), associated anomalies were present. The common associated anomalies were urogenital (10%), cardiovascular (8%), and gastrointestinal (6%). Down's syndrome was present in 8 (8%) patients. A total of 15 (15%) deaths occurred in this study. In patients having associated congenital anomalies, 11 deaths occurred, whereas, 4 deaths were in patients without associated anomalies (P < 0.5).

CONCLUSION: The mortality is higher in neonates with ARM having associated congenital anomalies.