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    PREVALENCE OF CONGENITAL ANOMALIES AND ASSOCIATED FACTORS AMONG INFANTS OF DIABETIC MOTHERS DELIVERED IN TERTIARY HOSPITALS OF TIGRAY, ETHIOPIA: A CROSS-SECTIONAL STUDY
    (Mekelle University, 2025-06-28) DAWIT TSEGAY
    Background: Congenital anomalies, or CAs, are structural or functional abnormalities that arise during intrauterine development and can be identified at birth, later in infancy, or throughout fetal life. CAs affects approximately 3% of live births worldwide, and this rised sharply to 5– 14% among infants of diabetic mothers. CAs account for approximately 25% of infant deaths worldwide. Maternal diabetes, particularly when poorly managed during the peri-conceptional period, increases the risk of CAs through mechanisms such as oxidative stress and impaired cellular development. Despite the growing concern of CAs, has been no study on the prevalence and risk factors of congenital anomalies among infants of diabetic mothers in Tigray, Ethiopia. Objective: To assess the prevalence of congenital anomalies and associated factors among infants of diabetic mothers delivered in tertiary hospitals of Tigray, Ethiopia, Nov 2022 to Dec 2024. Methods: An institution- based retrospective cross-sectional study was conducted among 356 infants of diabetic mothers delivered at Ayder and Aksum referral hospitals between November 2022 and December 2024. The minimum sample size was 345, and all eligible infants of diabetic mothers were included. Pretesting, supervision, and training were used to control data quality. Data were collected using Kobo Toolbox and analyzed with STATA version 17. Binary logistic regression model was used and variables with p-values less than 0.25 in bivariate analysis were included in multivariable logistic regression with a 95% confidence interval. Model fitness (p value = 0.95) and Multicollinearity (VIF < 1.78) were assessed. Result: The prevalence of congenital anomalies among infants of diabetic mothers was 5.34% (95% CI: 3.24 - 8.21). Cardiovascular (42.1%) and central nervous system (31.6%) anomalies were the most common. Significant factors associated with congenital anomalies included high maternal blood glucose during pregnancy (AOR = 4.04; 95% CI: 1.36 –12.03), comorbidities in pregnancy (AOR = 3.87; 95% CI: 1.29 –11.58), prior unexplained fetal death (AOR = 3.03; 95% CI: 1.05 –8.74), and a history of macrosomic delivery (AOR = 3.78; 95% CI: 1.24 -11.49). Conclusion and Recommendation: Congenital anomalies (CAs) were present in 5.34% of infants of diabetic mothers. Congenital anomalies were significantly associated with high maternal blood glucose, comorbidities related to diabetes mellitus during pregnancy, previous stillbirth, and macrosomia. These finding emphasize the need for proactive comorbidity management, enhanced glycemic control, and comprehensive prenatal care for mothers with a history of stillbirth or macrosomia in order to decrease CAs in diabetic pregnancies. The study recommends that the underlying modifiable factors be prevented through better glycemic control during preconception and pregnancy, that oral glucose tolerance tests be used to strengthen universal diabetes screening, that special attention be given to DM mothers who have a history of macrosomic babies or stillbirths, and that comorbidities be taken seriously during pregnancy.