Effect of consanguinity on congenital defects.
The highest rates of consanguineous marriage occur in north and sub-Saharan Africa, the Middle East, and west, central, and south Asia. (4) From a genetic perspective, consanguineous marriage increases the chances that both members of the union will carry recessive variants passed through the family, which increases the chance that their offspring will be affected by a recessive disease. (5)
Various defects show significant effect of consanguinity like Club foot, Polydactyly, syndactyly, Oligodactyly, Dysplasia of acetabulum, Atresia ani, Harelip with or without cleft palate, Simple cleft palate, Anencephalus, Anophthalmus and microphthalmus, Hydrocephalus. (6)
MATERIALS AND METHODS: The present study is retrospective in nature and conducted in Government medical college and hospital in western Maharashtra. Before starting the study prior permission of the Professor and Head of department of Anatomy, Obstetric and Gynaecology and Paediatric faculties of college mentioned above was taken. Approval of ethical committee was acquired before starting the study.
182 new births with congenital defect of any system of human body born in or referred to the above hospitals including stillbirths and abortions during the period between 1st October 2011 till 31st may 2012 were included in the study.
At the time of birth or referral whatever was the outcome of conception i.e. abortion, intrauterine death, live birth, neonatal death, stillbirth with any congenital malformation was termed as Proband. (7)
Before taking the history, Informed consent of proband's parents was taken using the consent form and the information was kept confidential.
Patient's history was recorded using the proforma / questionnaire especially designed for the study in Marathi and English by meeting the parents of proband in person. The proband of which the history was insufficient and in which the follow up of their parents could not be done were removed from the study.
The proforma/questionnaire for history taking included detailed information regarding type of congenital defect and associated defects, subtype of defect, history of consanguineous relationship between the parents and degree of consanguinity. Pedigree charts were prepared in all the cases.
The cases were classified depending upon the type and subtype of the congenital defect. Proband's were also divided based on all the variables mentioned earlier.
Degree of Consanguineous marriage was categorized into First degree i.e between first degree relatives i.e, between father and daughter, mother and son, between siblings; Second degree i.e between Second degree relatives like uncle -niece, nephew- aunt, half sibling; Third degree between third degree relatives like first cousins, half uncles and half niece, half aunt and half nephew. (8)
Data obtained in respect with all the variables was tabulated and shown by using Bardiagrams and Pie chart.
Comparison of the occurrence of congenital defect was done with presence of consanguineous relationship in parents, degree of consanguinity of parents. The findings were then statistically analysed using Pearson chi-square test and" p value" determined. Statistical significance of that finding was mentioned below each table.
The findings were then discussed with other comparable studies done previously by authors within or outside India and final conclusions were drawn from the present study.
OBSERVATIONS AND RESULTS: It was found that during the period between 1st October 2011 and 31st May 2012, total deliveries taking place in Government medical college and both civil hospitals were 10,114 including (Normal and caesarean section) and total admissions of anomalous births in the NICU were 182 hence incidence of congenital defects calculated was 1.79%.
The total 182 cases studied were classified depending on the system to which they belonged and showed in Table 1.9 It was seen that cardiovascular cases (39 cases) were the most common which was 21.4 % out of the 182 cases.
Table 2 shows that 48 cases of all 182 cases were born to consanguineously married parents which was 26.4 % against 134 cases which were born to non-consanguineously married parents which was 73.6%.
Table 3 shows correlation of degree of consanguinity with Occurrence of congenital defects which shows zero case born to parents having consanguineous marriage of degree one, followed by 21 cases and 27 cases out of total 182 cases born to parents having second and third degree of consanguineous marriage respectively.
Third degree cases/first cousin unions were most commonly occurring type of consanguineous marriage.
All the findings were statistically analysed and were found statistically non-significant.
The reason of findings coming statistically insignificant was lower sample size.
Hence there is scope for this study in future
Table 3 shows that Third degree cases / first cousin unions were most commonly occurring type of consanguineous marriage.
DISCUSSION: Births with congenital defects were commonly found to occur among normal births and the incidence calculated was 1.79 % in the present study.
Comparison of type of Congenital Defect (n= 182): In the present study we have classified all the anomalous cases according to the system and found that cardiovascular anomalies were the most common type. For discussion particularly with Z. Mosayebi and A.H. Movahedian (10) study we have included Diaphragmatic hernia in gastrointestinal group which was originally included in musculoskeletal group in present study.
Also urogenital anomalies were grouped along with renal anomalies and labeled as Genitourinary anomalies and Ano-rectal anomalies were included in Gastrointestinal system itself. Hence now present study shows Gastrointestinal cases (44 cases) as the most common type 24.17%, followed by cardiovascular cases (39) the second common which comes to 21.4%.
Z. Mosayebi and A.H. Movahedian (10) in 2007 stated in his study that of all 109 congenital malformations studied, Genitourinary system cases were most commonly occurring 32.1% of all 109 cases, followed by musculoskeletal cases 24 cases in 22% and cardiovascular cases 16 cases in 14.7% shown in table 4.
This finding did not match with finding of present study.
Comparison of Subtype of Congenital Defect:
These finding of Z.Mosayabi (10) study matches with that of present only in musculoskeletal system group.
Comparison of Degree of Consanguinity with Occurrence of Anomalies and Occurrence of Consanguineous Marriages: Z. Mosayebi, A. H. Movahedian (10) in 2007, P. S. Rao, S. G. Inbaraj, (11) in 1980, A. Nath, C Patil, V. A. Naik, (12) in 2004, in their respective studies stated similar findings that majority of consanguineous marriages were between first cousins i.e., third degree relationship between the parents.
Z. Mosayebi, A. H. Movahedian, (10) in 2007 in their study stated that among the consanguineous group, 54(7.0%) births had congenital anomalies, of which 39 cases were in first-cousin marriages and 15 cases were in second cousin or more distant relatives. This finding matches with present study.
P.S. Rao, S.G. Inbaraj, (11) in 1980 stated that in more than 80 % of consanguineous marriages the partners were First cousins or more closely related i.e., third order relationship shown in table 7. This finding matches with that of present study.
A. Nath et al, (12) stated that majority of consanguineous marriages were between First cousins i.e., Third degree relationship in 54.44 %shown in table 8. This finding matches with present study.
Comparison of Occurrence of Congenital Malformation with Presence of Consanguineous Marriages: Z. Mosayebi, A. H. Movahedian, (10) in 2007, William schull (2) in 1958, Naeimeb Tayebi and Katayon Tazdani, (13) in 2010, M L Kulkarni, Mathew Kurian, (14) in 1990, Khalid yunis and Reem SL Rafel, (15) in 2008, Yunis k, Mumtaz G, (16) in 2006, Ranajit Chakraborty and Arvinda Chakraborty, (17) in 1977, Asha Bai P V, John TI, (18) in 1981, AL-Kandari Y Y, Crews D E, (19) in 2011, V. K. Jain et al, (20) in Feb 1993 in their respective studies have stated that congenital malformations were occurring more common in consanguineous marriages than non-consanguineous marriages which matches present study findings.
Table 9 shows that Z. Mosayebi, A. H. Movahedian, (10) in 2007 stated that congenital malformations were 3.5 times more common in consanguineous marriages than consanguineous marriages. The findings match with that of present study.
This table shows distribution of major congenital anomalies by consanguinity and city. William schull, (2) in 1958 stated in his study stated that frequency of infants with major congenital defects increases significantly with increasing level of (inbreeding) consanguineous relationship shown in Table 10.
Hence findings are similar to present study.
Table 11 shows that Naeimeb Tayebi and Katayon Tazdani (13) in 2010 in their study done in 1195 newborns, stated that rate of congenital defect was higher in consanguineous (2.8%) than that in non- consanguineous (0.9%) marriages.
Table 12 shows that M L Kulkarni, Mathew Kurian, (14) in 1990 also stated that congenital anomalies were more common in consanguineous marriages. Their findings match with that of present study.
Khalid yunis, Reem SLRafel, (15) in 2008 stated in their article that most common form of consanguineous union was between first cousins i.e., third degree relationship.
Yunis K and Mumtaz G, (16) in their case-control trial studied 173 newborns having one or more congenital heart disease admitted to the Neonatal Intensive Care Units of participating hospitals during 3-year period from January 1, 2000 to December 31, 2002 and compared them with controls consisting of a random sample of 865 new borns without a congenital heart disease admitted to the NICU during the same period and found that first cousin consanguinity is significantly associated with an increased risk of congenital heart disease.
Infants born to first cousin marriages had a 1.8 times higher risk of having a congenital heart disease diagnosed at birth compared to those born to unrelated parents.
Ranajit Chakraborty and Aravinda Chakravarti, (17) in 1977 in their study stated that the incidence of major congenital defects was significantly higher among the inbred offspring (1.34%) as compared to that among non-inbred ones (0.81%).
Asha Bai P V, John TJ, Subramaniam VR, (18) in 1981 in their study stated that the number of pregnancies and live births were higher in consanguineous than in non -consanguineous unions. Although the intrauterine wastage showed no significant difference between the 2 groups, extrauterine loss of life, especially the death rate of children, was higher in the consanguineous marriages.
The frequency of developmental anomalies was significantly more frequent among the children of consanguineous parents.
Al-Kandari YY and Crews DE, (19) in 2011 studied a total of 9104 married Kuwaiti females aged 15-79 years from different backgrounds at ten primary health care centres from six governorates in Kuwait and Data collected using a questionnaire and analysed with chi-squared tests which indicated that the frequency of congenital disabilities in the offspring of couples from consanguineous marriages was higher than that in the offspring of non-consanguineous marriages. First-cousin marriages have the highest frequency of congenital disabilities compared with other kinds of marriages.
V. K. Jain and P. Nalini (20) in February 1993 in a study undertaken in Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, South India among four hundred children with existing congenital developmental disorders which were studied with regard to their consanguineous parentage and compared with 1,000 randomly selected patients attending the paediatric outpatient department.
There was a significantly higher prevalence of consanguinity in the study group (p < 0.001) and greater frequency in rural areas. The common types of consanguineous marriages were between first cousins (50.6%) and uncle and niece (42.4%).
SUGGESTIONS FOR FUTURE:
1. The observations from references and present study stress the need for communicating the deleterious effects of inbreeding to the public through regular health education.
2. Increasing awareness among the public of the deleterious effects of consanguinity is a simple prevention strategy must be taken into account for genetic counselling.
3. In case of pregnancy with consanguineous parents, recommendations are:
a) Compulsory counselling to estimate the risk of foetal illness and information about possible examination possibilities.
b) An ultrasound scan at the gestational age of 11-14 weeks in order to measure nuchal translucency and an early malformation scan.
c) An ultrasound scan for malformations at the gestational age of 18-20 weeks.
d) An ultrasound scan especially in order to detect foetal heart malformations at the gestational age of 20-24 weeks.
1. Births with congenital defects were commonly occurring among normal births and the incidence calculated was 1.79 % in the present study.
2. Cardiovascular defects were most common type of defects.
3. Third degree cases/First cousin unions were most commonly occurring type of consanguineous marriage.
4. Congenital defects were occurring more commonly in consanguineous unions than non-consanguineous unions.
(1.) A. H. Bittles. Endogamy, consanguinity and community genetics. Journal of Genetics, December 2002; vol. 81, issue no. 3, pg. 91-98.
(2.) William. j. Schull. Emperical risks in consanguineous marriages; sex ratio, malformation and viability, AmJ Hum Genet, 1958 September; vol. 10, issue 3, 294-343.
(3.) Consanguinity definition from (internet) available at en.wikipedia.org / wiki/ Consanguinity. H. Bittles and M. L. Black. Consanguinity, human evolution, and complex diseases. Proc Natl Acad Sci. U S A. 2010 January 26; 107(suppl_1): 1779-1786.
(4.) Bernadette Modell and Aamra Darr. Genetic counselling and customary consanguineous marriage. Nature reviews/ genetics, march 2002; vol. 3, 225- 229.
(5.) Monica Rittler, Rosa Liascovich, Jorge Lopez-Camelo, Eduardo E. Castilla. Parental consanguinity in specific types of congenital anomalies, American Journal of Medical Genetics, 22 July 2001; Vol. 102, Issue 1, pages 36-43.
(6.) Proband (internet) available at en.wikipedia.org/wiki/ Proband.
(7.) Harpar. P. Textbook of Practicle Genetic Counseling. Chapter 9, Special Problems In Genetic Counseling, Edition 4, 124, 125.
(8.) Richard. E. Behrman et al. Nelson textbook of Pediatrics. 17th edition, Jun 2007; published at Philadelphia, PA; Elsevier/Saunders, 2011.
(9.) Z. Mosayebi and A. H. Movahedian. Pattern of congenital malformations in consanguineous versus non-consanguineous marriages in Kashan, Islamic Republic of Iran. Eastern Mediterranean health journal, 2007; vol. 13, No.4, 869-875.
(10.) P. S. Rao, S.G. Inbaraj. Inbreeding effects on fetal growth and development. Journal of medical genetics. 1980; 17, 27-33.
(11.) A. Nath, C. Patil, V. A. Naik. Prevalence of Consanguineous Marriages in a Rural Community and Its Effect on Pregnancy Outcome. Indian Journal of Community Medicine, 2004 Jan- Mar; Vol. 29, No. 1.
(12.) Naeimeh Tayebi, Katayon Yazdani, Nazila Naghshin. The Prevalence of Congenital Malformations and its Correlation with Consanguineous Marriages, Oman Medical Journal 2010 Jan; Volume 25, Issue 1, 37-40.
(13.) M. L. Kulkarni and M Kurian. Consanguinity and its effect on fetal growth and development; a south Indian study. J. med. genet, 1990; 27: 348-352.
(14.) Yunis K, Reem El Rafei, and Ghina Mumtaz. Consanguinity: Perinatal Outcomes and Prevention - A View from the Middle East, Article International Perspectives Feb. 2008; Neoreviews vol. 9. No. 2, 59-64.
(15.) Yunis Khalid, Mumtaz Ghina, Bitar Fadi, Chamseddine Fadi, Kassar May, Rashkidi Joseph, Ghaith Makhoul, Tamim Hala. Consanguineous Marriage and Congenital Heart Defects- A Case-Control Study in the Neonatal Period. American Journal of Medical Genetics Part A (2006) Jul. 15; 140(14); 1524-30.
(16.) Ranajit Chakraborty and Arvinda Chakravarty. On consanguineous marriages and genetic load.human genetics, 1977; vol. 36. Number 1, 47-54.
(17.) Asha Bai P V, John T. J, Subramaniam V.R. Reproductive wastage and developmental disorders in relation to consanguinity in south India. Trop. Gregor. Med 1981 Sep; 33(3), 275-80.
(18.) Al-Kandari YY, Crews DE. The effect of consanguinity on congenital disabilities in the kuwaiti population. Journal of Biosocial Science / Volume 43 / Issue 01 / January 2011; pp 65-73.
(19.) V. K. Jain, P. Nalini, Chandra R, Srinivasan S. Congenital malformations, reproductive wastage and consanguineous mating. Aust. N Z J Obstet Gynaecol. 1993 Feb; 33(1): 33-6.
(1.) Sundip Hemant Charmode
PARTICULARS OF CONTRIBUTORS:
(1.) Assistant Professor, Department of Anatomy, ESIC Medical College, Paravoor Road, Parippally, Kollam.
FINANCIAL OR OTHER COMPETING INTERESTS: None
NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Sundip Hemant Charmode, ESIC Medical College, Paravoor Road, Parippally, Kollam-691574. E-mail: email@example.com
Date of Submission: 05/05/2015.
Date of Peer Review: 06/05/2015.
Date of Acceptance: 20/05/2015.
Date of Publishing: 26/05/2015.
Table 1: Classification of 182 new born cases according to system of type of congenital defect Type of Congenital No. of cases Percentage % defect out of 182 Cardiovascular 39 21.4 Respiratory 3 1.6 Cerebrovascular 14 7.7 Musculoskeletal 23 12.6 Renal 8 4.4 Urogenital 22 12.1 Anorectal 14 7.7 Gastrointestinal 24 13.2 (Combination of 35 19.2 anomalies) mixed Total 182 100.0 Table 2: Comparison of Consanguinity and occurrence of congenital defect Presence of No. of cases Percentage % Consanguinity Yes 48 26.4 No 134 73.6 Total 182 100.0 Table 3: Degree of Consanguinity and congenital defect Degree of Total No. Percentage % Consanguinity of cases Degree one 0 0 Degree two 21 11.5 Degree three 27 14.8 Non consanguineous 134 73.6 Total 182 100.0 Table 4: Shows comparison of present study findings with Z. Mosayabi (10) study Sl. Type of Congenital No. of cases % Z. Mosayebi (10) No. defect n = 109 Z. study Mosayebi (10) study 1 Genitourinary 35 32.1 2 Musculoskeletal 24 22.0 3 Cardiovascular 16 14.7 4 Gastrointestinal 7 6.4 5 Central nervous system 6 5.5 6 Eye and ear defects 5 4.6 7 Chromosomal defects 2 1.8 8 Cutaneous defects 1 0.9 9 Multiple defects 13 12.0 Total 109 100 Sl. Type of Congenital No. of cases % Present No. defect n=182, Present study study 1 Genitourinary 30 16.4 2 Musculoskeletal 23 12.6 3 Cardiovascular 39 21.4 4 Gastrointestinal 44 24.17 5 Central nervous system 14 7.7 6 Eye and ear defects 0 0 7 Chromosomal defects 6 3.29 8 Cutaneous defects 0 0 9 Multiple defects 35 19.2 Total 182 100 Table 5: Shows comparison of present study findings with Z. Mosayabi Sl. No. Type of congenital Most common subtype Z. defect Mosayebi (10) study 1 Genitourinary Undescended testes 2 Musculoskeletal Metatarsus adductus (limb defects) 3 Cardiovascular VSD 4 Gastrointestinal Cleft lip/palate 5 Central nervous system Anencephaly 6 Eye and ear Periauricular skin tag 7 Multiple Not specified Sl. No. Type of congenital No. of cases Z. defect Mosayebi (10) study 1 Genitourinary 17 2 Musculoskeletal 6 3 Cardiovascular 5 4 Gastrointestinal 3 5 Central nervous system 2 6 Eye and ear 3 7 Multiple Not specified Sl. No. Type of congenital % Out of 109 cases Z. defect Mosayebi (10) study 1 Genitourinary 15.0 2 Musculoskeletal 5.5 3 Cardiovascular 4.7 4 Gastrointestinal 2.8 5 Central nervous system 1.9 6 Eye and ear 2.8 7 Multiple Not specified Sl. No. Type of congenital Most common subtype defect Present study 1 Genitourinary Hypospadias 2 Musculoskeletal Limb defects 3 Cardiovascular ASD 4 Gastrointestinal Anal atresia 5 Central nervous system Hydrocephaly 6 Eye and ear None 7 Multiple Not specified Sl. No. Type of congenital No. of cases % Out of 182 cases defect Present study Present study 1 Genitourinary 7 3.84 2 Musculoskeletal 8 4.39 3 Cardiovascular 18 9.89 4 Gastrointestinal 9 4.94 5 Central nervous system 6 3.29 6 Eye and ear None None 7 Multiple Not specified Not specified 10 study Table 6: Shows comparison of present study findings with Z. Mosayebi (10) study Degree of consanguinity Congenital anomalies in Consanguineous and no of cases in each marriages(n=768) n= 54, Z. Mosayebi (10) category. Z. Mosayebi (10) study study Major % Minor % Total % First degree(n = 0) 0 0 0 0 0 0 Second degree / 11 3.8 4 1.4 15 5.2 uncle-niece (n=291) Third degree/ first 29 6.1 10 2.1 39 8.2 cousins (n = 477) Total = 768 40 5.2 14 1.8 54 7 Degree of consanguinity Out of total 182 and no of cases in each anomalous cases, Total category. Z. Mosayebi (10) consanguineous cases = 48. study Present study No. of cases First degree(n = 0) 0 Second degree / 21 uncle-niece (n=291) Third degree/ first 27 cousins (n = 477) Total = 768 48 Table 7: Shows comparison of present study findings with P.S. Rao, S.G. Inbaraj (11) study Degree of consanguinity Rural, P. S. S. Urban, P. S. S. P. S. S. Rao (11) study Rao (11) study Rao (11) study No. of cases % No. % Non-consanguineous 6169 53.1 6378 70.9 Consanguineous 5459 46.9 2620 29.1 First degree 0 0 0 0 Second degree / uncle 1841 15.8 589 6.6 niece and aunt nephew Third degree/ first 2886 24.8 1573 17.5 cousins Fourth degree /First 393 3.4 265 3.0 cousins once removed Fifth degree/ second 269 2.3 143 1.6 cousins Beyond second cousins 70 0.6 50 0.5 Degree of consanguinity Consanguinity Percentage P. S. S. Rao (11) study Present study 100% out of total 182 cases No. of cases % Non-consanguineous 134 73.6 Consanguineous 48 26.3 First degree 0 0 Second degree / uncle 21 11.5 niece and aunt nephew Third degree/ first 27 14.8 cousins Fourth degree /First 0 0 cousins once removed Fifth degree/ second 0 0 cousins Beyond second cousins 0 0 Table 8: Shows comparison of present study findings with A. Nath et al (12) study Degree of consanguinity No. of cases Percentage %, A. Nath et A. Nath et al (12) study al (12) study First degree 0 0 Second degree/uncle-niece 61 33.8 Third degree / First cousins 98 54.4 Other distant relations 21 11.6 Total cases 180 100 Degree of consanguinity Present study Present study % No. of cases Out of 48 cases First degree 0 0 Second degree/uncle-niece 21 43.75 Third degree / First cousins 27 56.25 Other distant relations 0 0 Total cases 48 100 Table 9: Shows comparison of present study findings with Z. Mosayebi (10) study Prevalence of congenital malformation among 3529 neonates from consanguineous and non-consanguineous marriages. (Z. Mosayebi, A. H. Movahedian (10) study) Congenital Consanguineous marriage n = 768 malformation Second cousin or Nonconsan First distant -guineous cousin relative Total, marriage (n=477) (n=291) n = 768 (n= 2761) No % No % No % No % Major 29 6.1 11 3.8 40 5.2 23 0.8 Minor 10 2.1 4 1.4 14 1.8 32 1.2 Total 39 8.2 15 5.2 54 7.0 55 2.0 Table 10: Shows comparison of present study findings with W. Schul (l2) study City William Degree of consanguineous relationship among schull (2) study parents W. Schull (2) study Degree one, Degree second, First cousins no. of cases. no. of cases /degree three, No. of cases Hiroshima 0 0 936 Kure 0 0 318 Nagasaki 0 0 1592 Total 0 0 2846 Present study 0 21 27 Consanguineous n=48 Present study -- -- -- Nonconsanguineous n=134 City William Degree of consanguineous schull (2) study relationship among parents W. Schull (2) study 1 1/2 cousins/ Second cousins/ degree four fifth degree no. of cases No. of cases Hiroshima 313 384 Kure 113 140 Nagasaki 412 637 Total 838 1161 Present study 0 0 Consanguineous n=48 Present study -- -- Nonconsanguineous -- -- n=134 City William Degree of consanguineous Total schull (2) study relationship among parents W. Schull (2) study Unrelated / non -consansanguinity No. of cases Hiroshima 26,012 27645 Kure 7544 8115 Nagasaki 30240 32881 Total 63796 68641 Present study 0 48 Consanguineous n=48 Present study 134 134 Nonconsanguineous n=134 Table 11: Shows comparison of present study findings with Naeimeh Tayebi (13) study Total no of congenital Total cases studied in Naeimeh defects in Naeimeh Tayebi (13) study, n=1195(100 %) Tayebi (13) study. N=45(3.76%) Cases from consanguineous marriages n=300(25%) No. of anomalies % of total births Total, n=45, 3.76%. 34 2.8 Naeimeh T ayebi study. Consanguineous % cases, in present study Total anomalies studied 48 26.4 in present study, n=182, 100 % Total no of congenital Total cases studied in Naeimeh defects in Naeimeh Tayebi (13) study, n=1195 (100%) Tayebi (13) study. N=45(3.76%) Cases from non-consanguineous marriages n= 895(75%) No. of anomalies % of total births Total, n=45, 3.76%. 11 0.9% Naeimeh T ayebi study. Non-consanguineous % cases, in present study Total anomalies studied 134 74.6 in present study, n=182, 100 % Table 12: Shows comparison of present study findings with Kulkarni M. L, Mathew Khurian (14) study Total no. of malformations Total no. of live and still found in 3700 births, births studied, n = 3700 n=146, Kulkarni M. L, (100%) Kulkarni M. L, Mathew Mathew Khurian1 (4) study Khurian (14) study Kulkarni M. L, Mathew Khurian (14) study Consanguineous cases, n=999 (27%) No. of cases % out of total anomalies i.e 146 Total cases = 146, 100% 80 54.79 Kulkarni M.L, Mathew Khurian (15) study Present study Total 48 26.4 anomalies studied, n=182, 100% Total no. of malformations Total no. of live and still found in 3700 births, births studied, n = 3700 n=146, Kulkarni M. L, (100%) Kulkarni M. L, Mathew Mathew Khurian (14) study Khurian (14) study Kulkarni M. L, Mathew Khurian (14) study Non-consanguineous cases, n= 2731(73.81%) No. of cases % out of total anomalies i.e 146 Total cases = 146, 100% 66 45.20 Kulkarni M.L, Mathew Khurian (15) study Present study Total 134 74.6 anomalies studied, n=182, 100%
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|Title Annotation:||ORIGINAL ARTICLE|
|Author:||Charmode, Sundip Hemant|
|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Date:||May 28, 2015|
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