# Anorectal Malformations (ARM) and associated maternal factors among children at Tikur Anbessa Specialized Hospital and St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: An unmatched case-control study

## TL;DR

This study identifies maternal and family risk factors for anorectal malformations in Ethiopian children, highlighting the need for targeted prevention strategies.

## Contribution

The study provides novel insights into ARM risk factors specific to the Ethiopian population.

## Key findings

- Family history of birth defects significantly increases the risk of ARMs.
- Maternal alcohol use and first-trimester medication use are significant risk factors.
- Advanced maternal age and unplanned pregnancy are linked to higher ARM occurrence.

## Abstract

Anorectal malformations (ARMs) are birth defects that affect the rectum, anus, and surrounding structures. While genetic and environmental factors may contribute to the risk of developing ARMs, the exact causes are largely unknown. Notably, there is a lack of research investigating predisposing factors for ARMs within the Ethiopian population, despite the burden of this condition in the country.

The research study aimed at to examine the maternal risk factors linked to the occurrence of anorectal abnormalities in children receiving treatment at designated public hospitals located in Addis Ababa, Ethiopia.

An unmatched case-control study was conducted at selected hospitals on mothers and their children between August 2022 and January 2023. The sample consisted of pediatric patients admitted to pediatric surgical units. Cases were diagnosed with ARMs, while controls had no congenital anomalies. Data was collected from the mothers of both cases and controls. The data was validated and then exported to SPSS version 26 for analysis. The analysis employed descriptive statistics and binary logistic regression. In a multivariable model, an adjusted odds ratio (AOR) together with a 95% confidence interval and p-value < 0.05 was used to determine significance.

This study included 68 ARM cases and 136 controls. Multivariable analysis found that a family history of birth defects (AOR = 6.15, 95% CI: 1.24–30.58), maternal alcohol use (AOR = 4.71, 95% CI: 1.71–12.00), first-trimester medication use (AOR = 4.86, 95% CI: 1.29–18.32), advanced maternal age (AOR = 4.22, 95% CI: 1.21–14.69), and unplanned pregnancy (AOR = 3.701, 95% CI: 1.551–8.828) were significant risk factors for ARM.

The study found that key risk factors for ARM include family history of birth defects, maternal alcohol use, first-trimester medication use, advanced maternal age, and unplanned pregnancy. These findings underscore the importance of tailored prevention strategies and screening programs to address the genetic, maternal lifestyle, and maternal health factors that contribute to this congenital disorder.