MEANING AND CLINICAL INTEREST
OF MINOR MALFORMATIONS
AND NORMAL VARIANTS IN NEONATOLOGY
Grubeša Raguž S, Jerković Raguž M, Brzica £, Džida S, Mikulić S, Kolobarić A, Galić T
*Corresponding Author: Svjetlana Grubeša Raguž, med MD, specialist in pediatrics, Clinic for Children’s
Diseases, Clinical Department of Neonatology, University Clinical Hospital Mostar;
E-mail: gsvjetlana@gmail.com Phone: 0038763952832; Fax: 0038736341970
page: 37
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RESULTS
In the period from January 1, 2023 until January 1,
2024, a total of 1,880 children were born (1,872 live births,
8 stillbirths), and some minor malformations were observed in 199 (10.59%) newborns. In total, 16 newborns out of 199
(8.04%) had one of the major malformations. More than
53% of mothers whose child had one of the malformations
gave birth between the ages of 30 and 39, while the least
represented age group was of mothers under 20. The larg-
est number of mothers gave birth naturally, 138 (69.35%)
of them. The highest number of children with some type
of malformation was registered in first pregnancies, 93
(46.73%). As many as 197 (98.99%) of women giving
birth, had natural insemination, and only 2 (1.01%) had
medically assisted insemination. 183 (91.96%) of women
who gave birth had no previous abortions, while 12 (6.03%)
of them had 1 abortion. In the categories where mothers
had at least one abortion, no statistically significant differ-
ences were noticed between the frequencies of the observed
types of malformation. All pregnant women were moni-
tored for certain pathological conditions during pregnancy.
The largest number of women giving birth were without
pathological conditions, 153 (74.63%). Among women
in labor who had at least one pathological condition, the
largest number of them had hypothyroidism 32 (15.61%).
The largest number of mothers did not use any medication
during pregnancy, 157 (77.34%), and of those who used
drugs, the largest number of them used levothyroxine so-
dium, 31 (15.27%). Malformation of the oral cavity was
the most frequent malformation in pregnant mothers who
did not use any therapy, 45.72%, and in pregnant mothers
who used levothyroxine sodium, 10.55%. In groups where
mothers used antidiabetic or antihypertensive drugs, all
malformations were equally represented. As stated earlier,
a total of 199 children were born, of which 116 (58.29%)
were boys and 83 (41.71%) were girls (χ2 = 5.47, df =
1, p < 0.05). The largest number of boys and girls had a
birth weight between 2500 and 3500 grams, and a length
between 53 and 56 centimeters. The largest number of male
and female children were born between the 37 th and 42 nd
week. Additionally, the study analyzed how many children
have up to three and how many more than 3 stigmata. In
total, 168 (84.42%) of the children had less than 3 stigmata,
while 31 (15.58%) of them had three or more stigmata (χ2
= 94.31, df = 1, p < 0.01). From the above mentioned data,
it is clearly visible that those children who had some type
of malformation on the eyes (χ2 =5.54, df = 1, p < 0.05),
head and neck (χ2 =6.26, df = 1, p < 0.05) mostly had
at least 2 additional malformations. All subjects who had
one of the malformations on their hand also had at least
2 other malformations. In malformations of the abdomen
(χ2 = 13.33, df = 1, p < 0.01) and oral cavity (χ2 = 40.33,
df = 1, p < 0.01), a greater number of children had up to
three malformations. Children with skin malformations
had no additional malformations. In malformations of the
chest, feet, and ears, no statistically significant differences
were observed between the frequencies of children who
had up to 3 malformations and those children who had
more than 3 malformations. Statistically significant differ-
ences were noticed between the observed frequencies of
different types of malformations (χ2 = 182.31, df = 9, p <
0.01). Thus, the most frequent malformation was the deep
sacral dimple, where as many as 89 (44.72%) of children
had this type of malformation. Of the other malformations,
the most common were poorly modeled ears observed in
30 (15.08%), and moderate rectus diastasis observed in 29
(14.57%) (Table2). In total, there were 16 (8.04%) of the
children with major malformations. Among 199 children,
cytogenetic analysis confirmed Down syndrome in 6 cases
(3.02%), and cleft palate was identified in 8 (4.02%). Out
of the children who had one of the major malformations,
the largest number of them had a malformation of the car-
diovascular system, 4.02% (χ2 = 9.63, df = 3, p < 0.05). No
statistically significant differences were noticed between the
observed frequencies of different types of minor malforma-
tions in children who had one of the major malformations
(χ2 = 20.22, df = 23, p = 0.63). In 16 children with one of
the major malformations, 8 of them (50.00%) had more
than three minor malformations, and the same number of
children had up to three malformations (Table 3).
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