Investigation of the risk factors of anorectal malformations

Purpose: To investigate the factors that influence the occurrence of anorectal malformations (ARMs).

Methods: From December 2018 to December 2019, 136 children treated for ARMs at the Children's Hospital of Chongqing Medical University were included in the case group. The control group consisted of children with intussusception or perianal abscesses. A uniform questionnaire was filled by the parents of the enrolled children.

Results: The birth weight of the cases was significantly lower than that of the controls (p < .01), and children with ARMs were more likely to be complicated with single umbilical artery (SUA) (p < .001). Maternal upper respiratory tract infection (adjusted odds ratio [OR_adj ], 2.44; 95% confidence interval [CI], 1.29-4.63) and urogenital infection (OR_adj , 2.67; 95% CI 1.11-6.38) during the first trimester of pregnancy, anemia during pregnancy (OR_adj , 5.69; 95% CI, 1.01-32.07), and exposure to hazardous substances 6 months before pregnancy and during the first trimester of pregnancy (OR_adj , 13.82; 95% CI, 3.86-49.35) are associated with increased risk of ARMs. Folic acid supplements (OR_adj , 0.31; 95% CI, 0.14-0.65) and multivitamin (OR_adj , 0.34; 95% CI, 0.15-0.79) had a protective effect on ARMs. Paternal drug use (OR_adj , 9.17; 95% CI, 2.19-38.49) 6 months before their wives' conception increased the risk of ARMs.

Conclusion: Maternal infection, anemia during pregnancy, and maternal hazardous substances exposure are possible risk factors for ARMs. Folic acid supplements and multivitamin can reduce the occurrence of ARMs. Meanwhile, paternal drug use may also be a risk factor for ARMs.