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A Study of the Risk Factors of Anorectal Malformation (ARM)

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M. Pai, A. D’Souza, E. Mathias, and V. Kumar 2
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1 Manipal College of Nursing, Manipal Academy of Higher Education, India, Kasturba Medical College,
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Manipal Academy of Higher Education, Manipal, India, and Prasanna School of Public Health, Manipal
Academy of Higher Education, Manipal, India

Background: In developing countries, the prevalence of Anorectal Malformations among children are
high. In paediatric surgery, anorectal malformation (ARM) is one of the prevalent congenital condition.
ARM in children can be the result from numerous factors in the child, environment and the parents.
Children need to be in good health (SDG 3) so that they become productive citizens of the society.

Objective: The objective of this study was to identify the parental risk factors associated with a child’s
anorectal malformation.

Methods: Quantitative research with case control design was used in this study. The sample size was
120 parents (60 fathers and 60 mothers) of children diagnosed with ARM as cases; and 240 parents
Oral Presentation Abstracts
(120 fathers and 120 mothers) of all children diagnosed with a disease condition other than ARM were
included as controls (1:2 -case: control). The study was approved by the ethics committee. The data
on risk factors were collected by the research assistant by interviewing the parents in the pediatric
surgical units of a tertiary care hospital. All data were managed using Jamovi software version 2.3.28.

Results: The risk of ARM increases 1.13 times with the age of the mother and 1.05 with father’s age
[OR 1.05, 95% (1.00-1.11, p=0.084)]. There was no association of pre pregnancy weight and height of
the mother with ARM. The probability of having ARM was shown to be 1.66 times higher in newborns
weighing < 2.5 kg .ARM was greater among mothers who had not taken folic acid[OR 1.408, 95%
CI (0.752–2.634)]. Parents who work in industry and are exposed to chemicals had a 1.95 times
[95%CI (0.962-3.97)] and 3.406 times [95%CI: (1.61-7.190), p 0.001] higher likelihood of becoming ARM,
respectively.

Conclusion: The parental risk factors assessed in this study is based on the verbal reports form the
parents, which has limitations on generalization of the results.

Keywords: anorectal malformation, case control study, India, SDG3, child health, parents

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Correspondence: Mamatha Shivananda Pai, Manipal College of Nursing, Manipal Academy of Higher
Education, India
E-mail: mamatha.spai@manipal.edu

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