A comprehensive survey of congenital malformations in three governorates of Southern Iraq (Basrah, Misan, and Thi Qar), 2020–2023

In Southern Iraq, as in other regions, neonates and infants suffer from health problems due to different potential risk factors leading to congenital malformations, which can result in either mortality or lifelong disability. Given the limited number of studies on congenital malformations in Iraq, especially in the south, this study surveyed malformations over four years to provide a clearer picture of their incidence and causes. Retrospective data on congenital malformations in South Iraq's governorates of Basrah, Misan, and Thi Qar from Health Directorates were derived and then analysed. The study classified malformations into six groups based on affected organ systems. Several variables were considered potential risk factors, including parental age, consanguinity, family history, place of residence, birth status, sex, and birth weight. A total of 365,106, 140,246, and 237,302 births were recorded in hospitals in Basrah, Misan, and Thi Qar, respectively, during the period from 2020 to 2023. Among them, the rate of congenital malformations per 1000 births was 2.13 in Basrah, 2.34 in Misan, and 2.91 in Thi Qar. The overall prevalence across the southern region was 2.42 per 1000. Nervous and circulatory system malformations were the most common types. The study did not identify any statistically significant temporal trends in malformations, either at the level of individual governorates or the region as a whole. Several significant associations emerged from the analysis. Malformations of the nerv [Formula: see text]. Limb and cleft lip and palate malformations were more commonly linked to parental consanguinity and a positive family history. Birth status, sex, and birth weight also showed significant associations with malformation type, while no meaningful association was found with place of residence. The low incidence of malformations reported does not necessarily reflect the actual situation in the region. Therefore, the study calls for addressing the underlying causes by improving hospital documentation systems, implementing modern recording methods, and ensuring accurate case reporting.