Antenatal Detection of Paediatric Surgical Congenital Abnormalities and its Impact on Maternal Anxiety: A Multicentre Prospective Study in a Middle-Income Country

Background : In middle-income countries, healthcare systems face unique challenges in ensuring timely antenatal detection of congenital abnormalities that require paediatric surgical intervention. Early detection can significantly improve outcomes, yet resource constraints often limit access to diagnostic technologies. This study evaluates the antenatal detection rate of congenital abnormalities referred to paediatric surgical services in three Malaysian tertiary centres and examines its effect on maternal anxiety. Methods : A prospective observational study was conducted at Hospital Raja Permaisuri Bainun (HRPB), Hospital Sultanah Aminah (HSA), and University of Malaya Medical Centre (UMMC) over a 8 month period. Data were collected from mothers of neonates born with congenital abnormalities, and the Spielberg State-Trait Anxiety Inventory (STAI) was used to assess maternal anxiety. Results : A total of 58 patients were recruited. The overall antenatal detection rate for congenital abnormalities was 43.1%, comparable to high-income countries despite resource limitations. Antenatal counselling by paediatric surgeons was rare (6.9%) and showed no significant reduction in maternal anxiety (p = 0.374). Conclusion : The antenatal detection rates at the three Malaysian centres align with those in more developed nations, underscoring the potential of middle-income healthcare systems to deliver high-quality prenatal care. However, improving access to diagnostic technologies and involving paediatric surgical teams in antenatal counselling could further enhance care.