"At fingers' ends": Risk factors and perinatal outcome of pregnancies complicated by digital malformations

Objective: To identify the incidence, risk factors, and perinatal outcome of newborns with congenital finger or toe (digital) anomalies. Method: A retrospective study including all neonates born at a tertiary medical center during 2001-2006 with congenital digital anomalies was conducted. The comparison group consisted of newborns without such anomalies born during the same period. Results: Of 115,876 newborns delivered during the study period, 360 (31 per 10,000) were diagnosed with digital anomalies. Polydactyly was the most common diagnosis (n = 263; 73% of digital anomalies). Associated anomalies in these patients were congenital heart malformations (n = 93; 25.8% of the newborns with congenital digital anomalies), central nervous system anomalies (n = 17; 4.7%), and musculoskeletal anomalies (n = 13; 3.6%). Newborns with congenital digital anomalies were more likely to be males (62.2 vs. 37.8%; P < 0.001), and of a Bedouin Arab descent compared to Jewish ethnicity (61.4 vs. 38.6%; P = 0.004). Significantly higher rates of severe pre-eclampsia, recurrent abortions, transverse lie, and low birth-weight (<2,500 g) infants were found among newborns with digital anomalies. Conclusions: The incidence of digital anomalies can vary according to the population characteristics. It may be associated with other skeletal and non-skeletal malformations as well as with certain adverse obstetrical and perinatal outcomes. If a fetal digit anomaly is suspected, a detailed assessment of fetal anatomy is mandatory to exclude other malformations.