Maternal risk factors associated with birth defects in newborns: a case-control study in the Lviv Region (Ukraine) in 2002–2025

Background. Birth defects (BDs) are a major cause of neonatal morbidity and mortality worldwide. Maternal socioeconomic, behavioral, and health factors may contribute to abnormal fetal development. Objective: to assess the association between maternal education, behavioral factors, and selected health conditions with BDs among newborns in the Lviv Region (Ukraine). Materials and methods. A case-control study was conducted using medical records from maternity hospitals in the Lviv Region (2002–2025). A total of 1,455 newborns with BDs and 1,448 healthy newborns (controls) were analyzed. Maternal education, reproductive history, lifestyle habits, endocrine disorders, extragenital diseases, and gynecological infections were evaluated. Results. Maternal educational level varied significantly between groups (p < 0.01). Mothers with incomplete secondary education were more frequent in the BDs group (10.2 vs. 1.6 %; odds ratio (OR) = 7.069; 95% confidence interval (CI): 4.528–11.036, p < 0.01), while there were less women with higher education in this group (24.5 vs. 30.2 %; OR = 0.811; 95% CI: 0.719–0.914; p < 0.01). Smoking (13.5 vs. 5.5 %; OR = 2.69; 95% CI: 2.06–3.52; p < 0.001) and alcohol consumption (2.0 vs. 0.14 %; OR = 14.6; 95% CI: 3.5–61.2; p < 0.001) were more prevalent among mothers of affected newborns. Endocrine disorders were more frequent in the BDs group (24.6 vs. 14.0 %; OR = 2.02; 95% CI: 1.68–2.43; p < 0.001), in most cases, it was thyroid diseases. Chronic extragenital disorders (33.1 vs. 22.0 %; OR = 1.501; 95% CI: 1.329–1.694; p < 0.01) and gynecological infections (24.1 vs. 19.3 %; OR = 1.248; 95% CI: 1.086–1.435; p < 0.01) were also significantly associated with BDs. No significant differences were observed between age at menarche, menstrual cycle characteristics, or hormonal contraceptive use (p > 0.05). Conclusions. Maternal socioeconomic, behavioral, and health-related factors may in common influence the risk of BDs, supporting their multifactorial etiology and the role of modifiable determinants. Further large-scale population studies are needed to clarify causal mechanisms.