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Robinson K, Parrish R, Adeyemo WL, Beaty TH, Butali A, Buxó CJ, Gowans LJJ, Hecht JT, Moreno Uribe L, Murray JC, Shaw GM, Weinberg SM, Brand H, Marazita ML, Cutler DJ, Epstein MP, Yang J, Leslie EJ. Genome-wide study of gene-by-sex interactions identifies risks for cleft palate. Hum Genet 2024:10.1007/s00439-024-02704-y. [PMID: 39361040 DOI: 10.1007/s00439-024-02704-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 09/10/2024] [Indexed: 10/09/2024]
Abstract
Structural birth defects affect 3-4% of all live births and, depending on the type, tend to manifest in a sex-biased manner. Orofacial clefts (OFCs) are the most common craniofacial structural birth defects and are often divided into cleft lip with or without cleft palate (CL/P) and cleft palate only (CP). Previous studies have found sex-specific risks for CL/P, but these risks have yet to be evaluated in CP. CL/P is more common in males and CP is more frequently observed in females, so we hypothesized there would also be sex-specific differences for CP. Using a trio-based cohort, we performed sex-stratified genome-wide association studies (GWAS) based on proband sex followed by a genome-wide gene-by-sex (G × S) interaction testing. There were 13 loci significant for G × S interactions, with the top finding in LTBP1 (RR = 3.37 [2.04-5.56], p = 1.93 × 10-6). LTBP1 plays a role in regulating TGF-β bioavailability, and knockdown in both mice and zebrafish lead to craniofacial anomalies. Further, there is evidence for differential expression of LTBP1 between males and females in both mice and humans. Therefore, we tested the association between the imputed genetically regulated gene expression of genes with significant G × S interactions and the CP phenotype. We found significant association for LTBP1 in cell cultured fibroblasts in female probands (p = 0.0013) but not in males. Taken altogether, we show there are sex-specific risks for CP that are otherwise undetectable in a combined sex cohort, and LTBP1 is a candidate risk gene, particularly in females.
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Affiliation(s)
- Kelsey Robinson
- Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Randy Parrish
- Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
- Department of Biostatistics and Bioinformatics, Emory University School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, 101017, Nigeria
| | - Terri H Beaty
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Azeez Butali
- Department of Oral Biology, Radiology, and Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - Carmen J Buxó
- School of Dental Medicine, University of Puerto Rico, San Juan, PR, 00925, USA
| | - Lord J J Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jacqueline T Hecht
- Department of Pediatrics, McGovern Medical School, University of Texas Health at Houston, Houston, TX, 77030, USA
| | - Lina Moreno Uribe
- Department of Orthodontics and The Iowa Institute for Oral Health Research, University of Iowa, Iowa City, IA, 52242, USA
| | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, 52242, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University, Stanford, CA, 94305, USA
| | - Seth M Weinberg
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, 15260, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Harrison Brand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Mary L Marazita
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, 15260, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - David J Cutler
- Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Michael P Epstein
- Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Jingjing Yang
- Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA
| | - Elizabeth J Leslie
- Department of Human Genetics, Emory University, Atlanta, GA, 30322, USA.
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Luo P, Li Q, Yan B, Xiong Y, Li T, Ding X, Mei B. Prevalence, characteristics and risk factors of birth defects in central China livebirths, 2015-2022. Front Public Health 2024; 12:1341378. [PMID: 39360259 PMCID: PMC11445127 DOI: 10.3389/fpubh.2024.1341378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 09/06/2024] [Indexed: 10/04/2024] Open
Abstract
Objective This study analyzed the prevalence, epidemiological characteristics and risk factors of birth defects among livebirths in central China, aiming to provide evidences for the prevention of birth defects and government Decision-makings. Methods Birth data from China's Hubei Province between 2015 and 2022 were collected, including basic information of the livebirths, the mothers and the fathers, as well as information about delivery and each prenatal examination. The livebirths prevalence of birth defects was calculated and the trends were mapped. The basic characteristics of birth defects were evaluated by the difference analysis between case and health groups. Univariate and multivariate Poisson regression was performed to examine the independent risk factors for birth defects. Results Among 43,568 livebirths, 166 livebirths were born with birth defects, resulted in a total prevalence rate of 3.81 per 1,000 livebirths, showing a remarkable uptrend from 0.41per 1,000 livebirths in 2015 to 9.23 per 1,000 livebirths in 2022. The peak of the prevalence was in January and February. Congenital malformation of the musculoskeletal system was the main type of birth defect in central China livebirths, followed by cleft lip and cleft palate. Overall, newborns with birth defect had significantly earlier delivery gestational age, poorer health and higher proportion of infants with low birth weight than healthy births. The gender of livebirths, excess weight at delivery (≥80 kg) of mothers, more than 2 times of gravidity or parity of mothers, and advanced paternal age (≥40 years) were independent risk factors for birth defects (or specific birth defects). Conclusion The livebirths prevalence of birth defects shows increasing trend in central China, which deserves the attention of the government and would-be parents. Elevated paternal age, excess maternal weight, gravidity and parity should be considered when planning their families.
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Affiliation(s)
- Ping Luo
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - Qian Li
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - Bin Yan
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - Yusha Xiong
- Department of Laboratory Medicine, Gongan County Maternal and Child Health Care Hospital, Jingzhou, China
| | - Ting Li
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - Xiao Ding
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - Bing Mei
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
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Zhou X, Zeng X, Fang J, He J, Kuang H, Hua X, Wang A. Comparison of total prevalence, perinatal prevalence, and livebirth prevalence of birth defects in Hunan Province, China, 2016-2020. Front Public Health 2024; 12:1297426. [PMID: 39324160 PMCID: PMC11422065 DOI: 10.3389/fpubh.2024.1297426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 07/08/2024] [Indexed: 09/27/2024] Open
Abstract
Objective Birth defect of any type is undesirable and often pose a negative impact on the health and development of the newborn. Birth defects surveillance with datasets from surveillance health-related programs are useful to predict the pattern of birth defects and take preventive measures. In this study, the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects were compared. Methods Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016-2020. The total prevalence is the number of birth defects (including livebirths, stillbirths, and selective terminations of pregnancy) per 1,000 births (including livebirths and stillbirths). The perinatal prevalence is the number of birth defects (between 28 weeks gestation and 7 days postpartum) per 1,000 births. The livebirth prevalence is the number of liveborn birth defects per 1,000 births (unit: ‰). Underestimated proportion (unit: %) is the reduction level of perinatal prevalence or livebirth prevalence compared to the total prevalence. Prevalence with 95% confidence intervals (CI) was calculated using the log-binomial method. Chi-square tests (χ 2) were used to examine if significant differences existed in prevalence or underestimated proportion between different groups. Results A total of 847,755 births were included in this study, and 23,420 birth defects were identified, including 14,459 (61.74%) birth defects with gestational age > =28 weeks, and 11,465 (48.95%) birth defects in livebirths. The total prevalence, perinatal prevalence, and livebirth prevalence of birth defects were 27.63‰ (95%CI, 27.27-27.98), 17.06‰ (95%CI, 16.78-17.33), and 13.52‰ (95%CI, 13.28-13.77), respectively, and significant differences existed between them (χ2 = 4798.55, p < 0.01). Compared to the total prevalence, the perinatal prevalence and livebirth prevalence were underestimated by 38.26 and 51.05%, respectively. Significant differences existed between the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects in all subgroups according to year, sex, residence, and maternal age (p < 0.05). Significant differences existed between the total prevalence, perinatal prevalence, and livebirth prevalence for 17 specific defects: congenital heart defect, cleft lip-palate, Down syndrome, talipes equinovarus, hydrocephalus, limb reduction, cleft lip, omphalocele, anal atresia, anencephaly, spina bifida, diaphragmatic hernia, encephalocele, gastroschisis, esophageal atresia, bladder exstrophy, and conjoined twins (p < 0.05). In comparison, no significant difference existed between the total prevalence, perinatal prevalence, and livebirth prevalence for 6 specific defects: polydactyly, other external ear defects, syndactyly, hypospadias, cleft palate, and anotia/microtia (p > 0.05). Conclusion The total prevalence and livebirth prevalence of birth defects in Hunan Province, China, was not well studied. A systematic study was conducted to compare the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects. The study reveals that significant differences existed between the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects (including many specific defects), and year, sex, residence, and maternal age had significant impacts on it. The outcomes of the study will help to take preventive measures for birth defects as well as benefit the people involving public health and policymakers to improve the current scenario.
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Affiliation(s)
- Xu Zhou
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Xiu Zeng
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Junqun Fang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Jian He
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Haiyan Kuang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Xinjun Hua
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Aihua Wang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
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Majani NG, Koster JR, Kalezi ZE, Letara N, Nkya D, Mongela S, Kubhoja S, Sharau G, Mlawi V, Grobbee DE, Slieker MG, Chillo P, Janabi M, Kisenge P. Spectrum of Heart Diseases in Children in a National Cardiac Referral Center Tanzania, Eastern Africa: A Six-Year Overview. Glob Heart 2024; 19:61. [PMID: 39100942 PMCID: PMC11295910 DOI: 10.5334/gh.1342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/10/2024] [Indexed: 08/06/2024] Open
Abstract
Background While communicable diseases have long been the primary focus of healthcare in Africa, the rising impact of paediatric and congenital heart disease (CHD) cannot be overlooked. This research aimed to estimate the frequency and pattern of heart diseases in children who underwent their first echocardiography at a national cardiac referral hospital in Tanzania. Methods A retrospective observational study was conducted on children aged 0 to 18 years referred for first-time cardiological evaluation from January 2017 to December 2022. Retrieval of social and echocardiogram data and descriptive analysis were performed. Results There were 6,058 children with complete reports. Of these, 52.8% (3,198) had heart disease, of whom 2,559 (80%) had CHD, while (340/639; 53.2%) with acquired heart disease (AHD) had rheumatic heart disease (RHD). Children with CHD had a median age 1.0 years (IQR: 0.3-3.5) and were predominantly 51.2% male. Children with RHD had a median age 9.7 years (IQR: 3.2-13.8) with equal gender distribution. Shunt lesions were common in 1,487 (58.1%), mainly VSD 19.3%, PDA 19.1%, ASD 15.1%, and atrioventricular septal defect (AVSD) 4.6%. Pulmonary valve stenosis was in 97 (3.8%). Around 35% (718) had cyanotic CHD, with TOF being most common (13.3%), followed by double outlet right ventricle (DORV) (3.6%). Compared to global average truncus arteriosus was higher in 69 (2.3%) children. In contrast, TGA and hypoplastic left heart syndrome (HLHS) were lower than the estimated global average seen in 2.3% and 0.5% of the cases, respectively. Atresia of the right-side valves was more common (174 vs. 24), and approximately 40% of the patients referred for first-time echocardiographic evaluation required hospitalization. Conclusion Congenital heart disease is the primary cause of heart disease in children presenting at a national referral hospital, surpassing RHD. With its distinct distribution pattern, acyanotic lesions are more frequent than cyanotic heart diseases. The observed late referral tendencies suggest improving the referral system, enhancing CHD awareness among healthcare professionals, and instituting nationwide screening programs.
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Affiliation(s)
- Naizihijwa G. Majani
- Department of Pediatric Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Joëlle R. Koster
- Faculty of Medicine, University of Utrecht, Utrecht, The Netherlands
| | - Zawadi E. Kalezi
- Department of Pediatric Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Nuru Letara
- Department of Pediatric Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Deogratias Nkya
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Stella Mongela
- Department of Pediatric Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Sulende Kubhoja
- Department of Pediatric Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Godwin Sharau
- Department of Pediatric Cardiac Surgery, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Vivienne Mlawi
- Department of Pediatric Cardiac Surgery, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Diederick E. Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Martijn. G. Slieker
- Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, Utrecht, The Netherlands
| | - Pilly Chillo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Peter Kisenge
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
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Zhou X, He J, Wang A, Hua X, Li T, Liu Q, Fang J, Jiang Y, Shi Y. Fetal deaths from birth defects in Hunan Province, China, 2016-2020. Sci Rep 2024; 14:15163. [PMID: 38956101 PMCID: PMC11219750 DOI: 10.1038/s41598-024-65985-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
To describe the fetal death rate of birth defects (including a broad range of specific defects) and to explore the relationship between fetal deaths from birth defects and a broad range of demographic characteristics. Data was derived from the birth defects surveillance system in Hunan Province, China, 2016-2020. Fetal death refers to the intrauterine death of a fetus at any time during the pregnancy, including medical termination of pregnancy. Fetal death rate is the number of fetal deaths per 100 births (including live births and fetal deaths) in a specified group (unit: %). The fetal death rate of birth defects with 95% confidence intervals (CI) was calculated by the log-binomial method. Crude odds ratios (ORs) were calculated to examine the relationship between each demographic characteristic and fetal deaths from birth defects. This study included 847,755 births, and 23,420 birth defects were identified. A total of 11,955 fetal deaths from birth defects were identified, with a fetal death rate of 51.05% (95% CI 50.13-51.96). 15.78% (1887 cases) of fetal deaths from birth defects were at a gestational age of < 20 weeks, 59.05% (7059 cases) were at a gestational age of 20-27 weeks, and 25.17% (3009 cases) were at a gestational age of ≥ 28 weeks. Fetal death rate of birth defects was higher in females than in males (OR = 1.25, 95% CI 1.18-1.32), in rural than in urban areas (OR = 1.43, 95% CI 1.36-1.50), in maternal age 20-24 years (OR = 1.35, 95% CI 1.25-1.47), and ≥ 35 years (OR = 1.19, 95% CI 1.11-1.29) compared to maternal age of 25-29 years, in diagnosed by chromosomal analysis than ultrasound (OR = 6.24, 95% CI 5.15-7.55), and lower in multiple births than in singletons (OR = 0.41, 95% CI 0.36-0.47). The fetal death rate of birth defects increased with the number of previous pregnancies (χ2trend = 49.28, P < 0.01), and decreased with the number of previous deliveries (χ2trend = 4318.91, P < 0.01). Many fetal deaths were associated with birth defects. We found several demographic characteristics associated with fetal deaths from birth defects, which may be related to the severity of the birth defects, economic and medical conditions, and parental attitudes toward birth defects.
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Affiliation(s)
- Xu Zhou
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Jian He
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Aihua Wang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - XinJun Hua
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Ting Li
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Qin Liu
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Junqun Fang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Yurong Jiang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China
| | - Yingrui Shi
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, Hunan Province, China.
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Kang LY, Guo ZR, Shang WJ, Cao GY, Zhang YP, Wang QM, Shen HP, Liang WN, Liu M. Perinatal prevalence of birth defects in the Mainland of China, 2000-2021: a systematic review and meta-analysis. World J Pediatr 2024; 20:669-681. [PMID: 38340146 DOI: 10.1007/s12519-023-00786-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/06/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Although birth defects are of great concern globally, the latest national prevalence has not yet been quantified in China. We conducted a systematic review and meta-analysis to estimate the perinatal prevalence of birth defects in the Mainland of China between 2000 and 2021. METHODS We performed a systematic literature search of six databases for relevant articles published between January 1, 2000, and March 1, 2023. We included published studies that reported data on the perinatal prevalence of birth defects in the Mainland of China. The DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and its 95% confidence interval (CI). We also conducted subgroup analyses and univariable meta-regressions to explore differences in prevalence by time period, geographic region, and other characteristics. RESULTS We included 254 studies reporting the perinatal prevalence of birth defects and 86 studies reporting only the prevalence of specific types of birth defects. Based on 254 studies covering 74,307,037 perinatal births and 985,115 cases with birth defects, the pooled perinatal prevalence of birth defects was 122.54 (95% CI 116.20-128.89) per 10,000 perinatal births in the Mainland of China during 2000-2021. Overall, the perinatal prevalence of birth defects increased from 95.60 (86.51-104.69) per 10,000 in 2000-2004 to 208.94 (175.67-242.22) per 10,000 in 2020-2021. There were also significant disparities among different geographical regions. Congenital heart defects (33.35 per 10,000), clefts of the lip and/or palate (13.52 per 10,000), polydactyly (12.82 per 10,000), neural tube defects (12.82 per 10,000), and inborn errors of metabolism (11.41 per 10,000) were the five most common types of birth defects. The perinatal prevalence among males was significantly higher than that among females (β = 2.44 × 10-3, P = 0.003); a higher perinatal prevalence of birth defects was observed among perinatal births whose mothers were ≥ 35 years (β = 4.34 × 10-3, P < 0.001). CONCLUSION Comprehensive and sustained efforts are needed to strengthen surveillance and detection of birth defects, improve prenatal and postnatal healthcare, and promote rehabilitation, especially in underdeveloped areas.
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Affiliation(s)
- Liang-Yu Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Vanke School of Public Health, Tsinghua University, No. 1, Tsinghua Garden, Haidian District, Beijing, 100084, China
| | - Zi-Rui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Wei-Jing Shang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Gui-Ying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yi-Ping Zhang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, China
| | - Qiao-Mei Wang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, China
| | - Hai-Ping Shen
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, China
| | - Wan-Nian Liang
- Vanke School of Public Health, Tsinghua University, No. 1, Tsinghua Garden, Haidian District, Beijing, 100084, China.
- Institute of Healthy China, Tsinghua University, No. 1, Tsinghua Garden, Haidian District, Beijing, 100084, China.
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education Beijing, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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Farhadi Hassankiadeh R, Dobson A, Rahimi S, Jalilian A, Schmid VJ, Mahaki B. Spatial Distribution and Birth Prevalence of Congenital Heart Disease in Iran: A Systematic Review and Hierarchical Bayesian Meta-analysis. Int J Health Policy Manag 2024; 13:7931. [PMID: 39099509 PMCID: PMC11270618 DOI: 10.34172/ijhpm.2024.7931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/07/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND This study aimed to comprehensively analyze the overall congenital heart disease (CHD) prevalence in live births and children in Iran, along with evaluating the spatial distribution of CHD birth prevalence across various geographical regions within the country. METHODS A Bayesian hierarchical meta-analysis (PROSPERO 2022: CRD42022331281) was performed to determine the pooled prevalence. A systematic search was conducted using Web of Science, ScienceDirect, PubMed, Iranian Research Institute for Information Science and Technology (IranDoc), Scientific Information Database (SID), and Magiran until October 4, 2023. Cross-sectional and cohort studies in both English and Persian languages, focusing on the age range of 0-10 years, were considered for the study population. The study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) Risk of Bias tool. Heterogeneity was assessed by I2 and τ2 statistics, and publication bias by Egger's and Begg's tests. RESULTS The meta-analysis included 62 studies, revealing an overall CHD prevalence of 2.5 per 1000 births. Over time, CHD birth prevalence in Iran has consistently increased. Spatial distribution analysis, including spatial autocorrelation and local spatial autocorrelation, indicated no spatial clustering (P=.46) or aggregation (P=.65) among Iran's provinces. Geographic disparities were significant (P=.000), with the northern and eastern regions showing the highest and lowest CHD prevalence, respectively. CONCLUSION The overall CHD prevalence in Iran is lower than global rates, but it continues to rise. Furthermore, there are variations in birth prevalence among different regions of Iran. Environmental, genetic, socioeconomic, and diagnostic accessibility differences are possibly involved in regional variation. The limitations like heterogeneity among studies, the potential inaccuracy of reports due to limited use of accurate diagnostic methods in some studies, and the absence of population-based models to investigate prevalence, underscore the urgent need for standardized diagnostic approaches, and the utilization of population-wide birth defect registries to accurately assess CHD prevalence in Iran.
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Affiliation(s)
| | - Annette Dobson
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Somayeh Rahimi
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Volker J. Schmid
- Department of Statistics, LudwigMaximilians-University, Munich, Germany
| | - Behzad Mahaki
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Robinson K, Parrish R, Adeyemo WL, Beaty TH, Butali A, Buxó CJ, Gowans LJ, Hecht JT, Moreno L, Murray JC, Shaw GM, Weinberg SM, Brand H, Marazita ML, Cutler DJ, Epstein MP, Yang J, Leslie EJ. Genome-wide study of gene-by-sex interactions identifies risks for cleft palate. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.01.24306701. [PMID: 38746184 PMCID: PMC11092717 DOI: 10.1101/2024.05.01.24306701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Structural birth defects affect 3-4% of all live births and, depending on the type, tend to manifest in a sex-biased manner. Orofacial clefts (OFCs) are the most common craniofacial structural birth defects and are often divided into cleft lip with or without cleft palate (CL/P) and cleft palate only (CP). Previous studies have found sex-specific risks for CL/P, but these risks have yet to be evaluated in CP. CL/P is more common in males and CP is more frequently observed in females, so we hypothesized there would also be sex-specific differences for CP. Using a trio-based cohort, we performed sex-stratified genome-wide association studies (GWAS) based on proband sex followed by a genome-wide gene-by-sex (GxS) interaction testing. There were 13 loci significant for GxS interactions, with the top finding in LTBP1 (RR=3.37 [2.04 - 5.56], p=1.93x10 -6 ). LTBP1 plays a role in regulating TGF-B bioavailability, and knockdown in both mice and zebrafish lead to craniofacial anomalies. Further, there is evidence for differential expression of LTBP1 between males and females in both mice and humans. Therefore, we tested the association between the imputed genetically regulated gene expression of genes with significant GxS interactions and the CP phenotype. We found significant association for LTBP1 in cell cultured fibroblasts in female probands (p=0.0013) but not in males. Taken altogether, we show there are sex-specific risks for CP that are otherwise undetectable in a combined sex cohort, and LTBP1 is a candidate risk gene, particularly in females.
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Choubey U, Srinivas V, Trivedi YV, Garg N, Gupta V, Jain R. Regenerating the ailing heart: Stem cell therapies for hypoplastic left heart syndrome. Ann Pediatr Cardiol 2024; 17:124-131. [PMID: 39184114 PMCID: PMC11343389 DOI: 10.4103/apc.apc_24_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 08/27/2024] Open
Abstract
Hypoplastic left heart syndrome (HLHS) is a complex congenital heart defect (CHD) characterized by a spectrum of underdeveloped left-sided cardiac structures. It is a serious defect and warrants either 3-staged surgical palliation or a heart transplant. Despite numerous surgical advancements, long-term outcomes remain challenging and still have significant morbidity and mortality. There have been notable advancements in stem cell therapy for HLHS, including developments in diverse stem cell origins and methods of administration. Clinical trials have shown safety and potential benefits, including improved ventricular function, reduced heart failure, and fewer adverse events. Younger myocardium seems particularly receptive to stem cell signals, suggesting the importance of early intervention. This review explores the potential of emerging stem cell-based therapies as an adjunctive approach to improve the outcomes for HLHS patients.
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Affiliation(s)
- Udit Choubey
- Department of General Surgery, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
| | - Varsha Srinivas
- Department of Internal Medicine, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
| | - Yash Vardhan Trivedi
- Department of Internal Medicine, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Nikita Garg
- Department of Pediatric College, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Vasu Gupta
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA
| | - Rohit Jain
- Penn State Milton S Hershey Medical Center, Hershey, PA, USA
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Kumar N, Yadav A. Influence of fetal gender on overall perinatal outcome: a prospective observational study. Minerva Pediatr (Torino) 2023; 75:795-802. [PMID: 32241105 DOI: 10.23736/s2724-5276.20.05650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Fetal gender is considered as one of significant predictors of pregnancy and perinatal outcome. The aim of this study is to assess impact of fetal gender on perinatal outcome. METHODS Present observational study was conducted in Obstetrics and Gynecology department of rural tertiary center of Northern India over one year (January-December 2018) on all randomly selected antenatal women at gestation ≥28 weeks, delivering by any route (cesarean/vaginal) and fulfilling inclusion criteria were enrolled. Immediately after delivery, neonatal birth weight was measured using table top beam weighing scale. Apgar scores at 1- and 5-minutes, Neonatal Intensive Care Unit admission, neonatal complications were assessed by pediatrician. Adverse perinatal outcome including neonatal morbidities (prematurity, neonatal intensive care unit admission, neonatal complications) and perinatal mortality were compared between two genders. Statistical analysis was done using SPSS 22 version software. RESULTS Of 3085 delivered neonates, 1450 (47%) were females, 1,633(52.9%) males and two (0.06%) had ambiguous genitalia, hence excluded. Mean values for neonatal birth weight for males was 2.77±0.540 kg and females 2.65±0.506 kg (P=0.0000). One- and 5-minute Apgar scores for male neonate were 6.81±1.565, 8.51±1.841 and for females 6.98±1.184, 8.70±1.383, respectively (P=0.001). NICU admission rate, need for oxygen and intubation, complications were significantly higher for male neonates (P<0.05) whereas females had higher incidence of intra-uterine growth restriction (P=0.000). Intra-uterine deaths were also more common with male gender (P=0.007). No significant difference was observed between two genders in relation to gestation at birth (P>0.05). CONCLUSIONS Male neonates had higher birth weight, but adverse perinatal outcome as compared to females.
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Affiliation(s)
- Naina Kumar
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri, India -
| | - Ashu Yadav
- Department of Obstetrics and Gynecology, Institute of Medical Sciences and Research, Maharishi Markandeshwar, Ambala, India
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Zhou X, Xie D, He J, Jiang Y, Fang J, Wang H. Perinatal deaths from birth defects in Hunan Province, China, 2010-2020. BMC Pregnancy Childbirth 2023; 23:790. [PMID: 37957594 PMCID: PMC10644441 DOI: 10.1186/s12884-023-06092-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE To describe the perinatal mortality rate (PMR) of birth defects and to define the relationship between birth defects (including a broad range of specific defects) and a broad range of factors. METHODS Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2010-2020. The prevalence rate (PR) of birth defects is the number of birth defects per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond). PMR is the number of perinatal deaths per 100 fetuses. PR and PMR with 95% confidence intervals (CI) were calculated using the log-binomial method. Chi-square trend tests (χ2trend) were used to determine trends in PR and PMR by year, maternal age, income, education level, parity, and gestational age of termination. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with perinatal deaths attributable to birth defects. RESULTS Our study included 1,619,376 fetuses, a total of 30,596 birth defects, and 18,212 perinatal deaths (including 16,561 stillbirths and 1651 early neonatal deaths) were identified. The PR of birth defects was 18.89‰ (95%CI: 18.68-19.11), and the total PMR was 1.12%(95%CI: 1.11-1.14). Birth defects accounted for 42.0% (7657 cases) of perinatal deaths, and the PMR of birth defects was 25.03%. From 2010 to 2020, the PMR of birth defects decreased from 37.03% to 2010 to 21.00% in 2020, showing a downward trend (χ2trend = 373.65, P < 0.01). Congenital heart defects caused the most perinatal deaths (2264 cases); the PMR was 23.15%. PMR is highest for encephalocele (86.79%). Birth defects accounted for 45.01% (7454 cases) of stillbirths, and 96.16% (7168 cases) were selective termination of pregnancy. Perinatal deaths attributable to birth defects were more common in rural than urban areas (31.65% vs. 18.60%, OR = 2.03, 95% CI: 1.92-2.14) and in females than males (27.92% vs. 22.68%, OR = 1.32, 95% CI: 1.25-1.39). PMR of birth defects showed downward trends with rising maternal age (χ2trend = 200.86, P < 0.01), income (χ2trend = 54.39, P < 0.01), maternal education level (χ2trend = 405.66, P < 0.01), parity (χ2trend = 85.11, P < 0.01) and gestational age of termination (χ2trend = 15297.28, P < 0.01). CONCLUSION In summary, birth defects are an important cause of perinatal deaths. Rural areas, female fetuses, mothers with low maternal age, low income, low education level, low parity, and low gestational age of termination were risk factors for perinatal deaths attributable to birth defects. Future studies should examine the mechanisms. Our study is helpful for intervention programs to reduce the PMR of birth defects.
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Affiliation(s)
- Xu Zhou
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
| | - Donghua Xie
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China
| | - Jian He
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China
| | - Yurong Jiang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
| | - Junqun Fang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan Province, China.
| | - Hua Wang
- The Hunan Children's Hospital, Changsha, Hunan Province, China.
- National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.
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Pugnaloni F, Felici A, Corno AF, Marino B, Versacci P, Putotto C. Gender differences in congenital heart defects: a narrative review. Transl Pediatr 2023; 12:1753-1764. [PMID: 37814719 PMCID: PMC10560357 DOI: 10.21037/tp-23-260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/25/2023] [Indexed: 10/11/2023] Open
Abstract
Background and Objective Congenital heart defects (CHD) represent the most frequent human birth defects, occurring in almost 1% of all live newborns. Understanding the effects of gender in the prevalence of CHD has a key role in defining personalized prevention, disease identification, prognosis definition and individualized therapeutic strategies. Recently, the attempt to achieve a holistic approach to patients with CHD cannot be separated from accounting for existing gender differences. The main aim of this narrative review is to provide an overview of gender differences in the epidemiology of CHD. Methods A standardized research through three electronic databases (PubMed/Scopus/Embase) was performed using a combination of keywords and Medical Subject Headings (MeSH) terms to include congenital heart diseases, gender difference(s), prevalence. Observational, prospective, population based and retrospective studies reporting gender differences in the prevalence of CHD were included. Conference abstracts were excluded as well as studies not written in English language and non-human studies. Further relevant papers were selected by hand-searching of the references list of selected articles. Key Content and Findings Search results returned 1,904 papers. Screening articles by title and abstracts resulted in 17 articles for full text review. Of these, 10 were included for analysis and additional 11 articles were included after hand searching review of reference lists. A total of 21 articles were included. Conclusions Our narrative review confirms that there is a significant gender variation in specific CHD subgroups. In particular, we summarized the evidence that there is a significantly greater risk for males to be born with severe CHD and for females with milder CHD subtypes. The etiology of the different distribution of CHD among genders is still under investigation and a deeper understanding of how gender influences the risk for CHD is warranted. In the future, a gender-based management of CHD should become an established medical approach.
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Affiliation(s)
- Flaminia Pugnaloni
- Department of Maternal Infantile and Urological Sciences, “Sapienza” University of Rome, Rome, Italy
- Area of Fetal, Neonatal, and Cardiological Sciences, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Alessandro Felici
- Department of Maternal Infantile and Urological Sciences, “Sapienza” University of Rome, Rome, Italy
| | | | - Bruno Marino
- Department of Maternal Infantile and Urological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Paolo Versacci
- Department of Maternal Infantile and Urological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Carolina Putotto
- Department of Maternal Infantile and Urological Sciences, “Sapienza” University of Rome, Rome, Italy
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Zhou Y, Yang D, Mao X, Zhou H, Wang L. Epidemiology of birth defects in a national hospital-based birth defect surveillance spot in Southern Jiangsu, China, 2014-2018. Front Med (Lausanne) 2023; 10:1138946. [PMID: 37766918 PMCID: PMC10520965 DOI: 10.3389/fmed.2023.1138946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 08/09/2023] [Indexed: 09/29/2023] Open
Abstract
Objective As the only hospital-based national surveillance spot of birth defects (BDs) in Changzhou city located in the economically developed eastern part of China, Changzhou Maternal and Child Health Care Hospital has encountered serious challenges in BD prevention. This study aimed to describe the epidemiology of total BDs born in the hospital from 2014 to 2018. Methods The data were collected from the national hospital-based birth defect surveillance system. BD prevalence was calculated by Poisson distribution. Trends of prevalence and the associations regarding information with BDs were analyzed by Poisson regression. Results The reported prevalence of total BDs was 313.92 (95% confidence interval [CI]: 299.59-328.76) per 10,000 perinatal infants (PIs), while the perinatal prevalence of BD was 160.19 (95% CI: 150.00-170.89) per 10,000 PIs. A remarkable uptrend in the prevalence of BDs was noticed with a prevalence rate ratio (PRR) of 1.09 (95% CI: 1.04-1.14) and 1.13 (95% CI: 1.09-1.16), respectively. Congenital heart disease (CHD), cleft lip with or without cleft palate (CL/P), congenital malformation of the kidney (CMK), polydactyly, Down syndrome (DS), cystic hygroma, neural tube defect (NTD), and congenital talipes equinovarus (CTE) were common types of total BDs. Mothers living in the urban area (PRR = 1.67, 95% CI:1.50-1.87), male fetuses (PRR = 1.16, 95% CI: 1.05-1.28), and maternal age younger than 20 (PRR = 2.28, 95% CI: 1.60-3.25) and 25 years (PRR = 1.41, 95% CI: 1.22-1.63) or older than 35 years (PRR = 1.18, 95% CI: 1.00-1.40) were risk factors for BD occurrence. Conclusion The reported prevalence of total BDs was nearly two times higher than the perinatal prevalence of BDs in PIs, and the ranks of total BDs and BDs in PIs were different. Mothers living in the urban area, male fetuses, and maternal ages younger than 25 or older than 35 years were risk factors for BD incidence. Thus, improving prenatal examination technology, expanding the surveillance time quantum of BDs, and keeping maternal health may be warranted.
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Affiliation(s)
- Ying Zhou
- Department of Health Emergency, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Di Yang
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
| | - Xueqin Mao
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
| | - Hua Zhou
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
| | - Li Wang
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
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Uguz F, Sharma V, Boyce P, Clark CT, Galbally M, Koukopoulos A, Marsh W, Stevens A, Viguera A. Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period: Clinical Scenario-Based Practical Recommendations From A Group of Perinatal Psychiatry Authors. J Clin Psychopharmacol 2023; 43:434-452. [PMID: 37683233 DOI: 10.1097/jcp.0000000000001740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
ABSTRACT Many women with bipolar disorder experience episodes of illness or relapses over the perinatal period, especially in the immediate postpartum period. Risks associated with treated/untreated psychopathologies and fetal exposure to bipolar medications make the management of bipolar disorder during these periods challenging for clinicians and patients. In light of the available effectiveness and reproductive safety data, the current clinical update based on the opinions of a group of international perinatal psychiatry authors recommends general considerations and specific management strategies for each possible clinical scenario, including mixed features, predominant polarity, diagnosis of subtypes of bipolar disorder, severity of previous episodes, and risk of recurrence of mood episodes.
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Affiliation(s)
- Faruk Uguz
- From the Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Verinder Sharma
- Schulich School of Medicine and Dentistry, The University of Western Ontario; Lawson Health Research Institute; Parkwood Institute Mental Health, Perinatal Mental Health Clinic, London Health Sciences Center, London, Ontario, Canada
| | - Philip Boyce
- Westmead Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Crystal T Clark
- Department of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Megan Galbally
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Alexia Koukopoulos
- University Hospital Policlinico Umberto I, La Sapienza University of Rome; Centro Lucio Bini, Rome, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School/UMass Memorial Medical Center, Worcester, MA.
| | - Anja Stevens
- Centre for Bipolar Disorders, Dimence Group, Deventer, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Psychiatry, the Netherlands
| | - Adele Viguera
- Cleveland Clinic, Cleveland Clinic Neurological Institute, Cleveland, OH
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15
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Peng Z, Wei J, Chen B, Huang X, Song P, Liang L, He J, Feng B, Que T, Qin J, Xie Y, Qiu X, Wei H, He S. Epidemiology of birth defects based on a birth defects surveillance system in southwestern China and the associated risk factors. Front Pediatr 2023; 11:1165477. [PMID: 37547102 PMCID: PMC10401059 DOI: 10.3389/fped.2023.1165477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background Birth defects (BDs) are associated with many potential risk factors, and its causes are complex. Objectives This study aimed to explore the epidemiological characteristics of BDs in Guangxi of China and the associated risk factors of BDs. Methods BDs data of perinatal infants (PIs) were obtained from the Guangxi birth defects monitoring network between 2016 and 2020. Univariate Poisson regression was used to calculate the prevalence-rate ratios (PRR) to explore the changing trends of BDs prevalence by year and the correlation between the regarding of characteristics of BDs (including infant gender, maternal age, and quarter) and BDs. Clinical characteristics of PIs with BDs and general characteristics of their mothers were documented, and Spearman correlation analysis was used to explore the potential associated risk factors of BDs. Results Between 2016 and 2020, 44,146 PIs with BDs were monitored, with an overall BDs prevalence of 121.71 (95% CI: 120.58-122.84) per 10,000 PIs, showing a significant increase trend (PRR = 1.116, 95% CI: 1.108-1.123), especially the prevalence of congenital heart defects (CHDs) that most significantly increased (PRR = 1.300, 95% CI: 1.283-1.318). The 10 most common BDs were CHDs, polydactyly, congenital talipes equinovarus, other malformation of external ear, syndactyly, hypospadias, cleft lip with cleft palate, cleft lip, hemoglobin Bart's hydrops fetalis syndrome (BHFS), and congenital atresia of the rectum and anus. BDs were positively correlated with pregnant women's age (R = 0.732, P < 0.01) and education level (R = 0.586, P < 0.05) and having pre-gestational diabetes mellitus (PGDM)/gestational diabetes mellitus (GDM) (R = 0.711, P < 0.01), while when the pregnant women had a family history of a dead fetus (R = -0.536, P < 0.05) and a birth of a fetus with BDs (R = -0.528, P < 0.05) were negatively correlated with BDs. Conclusion A significant increase in the prevalence of BDs was detected between 2016 and 2020 in Guangxi, especially the prevalence of CHDs that most significantly increased. Older maternal age, higher maternal education level, and having PGDM before pregnancy or GDM in early pregnancy were the risk factors for BDs.
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Affiliation(s)
- Zhenren Peng
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Jie Wei
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Biyan Chen
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Xiuning Huang
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Pengshu Song
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Lifang Liang
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Jiajia He
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Baoying Feng
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Ting Que
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Jie Qin
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Yu'an Xie
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Xiaoxia Qiu
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Hongwei Wei
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Sheng He
- Birth Defects Research Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning, China
- Birth Defects Research Laboratory, Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Birth Defects Research Laboratory, Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
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Zhao Y, Zhang H, Peng M, Zhou Y, Cheng X, Yang S, Zhang Z, Liu M, Li X, Jiang S. The burden of congenital birth defects between 1990 and 2019 in China: an observational study. Front Pediatr 2023; 11:1170755. [PMID: 37252046 PMCID: PMC10219611 DOI: 10.3389/fped.2023.1170755] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Background Congenital birth defects (CBDs) are a major public health issue. This study aims to assess trends in the burden of CBDs between 1990 and 2019 across China based on the Global Burden of Disease Study 2019 (GBD 2019). Methods Indicators of the burden of CBDs included incidence, mortality, and disability-adjusted life years (DALYs). Metrics included number, rate, and age-standardized rate with 95% uncertainty intervals (UIs). Data were stratified by region [China, global, high-, middle-, low-socio-demographic index (SDI)], age, sex, and type of CBD. Average annual percentage changes (AAPC) and trends were evaluated. Results In China, between 1990 and 2019, the age-standardized incidence rate for CBDs showed an increasing trend, with an AAPC of 0.26% (0.11% to 0.41%), reaching 148.12 per 105 person-years (124.03 to 176.33) in 2019. Most CBDs were congenital heart anomalies, with an AAPC of 0.12% (-0.08% to 0.32%). The age-standardized mortality rate for CBDs showed a decreasing trend, with an AAPC of -4.57% (-4.97% to -4.17%), reaching 4.62 per 105 person-years (3.88 to 5.57) in 2019. Most mortality was associated with congenital heart anomalies, with an AAPC of -3.77% (-4.35% to -3.19%). The age-standardized DALYs rate for CBDs showed a decreasing trend, with an AAPC of -3.74% (-3.95% to -3.52%), reaching 480.95 per 105 person-years (407.69 to 570.04) in 2019. Conclusions Morbidity associated with CBDs increased in China between 1990 and 2019, accelerated by the adoption of the two-child policy, and ranked high globally. These findings emphasize the need for prenatal screening and primary and secondary prevention strategies.
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Affiliation(s)
- Yajun Zhao
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haonan Zhang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Minghui Peng
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yemei Zhou
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xuelin Cheng
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shijia Yang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhaoyu Zhang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ming Liu
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Engineering Research Centre of AI Technology for Cardiopulmonary Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaopan Li
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Sunfang Jiang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China
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17
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Zhang M, Su Y, Sun YP. Gender bias in fetal malformations: A cross-sectional study in Asian populations. Front Endocrinol (Lausanne) 2023; 14:1146689. [PMID: 37065765 PMCID: PMC10101566 DOI: 10.3389/fendo.2023.1146689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 04/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to detect any gender bias in fetal malformation cases. DESIGN This study was a cross-sectional, quantitative survey. SUBJECTS Overall, 1,661 Asian fetal malformation cases involving induced abortions in the obstetrics department of the first Affiliated Hospital of Zhengzhou University from 2012 to 2021 were included. MAIN OUTCOME MEASURES Measurements of ultrasound detectable structural malformations were classified into 13 subtypes. Karyotyping, single nucleotide polymorphism (SNP) array, or sequencing diagnosis of these fetus was also included in the outcome measures. RESULTS The sex ratio (male/female) of all malformation types was 1.446. Cardiopulmonary had the highest proportion of all malformation types with 28%. Diaphragmatic hernia, omphalocele, gastroschisis, nuchal translucency (NT), and Multy malformations had significantly higher proportions of males (p < 0.05). Digestive system malformations had a significantly higher proportion of females (p < 0.05). Maternal age was associated with genetic factors (r = 0.953, p < 0.001) and inversely associated with brain malformations (r = -0.570, p = 0.002). More males were found with trisomy 21, trisomy 18, and monogenetic diseases, while duplications, deletions, and uniparental disomy (UPD) had similar sex ratios between males and females, but not statistically significant. CONCLUSION Sex differences are common with fetal malformations, with higher proportions of males. Genetic testing has been proposed to account for these differences.
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Affiliation(s)
- Meixiang Zhang
- Center for Reproductive Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yingchun Su
- Center for Reproductive Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ying-pu Sun
- Center for Reproductive Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- *Correspondence: Ying-pu Sun,
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18
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Daltveit DS, Klungsøyr K, Engeland A, Ekbom A, Gissler M, Glimelius I, Grotmol T, Madanat-Harjuoja L, Ording AG, Sørensen HT, Troisi R, Bjørge T. Sex differences in childhood cancer risk among children with major birth defects: a Nordic population-based nested case-control study. Int J Epidemiol 2022; 52:450-465. [PMID: 36179253 PMCID: PMC10114053 DOI: 10.1093/ije/dyac192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Childhood cancer is more common among children with birth defects, suggesting a common aetiology. Whether this association differs by sex is unclear. METHODS We performed a population-based nested case-control study using nationwide health registries in four Nordic countries. We included 21 898 cancer cases (0-19 years) and 218 980 matched population controls, born 1967-2014. Associations between childhood cancer and major birth defects were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) using logistic regression models. Effect modification was evaluated using a counterfactual framework to estimate confidence intervals and P-values for the natural indirect effects. RESULTS Birth defects were present for 5.1% (1117/21 898) of childhood cancer cases and 2.2% (4873/218 980) of controls; OR of cancer was higher for chromosomal (OR = 10, 95% CI = 8.6-12) than for non-chromosomal defects (OR = 1.9, 95% CI = 1.8-2.1), strongest between genetic syndromes/microdeletion and renal tumours, Down syndrome and leukaemia, and nervous system defects and central nervous system tumours. The association between birth defects and cancer was stronger among females (OR = 2.8, 95% CI = 2.6-3.1) than males (OR = 2.1, 95% CI = 1.9-2.2, Pinteraction <0.001). Male sex was an independent risk factor for childhood cancer, but very little of the overall association between sex and childhood cancer was mediated through birth defects (4.8%, PNIE <0.001), although more at younger ages (10% below years and 28% below 1 year). CONCLUSIONS The birth defect-cancer associations were generally stronger among females than males. Birth defects did not act as a strong mediator for the modest differences in childhood cancer risk by sex, suggesting that other biological pathways are involved.
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Affiliation(s)
- Dagrun Slettebø Daltveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Quality Registry of Cleft Lip and Palate, Surgical Clinic, Haukeland University Hospital, Bergen, Norway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Anders Ekbom
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland.,Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Glimelius
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Laura Madanat-Harjuoja
- Cancer Society of Finland, Finnish Cancer Registry, Helsinki, Finland.,Dana Farber Cancer Institute, Boston Children's Cancer and Blood Disorders Centre, Boston, MA, USA
| | - Anne Gulbech Ording
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Rebecca Troisi
- Trans-divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Cancer Registry of Norway, Oslo, Norway
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Khadka M, Agarwal J, Shrestha R, Das D. Birth Defects among Newborns in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:588-591. [PMID: 36705206 PMCID: PMC9297362 DOI: 10.31729/jnma.6610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 06/25/2022] [Indexed: 01/31/2023] Open
Abstract
Introduction The incidence of birth defects is 2-3% in the general population but it is increasing. An estimated 303,000 newborns die within 4 weeks of birth every year, worldwide, due to congenital anomalies. The objective of this study was to find out the prevalence of birth defects among newborns in a tertiary care centre. Methods A descriptive cross-sectional study was done in the Department of Obstetrics and Gynaecology and the Department of Paediatrics from 15 June 2016 and 14 June 2019. Ethical approval was obtained from the Institutional Review Committee (Reference number: 142/077/078-IRC). Data of newborns were collected from the hospital records. Convenience sampling method was used. Point estimate and 99% Confidence Interval were calculated. Results Among 32,695 newborns, birth defects were seen in 169 (0.51%) (0.41-0.61, 99% Confidence Interval). The most common birth defect was musculoskeletal defects seen in 60 (35.50%) newborns followed by central nervous system defect seen in 30 (17.75%) newborns. Conclusions The prevalence of birth defects among newborns was lower than in other studies done in a similar setting. Keywords birth defect; congenital malformation; prevalence.
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Affiliation(s)
- Madan Khadka
- Department of Obstetrics and Gynaecology, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal,Correspondence: Dr Madan Khadka, Department of Obstetrics and Gynaecology, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal. , Phone: +977-9846044743
| | - Jyoti Agarwal
- Department of Paediatrics, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Ramesh Shrestha
- Department of Obstetrics and Gynaecology, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Dipti Das
- Department of Obstetrics and Gynaecology, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
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Fernandes PS, Magalhães LR, Pezzini TR, de Sousa Santos EF, Calderon MG. Congenital heart diseases trends in São Paulo State, Brazil: a national live birth data bank analysis. World J Pediatr 2022; 18:472-481. [PMID: 35338440 DOI: 10.1007/s12519-022-00543-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/03/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Congenital heart diseases (CHD) are the most common type of birth defects, affecting millions of newborns every year; no prevalence data are available in São Paulo State, Brazil's most populous state. The objective is to identify trends in prevalence and risk factors for CHD in São Paulo State, Brazil. METHODS We developed a population-based study to estimate the CHD trend of prevalence in recent years, stratified by maternal age and geographical clusters, using all cases of CHD identified by the Live Births Information System (SINASC-Sistema de Informação Sobre Nascidos Vivos) from January 1, 2005, to December 31, 2018. We calculated the trends of prevalence, the regression coefficient (β), the annual percent change (APC), and 95% confidence interval using the Prais-Winsten regression model, with the Durbin-Watson test. RESULTS We found 10,594 cases of CHD among 8,536,101 live births (LB), a prevalence of 12.4/10,000 LB. There was no difference in the sex distribution; they are primarily Caucasian (60.2%), 75.2% born at term, and 74.4% weight > 2500 g, 66.9% of births were by cesarean section. São Paulo State presented an increasing CHD trend of prevalence (APC = 18.9%). The highest CHD prevalence rate was in mothers aged ≥ 35 years (22.2/10,000 LB). There were 12,271 specific congenital heart defects among 10,594 patients (1.16 CHD/patient). Atrial septal defect has the highest number of cases (3835), with a prevalence of 4.49/10,000 LB, corresponding to 31.3% of all CHD. CONCLUSION CHD had an increasing prevalence trend in recent years, being highest in São Paulo City and ≥ 35-year mothers.
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Affiliation(s)
| | | | - Tainara Rita Pezzini
- Medical School, Nine of July University (Uni9), São Bernardo do Campo, SP, Brazil
| | | | - Mauricio Giusti Calderon
- Pediatric Surgery Department, Hospital Benficência Portuguesa de São Paulo, Rua Maestro Cardim, 768, São Paulo, SP, CEP 01323-011, Brazil. .,Pediatric Surgery Department, Hospital Santa Catarina Paulista, Av. Paulista, 200, São Paulo, SP, CEP: 01310-000, Brazil.
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21
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Pan F, Li J, Lou H, Li J, Jin Y, Wu T, Pan L, An J, Xu J, Cheng W, Tao L, Lei Y, Huang C, Yin F, Chen J, Zhu J, Shu Q, Xu W. Geographical and socioeconomic factors influence the birth prevalence of congenital heart disease: a population-based cross-sectional study in eastern China. Curr Probl Cardiol 2022; 47:101341. [DOI: 10.1016/j.cpcardiol.2022.101341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022]
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22
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Zhang L, Liu B, Li H, Wang C, Yang S, Li Z. Epidemiology of Congenital Heart Disease in Jinan, China From 2005 to 2020: A Time Trend Analysis. Front Cardiovasc Med 2022; 9:815137. [PMID: 35571178 PMCID: PMC9092597 DOI: 10.3389/fcvm.2022.815137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background Although congenital heart defect (CHD) was the dominating birth defect, the time trend analysis of CHD was largely unknown. In our study, the time trend analysis of CHD from 2005 to 2020 in Jinan was conducted, aimed to reveal the epidemiological characteristics in a city and provided the data basis for the government to make a policy intervention. Methods A multi-institutional and retrospective review of CHD for all births from January 1, 2005 to December 31, 2020 was performed. Proportioner prevalence was used to describe the distribution of CHD. Comparisons of CHD characteristics among different groups were assessed with Chi-squares tests. Cochran-Armitage tests (CAT) were used to track changes in CHD prevalence. Results About 322,374 births and 5,180 CHD in Jinan were included from 2005 to 2020, and the total CHD prevalence was 3.92 per 1,000 births. The CHD prevalence showed an upward trend, with a total increase of 227.66% from 2005 to 2020. The CHD prevalence in urban areas was 34.17% higher than that in rural areas, but the gap was narrowing. Atrial septal defect (3.07 per 1,000 births), patent ductus arteriosus (1.62 per 1,000 births), ventricular septal defect (1.18 per 1,000 births), tetralogy of Fallot (0.62 per 1,000 births), and atrioventricular septal defect (0.47 per 1,000 births) were the 5 most common subtypes. Conclusion The prevalence of CHD in Jinan was gradually on the rise, which needs to be highly focused on by the health management department. Older pregnant women and women in rural areas should be concerned, and targeted measures need to be introduced.
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Affiliation(s)
- Lihua Zhang
- Department of Medicine, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Bei Liu
- Department of Health Education, Jinan Health Publicity and Education Center, Jinan, China
| | - Huimin Li
- Neonatal Intensive Care Unit, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chengxiang Wang
- Department of Women Healthcare, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shimin Yang
- Department of Public Health, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhongliang Li
- Department of Women Healthcare, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Zhongliang Li
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23
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Maternal air pollution exposure and neonatal congenital heart disease: A multi-city cross-sectional study in eastern China. Int J Hyg Environ Health 2021; 240:113898. [PMID: 34875582 DOI: 10.1016/j.ijheh.2021.113898] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the association between air pollution and neonatal congenital heart disease (CHD), and evaluate the cumulative burden of CHD attributed to above certain level for ambient air pollution exposure. METHODS We identified newborns who were diagnosed as CHD by echocardiography in Network Platform for Congenital Heart Disease (NPCHD) from January 2019 to December 2020 in 11 cities eastern China. The exposure lag response relationship between air pollutants (PM2.5, PM10, SO2, NO2, CO, and O3) concentration and CHDs was calculated by the distributed lag nonlinear model (DLNM). We further calculated the cumulative risk ratios (CRRs) of each air pollutant above reference concentrations on CHDs. RESULTS A total of 5904 CHDs from 983, 523 newborns were enrolled in this study. A 10 μg/m3 increase in PM2.5, PM10, SO2, NO2, CO and O3 exposure was associated with an increased risk of higher CHD incident RR = 1.025, 95% CI: 1.016-1.038 for PM2.5 in the third trimester, RR = 1.001, 95% CI: 1.000-1.002 for PM10 in the third trimester, 1.020, 95%CI: 1.004-1.036 for NO2 in the third trimester, RR = 1.001, 95%CI: 1.000-1.002 for O3 in the first trimester, all P value < 0.05). Cumulative effect curves of PM2.5, PM10, SO2, NO2, CO, and O3 were observed as sub-linear with a maximum of 1.876 (95%CI:1.220-2.886), 1.973 (95%CI:1.477,2.637), 2.169 (95%CI:1.347-3.493), 2.902 (95%CI:1.859-4.530), 1.398 (95%CI:1.080-1.809), 2.691 (95%CI:1.705-4.248), respectively. Significant associations were observed for air pollutants and CHDs in cities with higher average education years and babies concepted in cold season. CONCLUSIONS Our findings could provide growing evidence regarding the adverse health effects of air pollution on CHD, thereby strengthening the hypothesis that air pollutants have harmful impacts on cardiac development. Further studies are needed to verify the associations.
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24
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Alanazi AFR, Naser AY, Pakan P, Alanazi AF, Alanazi AAA, Alsairafi ZK, Alsaleh FM. Trends of Hospital Admissions Due to Congenital Anomalies in England and Wales between 1999 and 2019: An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211808. [PMID: 34831564 PMCID: PMC8617891 DOI: 10.3390/ijerph182211808] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 11/28/2022]
Abstract
Objectives: To investigate the trends in congenital anomalies-related hospital admissions in England and Wales. Methods: This was an ecological study that was conducted using hospital admission data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Congenital malformations, deformations and chromosomal abnormalities hospital admissions data were extracted for the period between April 1999 and March 2019. Results: Hospital admission rate increased by 4.9% [from 198.74 (95% CI 197.53–199.94) in 1999 to 208.55 (95% CI 207.39–209.71) in 2019 per 100,000 persons, trend test, p < 0.01]. The most common hospital admissions causes were congenital malformations of the circulatory system, the musculoskeletal system, genital organs, and the digestive system. The most notable increase in hospital admissions rate was observed in congenital malformations of the respiratory system (1.01-fold). The age group below 15 years accounted for 75.1% of the total number of hospital admissions. Males contributed to 57.5% of the whole number of hospital admission. Hospital admission rate between females was increased by 6.4% [from 162.63 (95% CI 161.10–164.16) in 1999 to 173.05 (95% CI 171.57–174.54) in 2019 per 100,000 persons]. Hospital admission rate between males was increased by 3.4% [from 236.61 (95% CI 234.72–238.50) in 1999 to 244.70 (95% CI 242.92–246.49) in 2019 per 100,000 persons]. Conclusions: Males had a higher percentage of hospitalisation compared to females. Further studies to investigate the factors associated with higher hospitalisation rate among males are needed.
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Affiliation(s)
- Abeer F. R. Alanazi
- Department of Pharmaceutical and Biological Sciences, UCL School of Pharmacy, London WC1E 6BT, UK;
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan;
| | - Prisca Pakan
- Department of Microbiology, Medical Faculty, University of Nusa Cendana, Kupang 09200, Indonesia;
| | - Atheer F. Alanazi
- Department of Biology, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - Alyamama Abdulaziz A. Alanazi
- Department of Biological Sciences, School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK;
| | | | - Fatemah M. Alsaleh
- Department of Pharmacy Practice, Kuwait University, Kuwait City 12037, Kuwait;
- Correspondence:
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25
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Fernandez RC, Moore VM, Willson KJ, Davies M. Night shift work undertaken by women and fertility treatment interact to increase prevalence of urogenital anomalies in children. Occup Environ Med 2021; 78:782-788. [PMID: 34226199 DOI: 10.1136/oemed-2021-107430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/31/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the role of maternal night shift work in occurrence of urogenital anomalies in offspring, considering a possible interaction with mode of conception. METHODS A population-based cohort comprising births in South Australia (1986-2002) was produced via linkage of fertility clinic records, perinatal and birth defects data. This study concerned first births to women in paid employment (n=98 103). Potential exposure to night shift was imputed by applying a job-exposure matrix to recorded occupation. Associations were examined using logistic regression, first for nurses and other night shift workers separately, then combined. An interaction term for night shift work and mode of conception was included in all models, while adjusting for covariates. RESULTS Associations were similar for nurses and other night shift workers, although only statistically significant for the former when considered separately. A multiplicative interaction was supported: for natural conceptions, maternal night shift work was not associated with offspring urogenital anomalies (OR=0.99, 95% CI 0.84 to 1.15); where a birth arose from fertility treatment, urogenital anomalies were significantly higher among births to all night shift workers compared with day workers (OR=2.07, 95% CI 1.20 to 3.55). This was not due to differences in the type of fertility treatment received. CONCLUSIONS Women in occupations that probably involved night shift did not have offspring with increased prevalence of urogenital anomalies if they conceived naturally. When night shift workers conceived with fertility treatment, the prevalence of urogenital anomalies was elevated. Possibly these women had the greatest exposure to night shift work, or least tolerance for this work schedule, or heightened sensitivity to hormonal aspects of fertility treatment.
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Affiliation(s)
- Renae C Fernandez
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia .,The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia.,School of Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - Vivienne M Moore
- The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia.,School of Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia.,Fay Gale Centre for Research on Gender, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kristyn J Willson
- The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia.,School of Public Health, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - Michael Davies
- Adelaide Medical School, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia.,The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia
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26
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Jemal S, Fentahun E, Oumer M, Muche A. Predictors of congenital anomalies among newborns in Arsi zone public hospitals, Southeast Ethiopia: a case-control study. Ital J Pediatr 2021; 47:143. [PMID: 34193221 PMCID: PMC8243734 DOI: 10.1186/s13052-021-01093-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/30/2021] [Indexed: 11/21/2022] Open
Abstract
Background Congenital anomaly is a partial or complete structural and/or functional defect during intrauterine life. Globally, major congenital anomalies account for 6% of all newborns among which about 94% of cases occurred in developing countries. In spite of its public health importance, very limited studies are reported in Ethiopia, and hardly any study in Arsi Zone. Objectives To determine the predictors of congenital anomalies among newborns in Arsi Zone Public Hospitals, Southeast Ethiopia. Methods A multi-center institutional-based case-control study was conducted in 418 (105 cases and 313 controls) of newborns in Arsi Zone Public Hospitals. Descriptive analysis, binary and multivariable logistic regressions were implemented. Results In this study, women who have been drinking alcohol during pregnancy were 3.48 times more prone to have newborns with congenital anomalies than their counterparts (AOR = 3.48; 95% CI: 1.38, 8.74). The likelihood of having a newborn with congenital anomalies was six and four times higher for women who had a maternal illness (AOR = 6.10; 95%CI: 2.39, 15.57) and chewing khat during pregnancy (AOR = 4; 95%CI: 1.49, 10.65), respectively. Moreover, the lack of folic acid supplementation and pesticides during pregnancy were 3.25 and 4.76 times more likely to experience a newborn with congenital anomalies, respectively. Conclusion Alcohol drinking, maternal illness, khat chewing, and chemical exposure during pregnancy had a significant association with the occurrence of congenital anomalies. While, taking folic acid supplements had a protective effect. Health experts and the community should take these factors into consideration and act accordingly.
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Affiliation(s)
- Sudi Jemal
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Engidaw Fentahun
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Mohammed Oumer
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Abebe Muche
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia.
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Wu X, Luo Q, Su Z, Li Y, Wang H, Yuan S, Yan F. Prognostic Value of Preoperative Absolute Lymphocyte Count in Children With Tetralogy of Fallot. J Am Heart Assoc 2021; 10:e019098. [PMID: 33998242 PMCID: PMC8483512 DOI: 10.1161/jaha.120.019098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Absolute lymphocyte count (ALC) is a low‐cost and easy‐to‐obtain inflammatory indicator; however, its association with the prognosis of patients with TOF remains unknown. This study aimed to determine the prognostic value of preoperative ALC in children with TOF. Methods and Results This retrospective study included 707 patients aged <6 years who underwent corrective operations for TOF between January 2016 and December 2018 in Fuwai Hospital, China. The end points were mortality, extracorporeal membrane oxygenation placement, postoperative hospital stay >30 days, and severe postoperative complications; patients were grouped on the basis of prognosis: poor prognosis (n=76) and good prognosis (n=631). Univariable and multivariable logistic regression analyses were performed to identify the independent risk factors for poor prognosis, on which a risk scoring system was based. The receiver operating characteristic curve was used to assess model performance. Using another model without ALC, the effect of the addition of ALC was assessed. Results suggested that ALC was an independent factor with a cutoff point of 4.36×109/L. The addition of ALC improved the area under the curve from 0.771 to 0.781 (P<0.001). To avoid reverse causality and further control for confounding factors, the patients were further divided on the basis of ALC level, and a propensity score matching was performed; 117 paired patients were identified for further analysis. Low ALC levels had an odds ratio of 3.500 (95% CI, 1.413–8.672). Conclusions Low preoperative ALC represents an independent predictor of poor prognosis in children with TOF.
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Affiliation(s)
- Xie Wu
- Department of Anesthesiology Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
| | - Qipeng Luo
- Department of Anesthesiology Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
| | - Zhanhao Su
- Center for Pediatric Cardiac Surgery Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
| | - Yinan Li
- Department of Anesthesiology Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
| | - Hongbai Wang
- Department of Anesthesiology Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
| | - Su Yuan
- Department of Anesthesiology Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
| | - Fuxia Yan
- Department of Anesthesiology Fuwai HospitalNational Center of Cardiovascular DiseasesChinese Academy of Medical Sciences, and Peking Union Medical College Beijing China
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Peppa M, Minassian C, Mangtani P, Thomas SL. The identification and validity of congenital malformation diagnoses in UK electronic health records: A systematic review. Pharmacoepidemiol Drug Saf 2021; 30:875-898. [PMID: 33881794 DOI: 10.1002/pds.5251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE To describe the methods used to identify and validate congenital malformation diagnoses recorded in UK electronic health records, and the results of validation studies. METHODS Medline and Embase were searched for publications between 1987 and 2019 that involved identifying congenital malformations from UK electronic health records using diagnostic codes. The methods and code-lists used to identify congenital malformations, and the methods and results of validations, were examined. RESULTS We retrieved 54 eligible studies; 36 identified congenital malformations from primary care data and 18 from secondary care data alone or in combination with birth and/or death records. Identification in secondary care data relied on codes from the 'Q' chapter for congenital malformations in ICD-10. In contrast, studies using primary care data frequently used additional codes outside of the 'P' chapter for congenital malformation diagnoses in Read, although the exact codes used were not always clear. Eight studies validated diagnoses identified in primary care data. The positive predictive value was highest (80%-100%) for congenital malformations overall, major malformations, and heart defects although the validity of the reference standard used was often uncertain. It was lowest for neural tube defects (71%) and developmental hip dysplasia (56%). CONCLUSIONS Studies identifying congenital malformations from primary care data provided limited details about the methods used. The few validation studies were limited to diagnoses recorded in primary care. Further assessments of all measures of validity in both data sources and of other malformation subgroups are needed, using robust reference standards and adhering to reporting guidelines.
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Affiliation(s)
- Maria Peppa
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Caroline Minassian
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Punam Mangtani
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sara L Thomas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Tidrenczel Z, Hajdu J, Simonyi A, Szabó I, Ács N, Demeter J, Beke A. Trends in the prenatal diagnosis of trisomy 21 show younger maternal age and shift in the distribution of congenital heart disease over a 20-year period. Am J Med Genet A 2021; 185:1732-1742. [PMID: 33683014 DOI: 10.1002/ajmg.a.62162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/20/2020] [Accepted: 02/20/2021] [Indexed: 11/07/2022]
Abstract
Prenatal testing has changed greatly over the past two decades, which may affect the diagnosis of congenital heart disease (CHD) in Down syndrome. The present study aimed to analyze changes in the prevalence and distribution of CHD diagnosed via ultrasonography and fetopathology in 462 fetuses with trisomy 21 between two consecutive 10-year periods (1999-2018), as well as the associations between CHDs, ultrasound markers, and extracardiac malformations. Overall, the frequency of cardiovascular malformations in trisomy 21 was 27.7 and 26.5%, and ultrasound identified 70 and 62% of CHDs during these periods. A profound increase in first-trimester ultrasound findings and associated anomalies with CHDs (ventricular septal defect, Tetralogy of Fallot) since 2009 were observed. Second-trimester nonstructural heart abnormalities were associated with ultrasound anomalies (74%) and major extracardiac malformations (42.9%). During both study periods, mothers carrying fetuses with CHD were significantly younger than those without CHD (p = 0.038, p = 0.009, respectively). Comparing the two 10-year periods, there were no changes in the prevalence and detection of CHDs. Trend analysis revealed that, although the frequency of CHD remained stable, the diagnostic spectrum had shifted between the study periods. Detection of nonstructural heart abnormalities necessitates detailed follow-up for cardiac/extracardiac malformations and chromosomal disorders.
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Affiliation(s)
- Zsolt Tidrenczel
- Genetic Center, Department of Obstetrics and Gynecology, Medical Centre Hungarian Defense Forces, Budapest, Hungary
| | - Julia Hajdu
- Gottsegen György Institute of Cardiology, Budapest, Hungary
| | - Aténé Simonyi
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - István Szabó
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - János Demeter
- Genetic Center, Department of Obstetrics and Gynecology, Medical Centre Hungarian Defense Forces, Budapest, Hungary
| | - Artúr Beke
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
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Rykiel G, Gray M, Rongish B, Rugonyi S. Transient increase in VEGF-A leads to cardiac tube anomalies and increased risk of congenital heart malformations. Anat Rec (Hoboken) 2021; 304:2685-2702. [PMID: 33620155 DOI: 10.1002/ar.24605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/12/2021] [Accepted: 01/25/2021] [Indexed: 11/09/2022]
Abstract
Vascular endothelial growth factor (VEGF) plays a critical role during early heart development. Clinical evidence shows that conditions associated with changes in VEGF signaling in utero are correlated with an increased risk of congenital heart defects (CHD) in newborns. However, how malformations develop after abnormal VEGF exposure is unknown. During embryogenesis, a primitive heart, consisting of an endocardial tube enveloped by a myocardial mantle, is the first organ to function. This tubular heart ultimately transforms into a four-chambered heart. To determine how a transient increase in VEGF prior to heart tube formation affects heart development leading to CHD, we applied exogenous VEGF or a control (vehicle) solution to quail embryos in ovo at Hamburger-Hamilton (HH) stage 8 (28-30 hr of incubation), right before heart tube formation. Light microscopy analysis of embryos re-incubated after treatment for 13 hrs (to approximately HH11/HH12) showed that increased VEGF leads to impaired heart tube elongation accompanied by diameter expansion. Micro-CT analysis of embryos re-incubated for 9 days (to approximately HH38), when the heart is fully formed, showed that VEGF treatment increased the rate of cardiac malformations in surviving embryos. Despite no sex differences in survival, female embryos were more likely to develop cardiac malformations. Our results further suggest that heart tube malformations after a transient increase in VEGF right before heart tube formation may be reversible, leading to normal hearts.
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Affiliation(s)
- Graham Rykiel
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, Oregon, USA
| | - MacKenzie Gray
- Department of Biology, Portland State University, Portland, Oregon, USA
| | - Brenda Rongish
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Sandra Rugonyi
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, Oregon, USA
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Silesh M, Lemma T, Fenta B, Biyazin T. Prevalence and Trends of Congenital Anomalies Among Neonates at Jimma Medical Center, Jimma, Ethiopia: A Three-Year Retrospective Study. Pediatric Health Med Ther 2021; 12:61-67. [PMID: 33628075 PMCID: PMC7898197 DOI: 10.2147/phmt.s293285] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/09/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Congenital anomalies are a major public health problem which is defined as structural or functional anomalies that occur during intrauterine life which can be detected prenatally, at birth, or sometimes may only be detected later in infancy. The impact of congenital anomalies is severe in middle- and low-income countries than in other developed and developing countries. Objective To assess the prevalence and trends of congenital anomalies among neonates admitted at Jimma Medical Center from 2017 to 2019. Methods A facility-based retrospective, descriptive crossectional study was conducted among neonates admitted at Jimma Medical Center from 2017–2019. Descriptive analysis (frequency and percentage) was calculated for the variables. The result was present in the table, text, and figure. Results From a total of 3346 admitted neonates, 199 (5.95%) neonates were diagnosed with congenital anomalies; of which 120 (60.3%), 146 (73.4%), 144 (72.4%) and 30 (15.1%) of neonates were males, urban dwellers, delivered with normal birth weight and had multiple congenital anomalies, respectively. Central nervous system was the most commonly affected body system 56 (28.1%), followed by the gastrointestinal tract 41 (20.1%) and musculoskeletal system 32 (16.1%). The proportion of congenital anomalies was significantly increasing over time. Conclusion The overall prevalence of congenital anomalies was high and increased from year to year. The proportions observed in the study indicated that a significant number of neonates were affected and suffered from the impacts of congenital anomalies which need immediate preventive actions such as iron folate supplementation during preconception and early pregnancy. Therefore, design strategies to create community awareness and prevention mechanism of congenital anomalies, and strengthening the care and rehabilitation services for affected patients are crucial.
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Affiliation(s)
- Mulualem Silesh
- Department of Midwifery, College of Health Science and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
- Correspondence: Mulualem Silesh Department of Midwifery, College of Health Sciences, Debre Berhan University, Debre Berhan, EthiopiaTel +251920249873 Email
| | - Tesfanesh Lemma
- Department of Midwifery, College of Health Science and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Belete Fenta
- School of Nursing and Midwifery, Institute of Health, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Tsegaw Biyazin
- School of Nursing and Midwifery, Institute of Health, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
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32
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Nimeri N, Ali H, Mahmoud N. Lethal severe congenital tracheal stenosis with tracheal ring complicating respiratory distress syndrome in an extremely premature infant: first reported case in Qatar with a literature review. BMJ Case Rep 2020; 13:13/12/e236107. [PMID: 33310828 PMCID: PMC7735117 DOI: 10.1136/bcr-2020-236107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In the context of prematurity, lethal congenital airways malforamtion can be masked by the symptoms of respiratory distress syndrome. A high index of suspicion is required. We present the case of a 28-week preterm infant, with atypical protracted respiratory insufficiency despite the escalation of mechanical ventilation. The possibility of airway obstruction was considered in view of severe chest retraction while on the mechanical ventilator. It was also difficult to pass suction catheters beyond a certain depth in the trachea; however, intubation of the upper trachea was accomplished twice without difficulty. Flexible bronchoscopy revealed complete tracheal ring with severe tracheal stenosis; there was no evidence of tracheo-oesophageal fistula. Due to advanced multi-organ dysfunction at diagnosis, a decision was made with the family to re-orientate from intensive care to compassionate care. Ethical considerations in similar cases should incorporate the improved outcomes of prematurity and recent advances in tracheal reconstruction.
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Affiliation(s)
- Nuha Nimeri
- Department of Paediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Haytham Ali
- Department of Pediatric, Sidra Medical and Research Center, Doha, Qatar
| | - Nazla Mahmoud
- Department of Paediatrics, Hamad Medical Corporation, Doha, Qatar
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Badran EF, Kamal W, Yaseen A, Abbad A, Al-Lawama M, Khdair Ahmad F, Al-Momani H, Salim Omari M. Esophageal atresia: Associated anomalies, mortality, and morbidity in Jordan. Pediatr Int 2020; 62:1250-1255. [PMID: 32432365 DOI: 10.1111/ped.14311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/25/2020] [Accepted: 05/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Esophageal atresia is a developmental disorder in which the upper and lower esophagus fail to connect. It has an estimated prevalence of 1 in 2,500-4,500 live births and has poorer outcomes in low- and middle-income countries than in high-income countries. This study focused on the disorder's epidemiology, morbidity, and mortality in Jordan to address the lack of data regarding esophageal atresia in this country. METHODS This was a retrospective study covering a 16-year period at a tertiary care academic hospital. Data were extracted from archived medical records and operative notes. All patients who had complete congenital esophageal atresia data were included. In total, the records of 55 patients were analyzed. RESULTS Of the included patients, 9% were diagnosed prenatally and 47% were diagnosed with polyhydramnios. The mean gestational age was 37 weeks, the mean birthweight was 2,550 g, and 60% of patients were male. Isolated cases of esophageal atresia were reported in 58.2% of patients. There was a high rate of associated congenital anomalies (41.8%), with cardiac lesions the most common (20%), and 5.5% were syndromic. Parental consanguinity was found in 18.2% of patients. Postoperative surgical-related morbidities included stricture (18/24; 75%) and leakage (5/24; 20.8%). Fistula recurrence occurred in one patient (4.2%). The mortality rate was 12.8%. CONCLUSION Esophageal atresia causes a high rate of mortality and exhibits post-operative morbidities. Moreover, associated anomalies were frequently observed. A high level of the malformation was found among offspring from consanguineous marriages.
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Affiliation(s)
- Eman F Badran
- Division of Neonatology-Perinatology, Department of Pediatrics University of Jordan-School of Medicine, Amman, Jordan
| | - Waseem Kamal
- Division of Neonatology-Perinatology, Department of Pediatrics University of Jordan-School of Medicine, Amman, Jordan
| | - Aseel Yaseen
- Division of Neonatology-Perinatology, Department of Pediatrics University of Jordan-School of Medicine, Amman, Jordan
| | - Aseel Abbad
- Division of Neonatology-Perinatology, Department of Pediatrics University of Jordan-School of Medicine, Amman, Jordan
| | - Manar Al-Lawama
- Division of Neonatology-Perinatology, Department of Pediatrics University of Jordan-School of Medicine, Amman, Jordan
| | - Fareed Khdair Ahmad
- Division of, Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Jordan-School of Medicine, Amman, Jordan
| | - Hashem Al-Momani
- Division of Pediatric Surgery, Department of Surgery, University of Jordan-School of Medicine, Amman, Jordan
| | - Mohammad Salim Omari
- Division of Pediatric Surgery, Department of Surgery, University of Jordan-School of Medicine, Amman, Jordan
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Saraiva IQ, Delgado E. Congenital ocular malformations in dogs and cats: 123 cases. Vet Ophthalmol 2020; 23:964-978. [PMID: 33058381 DOI: 10.1111/vop.12836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 09/19/2020] [Accepted: 09/26/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Provide epidemiological data regarding the prevalence of congenital ocular malformations in dogs and cats. ANIMALS STUDIED A population of 32 974 dogs and 13 977 cats that presented for consultation at the veterinary teaching hospital. PROCEDURES Medical records from 2011 to 2018 were reviewed. A retrospective and prospective epidemiological clinical study addressing congenital ocular malformations was conducted. Signalment, medical history, reason for presentation, clinical findings, vision impairment, and treatment options were analyzed. RESULTS From the total of cases analyzed, 103 dogs (0.3%) and 20 cats (0.1%) met the inclusion criteria. The majority of dogs were mixed breed, the most common breed being the French Bulldog, while the majority of cats were European domestic shorthair. The median age of diagnosis was 12 months for dogs and 6 months for cats. Sex predisposition was not found. The most frequently identified abnormalities were as follows: congenital cataract (dogs: 31.1%; cats: 30.0%), microphthalmia (dogs: 35.0%, cats: 25.0%), and persistent pupillary membrane (dogs: 27.2%, cats: 40.0%). Some of the concurrently observed malformations were significantly associated. A statistically significant association was found between ocular dermoids and the French Bulldog breed (P < .001). CONCLUSIONS Even though congenital ocular malformations are uncommon, knowledge about their prevalence is important, since they can cause vision impairment or even blindness. Moreover, some human ocular disease phenotypes are similar to the ones presented by dogs and cats, so they can be used as models to investigate pathophysiology and therapeutic approaches.
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Affiliation(s)
- Inês Q Saraiva
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Esmeralda Delgado
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
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Uguz F. Selective serotonin reuptake inhibitors and the risk of congenital anomalies: a systematic review of current meta-analyses. Expert Opin Drug Saf 2020; 19:1595-1604. [PMID: 33001713 DOI: 10.1080/14740338.2020.1832080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: A review of current meta-analyses examining the relationship between maternal use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and congenital anomalies. Methods: PubMed was searched for meta-analyses published in English language between January 2010 and April 2020 by using the following combinations of key words: meta-analysis, pregnancy, antidepressant, SSRI, citalopram, escitalopram, fuloxetine, paroxetine, sertraline, fluvoxamine, neonatal outcome, birth outcome, congenital malformation, congenital anomaly, birth defect, cardiac malformation and heart defect. Results: A total of 15 meta-analyses met the search criteria. These meta-analyses consistently suggested a significant positive association between the use of SSRIs in general and paroxetine and fluoxetine in particular and the risk of major congenital anomalies. The data also showed a consistency in increased cardiovascular defects in infants due to maternal use of paroxetine. The risk of cardiovascular defects in infants of women using SSRIs in general and fluoxetine and sertraline in particular was controversial. Conclusion: Further large-scale prospective observational studies and meta-analyses on the effects of individual SSRIs other than paroxetine, especially escitalopram and fluvoxamine, are required to reach definitive conclusions.
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Affiliation(s)
- Faruk Uguz
- Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey
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36
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Foreman PK, van Kessel F, van Hoorn R, van den Bosch J, Shediac R, Landis S. Birth prevalence of achondroplasia: A systematic literature review and meta-analysis. Am J Med Genet A 2020; 182:2297-2316. [PMID: 32803853 PMCID: PMC7540685 DOI: 10.1002/ajmg.a.61787] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/15/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
Achondroplasia is a genetic disorder that results in disproportionate short stature. The true prevalence of achondroplasia is unknown as estimates vary widely. This systematic literature review and meta‐analysis was conducted to better estimate worldwide achondroplasia birth prevalence. PubMed, Embase, Scielo, and Google Scholar were searched, complemented by manual searching, for peer‐reviewed articles published between 1950 and 2019. Eligible articles were identified by two independent researchers using predefined selection criteria. Birth prevalence estimates were extracted for analysis, and the quality of evidence was assessed. A meta‐analysis using a quality effects approach based on the inverse variance fixed effect model was conducted. The search identified 955 unique articles, of which 52 were eligible and included. Based on the meta‐analysis, the worldwide birth prevalence of achondroplasia was estimated to be 4.6 per 100,000. Substantial regional variation was observed with a considerably higher birth prevalence reported in North Africa and the Middle East compared to other regions, particularly Europe and the Americas. Higher birth prevalence was also reported in specialized care settings. Significant heterogeneity (Higgins I2 of 84.3) was present and some indication of publication bias was detected, based on visual asymmetry of the Doi plot with a Furuya‐Kanamori index of 2.73. Analysis of pooled data from the current literature yields a worldwide achondroplasia birth prevalence of approximately 4.6 per 100,000, with considerable regional variation. Careful interpretation of these findings is advised as included studies are of broadly varying methodological quality.
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Affiliation(s)
| | - Femke van Kessel
- Pallas Health Research and Consultancy, Rotterdam, the Netherlands
| | - Rosa van Hoorn
- Pallas Health Research and Consultancy, Rotterdam, the Netherlands
| | | | - Renée Shediac
- BioMarin Pharmaceutical, Inc, Novato, California, USA
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Zhou Y, Mao X, Zhou H, Wang L, Qin Z, Cai Z, Yu B. Birth Defects Data From Population-Based Birth Defects Surveillance System in a District of Southern Jiangsu, China, 2014-2018. Front Public Health 2020; 8:378. [PMID: 32850599 PMCID: PMC7423872 DOI: 10.3389/fpubh.2020.00378] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/30/2020] [Indexed: 01/24/2023] Open
Abstract
As a population-based national surveillance region, Tianning District confronts with great challenges in birth defects (BDs) prevention. We aimed to describe the epidemiology of BDs in infants (including dead fetus, stillbirth, or live birth between 28 weeks of gestation and 42 days after birth) in Tianning District from 2014 to 2018. The data was collected from the national birth defect surveillance system. The prevalence rates of BDs were calculated by poisson distribution. Trends of incidence and the associations of regarding perinatal characteristics with BDs were analyzed by poisson regression. During the study period, the prevalence of BD was 155.49 per 10,000 infants. The ten leading BDs were congenital heart defects (CHD), polydactyly, Congenital malformation of kidney (CMK), syndactyly, cleft palate, hypospadias, Congenital hypothyroidism (CH), congenital atresia of rectum and anus, congenital talipes equinovarus (CTE), and microtia. A significant increase in the prevalence of CHD was observed with a prevalence rate ratio (PRR) of 1.191. Gravidity ≥ 3 (PRR = 1.38) and multiple births (PRR = 2.88) were risk factors for BDs. Premature delivery (PRR = 4.29), fetal death or stillbirth (PRR = 24.79), and infant death (PRR = 43.19) were adverse consequences of BDs. Strengthening publicity and education, improving the ability of diagnosis and monitoring, expanding surveillance time quantum of BDs system may be warranted.
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Affiliation(s)
- Ying Zhou
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Xueqin Mao
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Hua Zhou
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Li Wang
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Zhiqiang Qin
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Zhengmao Cai
- Changzhou Commission of Health, Changzhou, China
| | - Bin Yu
- Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
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Chukwubuike KE, Ozor I, Enyi N. Prevalence and pattern of birth defects in the two tertiary hospitals in Enugu, South East Nigeria: A hospital-based observational study. Afr J Paediatr Surg 2020; 17:85-89. [PMID: 33342840 PMCID: PMC8051625 DOI: 10.4103/ajps.ajps_59_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Birth defects have medical, surgical and aesthetic consequences. The impact of birth defects is particularly severe in low-income countries where health-care resources are limited. AIMS AND OBJECTIVES The aim of this study was to determine the prevalence and types of birth defects in live newborns delivered at the two tertiary hospitals in Enugu, South East Nigeria. MATERIALS AND METHODS This was a hospital-based observational study carried out on neonates delivered in the maternity units of the University of Nigeria Teaching Hospital Ituku/Ozalla and Enugu State University Teaching Hospital Parklane, Enugu during the periods of January 2015 and December 2018. All the live-born babies born in the two hospitals during this period were recruited into the study. The neonates were examined by a paediatrician for the presence of birth defects. The birth defects were classified according to the system involved and also into major and minor. RESULTS During the study period, 9492 babies were born, of which 166 had birth defects, which gave a prevalence of 1.75%. The predominant system affected by birth defects was the musculoskeletal system (45.2%) followed by the central nervous system (34.9%), urogenital system (10.8%) and gastrointestinal tract (9%). 13 (7.8%) patients had their birth defects diagnosed prenatally during the maternal ultrasound scan. Fifteen (9%) and 13 (7.8%) mothers of the neonates who had birth defects were diabetics and hypertensives, respectively. Most of the neonates were delivered vaginally. CONCLUSION Birth defects are not uncommon. This study showed a prevalence of 1.75% in the two tertiary hospitals in Enugu, South East Nigeria. The most commonly affected system was the musculoskeletal system.
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Affiliation(s)
- Kevin Emeka Chukwubuike
- Department of Surgery, Paediatric Surgery Unit, Enugu State University Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Ignatius Ozor
- Department of Surgery, Neurosurgery Unit, Enugu State University Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Nnenna Enyi
- Department of Anatomy, Enugu State University, Enugu, Enugu State, Nigeria
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Zhao L, Chen L, Yang T, Wang T, Zhang S, Chen L, Ye Z, Luo L, Qin J. Birth prevalence of congenital heart disease in China, 1980-2019: a systematic review and meta-analysis of 617 studies. Eur J Epidemiol 2020; 35:631-642. [PMID: 32519018 PMCID: PMC7387380 DOI: 10.1007/s10654-020-00653-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
To assess the birth prevalence and spatial distribution of congenital heart disease (CHD) in China by conducting a complete overview and using spatial epidemiological methods. Unrestricted searches were conducted on seven electronic databases, with an end-date parameter of May 2019. Data on the birth prevalence of CHD and its subtypes were collected and combined using either the random-effect model or fixed-effect model. Subgroup sensitivity analyses were performed to explore potential heterogeneity moderators. The three-dimensional trend analysis and a visualization of CHD birth prevalence among different provinces were performed to describe the spatial distribution characteristics. Total 617 studies involving 76,961,354 births and 201,934 CHD individuals were included. Overall, total CHD birth prevalence increased continuously over time, from 0.201‰ in 1980-1984 to 4.905‰ in 2015-2019. The study on the high-income provinces, population-based monitoring model, male births, and urban regions reported a significantly higher prevalence of total CHD compared with upper-middle-income provinces, hospital-based monitoring model, female births, and rural regions, respectively. National CHD birth prevalence increased gradually from western region to eastern region, but decreased gradually from southern to northern region. Relevant heterogeneity moderators including gender, geographic region, income levels, and monitoring models have been identified by subgroup analyses. Sensitivity analysis yielded consistent results. Total CHD birth prevalence in China increases continuously in the past 40 years. Significant differences in gender, geographical regions, income levels, and monitoring models were found. In the future, population wide prospective birth defect registries covering the entire Chinese population need to determine the exact birth prevalence.
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Affiliation(s)
- Lijuan Zhao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan, China.
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Letao Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Ziwei Ye
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Liu Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- National Health Commission Key Laboratory for Birth Defect Research and Prevention, Changsha, Hunan, China.
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Academy of Medical Sciences, Guangzhou, Guangdong, China.
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Zhou Y, Mao X, Zhou H, Qin Z, Wang L, Cai Z, Yu B. Epidemiology of birth defects based on a birth defect surveillance system in Southern Jiangsu, China, 2014-2018. J Matern Fetal Neonatal Med 2020; 35:745-751. [PMID: 32098533 DOI: 10.1080/14767058.2020.1731459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Changzhou has been confronted with great challenges in birth defects (BDs) prevention, as the prevalence rates of BDs in Changzhou increased rapidly. The aims of this study were to describe the epidemiology of BDs in perinatal infants (PIs, including dead fetus, stillbirth, or live birth between 28 weeks of gestation and 7 days after birth) in Changzhou during the period from 2014 to 2018.Methods: The BD surveillance data of PIs were collected from 56 hospitals of Changzhou. The prevalence rate of BDs with 95% confidence interval (CI) were calculated by Poisson distribution. Univariate and multivariate Poisson regression was performed to identify the changing trends of prevalence rates of BDs by year and the association of regarding BD characteristics including year, infant gender, maternal age, and season with BDs successively.Results: From 2014 to 2018, there were a total of 238,712 PIs of which 1707 had BDs, with the average prevalence of 71.509 per 10,000 PIs, showing a remarkable uptrend (aPRR = 1.133, 95%CI: 1.094-1.173). The ten leading BDs were polydactyly, congenital heart defects (CHD), syndactyly, microtia, cleft lip and palate (CLP), hypospadias, cleft palate, other malformation of external ear (OMEE), congenital atresia of rectum and anus, and congenital talipes equinovarus (CTE). During the study period, the prevalence rates of polydactyly, CHD and syndactyly increased significantly (PRR = 1.195, 95%CI: 1.109-1.288, PRR = 1.194, 95%CI: 1.105-1.291, and PRR = 1.143, 95%CI: 1.007-1.297, respectively); the prevalence rates of congenital esophageal atresia decreased significantly (PRR = 0.571, 95%CI: 0.395-0.826). The risk of BDs was higher in male PIs versus female PIs (aPRR = 1.235, 95%CI: 1.123-1.358).Conclusions: A significant increase in the prevalence of BDs was detected from 2014 to 2018 in Changzhou. CHD, polydactyly, and syndactyly increased much and congenital esophageal atresia declined much. Male PIs was risk factor for occurrence of BDs. Collecting information on factors associated with BDs, setting the report time of BDs system at smaller gestational age so as to get an exact prevalence and make better prevention strategy, strengthening the publicity and education, improving the ability of monitoring, and wider use of new diagnosis technology are important to reduce the prevalence of BDs in PIs.
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Affiliation(s)
- Ying Zhou
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, China
| | - Xueqin Mao
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, China
| | - Hua Zhou
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, China
| | - Zhiqiang Qin
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, China
| | - Li Wang
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, China
| | - Zhengmao Cai
- Changzhou Commission of Health, Changzhou, China
| | - Bin Yu
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, China
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Elghanmi A, Razine R, Jou M, Berrada R. Congenital malformations among newborns in Morocco: A retrospective study. Pediatr Rep 2020; 12:7405. [PMID: 32308967 PMCID: PMC7160859 DOI: 10.4081/pr.2020.7405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 05/28/2018] [Indexed: 11/23/2022] Open
Abstract
Congenital malformations are one of the leading causes of neonates and infants' mortality and morbidity. The frequency of these congenital malformations varies in different populations. The objective of this study was to find out the prevalence and pattern of congenital malformations in a tertiary teaching hospital in Rabat, Morocco. This four-year retrospective descriptive study was conducted from January 2011 to December 2014. All newborns with congenital malformations diagnosed at birth were included. Mothers and newborn characteristics were analyzed using SPSS 13.0. A total of 706 newborns were noted to have congenital malformation. The prevalence rate was 1.02%. The mean maternal age was 28.8±7.2 years. The mean maternal body mass index was 28.1±6.9 kg/m2. 13.3% of the mothers had a history of abortion. The nervous system was the most affected system (19.4%) followed by the musculoskeletal system (14.2%), the chromosomal abnormalities (12.3%) and the genito-urinary system (10.8%). Males newborns (57.9%) had more congenital malformations than females (40.5%). The rates for live-births, fetal asphyxia and stillbirths were 75.2%, 7.2% and 17.3%, respectively. This retrospective study provides recent and detailed data about congenital malformations in a Moroccan region. The result from this study will contribute to the knowledge of congenital malformations in this particular area and hence the supportive preventive policy.
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Affiliation(s)
- Adil Elghanmi
- Centre for Doctoral Studies in Life and Health Sciences, Faculty of Medicine and Pharmacy, Mohammed VI University of Health Sciences (UM6SS), Casablanca
| | - Rachid Razine
- Laboratory of Public Health, Faculty of Medicine, Mohammed V University, Rabat
| | - Mohamed Jou
- Service of Obstetrics and Gynecology, Souissi, CHU Rabat
| | - Rachid Berrada
- Faculty of Medicine, Mohammed V University, Rabat, Morocco
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Jiang B, Liu J, He W, Wei S, Hu Y, Zhang X. The effects of preconception examinations on birth defects: a population-based cohort study in Dongguan City, China. J Matern Fetal Neonatal Med 2019; 33:2691-2696. [PMID: 30522364 DOI: 10.1080/14767058.2018.1557141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To evaluate the effect of preconception examinations programs on the prevention of birth defects in Dongguan City during 2013-2017.Methods: The data were from preconception examinations system and the birth defects surveillance system during 2013-2017. The study population included 63,175 infants born to mothers accepted preconception examinations during pregnancy (the screening group) and 649,862 infants whose mother did not check (the control group). The infants included for stillbirth, dead fetus, live birth between 28 weeks of gestation and 7 days after birth and legal pregnancy termination. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to examine for the association between birth defects and preconception examinations. We also conducted a stratified analysis based on infant gender and disease classification, and maternal age and region.Results: The incidence of birth defects in the screening group was 134.55/10,000, while that in the control group was 241.53/10,000. Preconception examinations can effectively reduce the incidence of birth defects (BDs) (RR: 0.557, 95%CI: 0.520-0.597). Bifid spine (RR: 0.076, 95%CI: 0.011-0.545), anencephalia (RR: 0.134, 95%CI: 0.033-0.543) and anorectal atresia or stenosis (RR: 0.151, 95%CI: 0.048-0.471) were controlled best, and Down syndrome (RR: 0.684, 95%CI: 0.435-1.075) was no effect. Young maternal age (14-19 years) and old maternal age will increase the risk of birth defects. Preconception examinations had the best effect for pregnant women under 25 years of age (RR: 0.465, 95%CI: 0.387-0.559), and were relatively poor for women aged 30-34 years (RR: 0.678, 95%CI: 0.593-0.776). The incidence of the urban was significantly higher than that of the rural. The effect of preconception examinations to prevent birth defects was more effective in urban areas (RR: 0.453, 95%CI: 0.391-0.525) than in rural areas (RR: 0.577, 95%CI: 0.533-0.625). The incidence of BDs in males was higher than that in females.Conclusions: By implementing preconception examinations project, birth defects in Dongguan have been well controlled. This can provide reference for other developing countries to prevent birth defects.
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Affiliation(s)
- Bi Jiang
- Dongguan Maternal and Child Health Care Hospital, Dongguan, China
| | - Jianxin Liu
- Dongguan Maternal and Child Health Care Hospital, Dongguan, China
| | - Weichao He
- Dongguan Maternal and Child Health Care Hospital, Dongguan, China
| | - Sisi Wei
- Dongguan Maternal and Child Health Care Hospital, Dongguan, China
| | - Yanmei Hu
- Dongguan Maternal and Child Health Care Hospital, Dongguan, China
| | - Xinjian Zhang
- Dongguan Maternal and Child Health Care Hospital, Dongguan, China
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Al Kibria GM, Khanam R, Mitra DK, Mahmud A, Begum N, Moin SMI, Saha SK, Baqui A. Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh. PLoS One 2018; 13:e0206795. [PMID: 30462674 PMCID: PMC6248927 DOI: 10.1371/journal.pone.0206795] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 10/20/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Reducing neonatal mortality rate (NMR) is a challenge in many low- and middle-income countries including Bangladesh. In 2014, the estimated NMR in this country was 28 per 1,000 live births. This rate is higher in rural regions compared to the national average. Currently, Sylhet Division has the highest NMR in Bangladesh. Investigating rates and determinants of neonatal mortality in rural regions of this high-risk division is particularly important to implement evidence-based programs. This study examined rates and determinants of neonatal deaths in a large rural cohort in Sylhet Division. METHODS We analyzed data from a multi-country cohort study, Aetiology of Neonatal Infections in South Asia. From November 2011 to December 2013, this study was conducted in two rural sub-districts in Sylhet Division. Community health workers followed 28,960 pregnant women and their newborns up to two months postpartum and collected data on pregnancy outcomes and newborns' survival status. The NMR was obtained by dividing total number of neonatal deaths with all studied newborns. Logistic regression was employed to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with neonatal mortality. Stata 14.0 was used for data analysis. RESULTS This study analyzed data of 21,227 newborns. The NMR was 43.4 (95% CI: 39.3-48.0) per 1,000 live births (N = 922). Multivariable analysis showed that the odds of neonatal mortality were significantly higher among male newborns (AOR: 1.5, 95% CI: 1.2-1.8), babies born before 34 weeks of gestation (AOR: 5.0, 95% CI: 4.1-6.1), those who were twins or triplets (AOR: 6.2, 95% CI: 3.6-10.9), and first-born child (AOR: 2.9, 95% CI: 1.6-5.3). Additionally, maternal age 30-35 years (AOR: 1.4, 95% CI: 1.-1.8), history of child death (AOR: 1.6, 95% CI: 1.2-2.2), and delivery complications (AOR: 2.1, 95% CI: 1.6-2.6) had positive associations with neonatal deaths. CONCLUSION Public health programs in Bangladesh need to adopt a comprehensive strategy to address the individual, maternal, and intrapartum factors associated with neonatal mortality in rural regions. Interventions should aim to prioritize managing pre-term deliveries, first-born child, and delivery complications among pregnant women.
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Affiliation(s)
- Gulam Muhammed Al Kibria
- Department of Epidemiology and Public Health, University of Maryland Baltimore, Baltimore, MD, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- * E-mail: ,
| | - Rasheda Khanam
- International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | | | - Arif Mahmud
- International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Nazma Begum
- International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Syed Mamun Ibne Moin
- International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Samir Kumar Saha
- Department of Microbiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Abdullah Baqui
- International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Sex differences for major congenital heart defects in Down Syndrome: A population based study. Eur J Med Genet 2018; 61:546-550. [DOI: 10.1016/j.ejmg.2018.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/23/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022]
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Xie D, Fang J, Liu Z, Wang H, Yang T, Sun Z, Wang A, Xiong L. Epidemiology and major subtypes of congenital heart defects in Hunan Province, China. Medicine (Baltimore) 2018; 97:e11770. [PMID: 30075604 PMCID: PMC6081061 DOI: 10.1097/md.0000000000011770] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Congenital heart defects (CHDs) are the most common birth defects (BDs) and account for nearly one-third of all BDs. The aim of this article was to investigate the epidemiology and major subtypes of CHDs in Hunan Province, China in the last 5 years.CHD surveillance data from 2012 to 2016 were collected from 52 registered hospitals in Hunan. The prevalence rates of CHDs, incidence rates of CHDs combined with other BDs, and rates of termination of pregnancy (TOP) for CHDs among different regions, infant sexes, and maternal ages were calculated for both early fetuses (<28 weeks of gestation) and perinatal infants (PIs) (between 28 weeks of gestation and 7 days after birth). Both the constituent ratio and prevalence rates were computed among subtypes.CHDs were found in 6289 out of 673,060 births. The overall prevalence was 93.44 per 10,000 PIs, with 19.27 and 74.17 per 10,000 in early fetuses and PIs, respectively. The risks of CHDs were higher in infants from urban areas than those from rural areas during the whole gestation and were higher in male infants than in female infants during the perinatal period. The total prevalence of CHDs increased significantly with maternal age (χ trend = 141.84, P < .05). Among fetuses in early gestation, there were 288 cases (22.21%) of CHDs combined with other BDs and 1292 cases (99.61%) of TOP for CHD. The 3 major subtypes of CHDs were ventricular septal defect (VSD) (22.06%), Tetralogy of Fallot (TOF) (9.43%), and atrioventricular septal defect (AVSD) (6.69%). Among PIs, there were 1541 cases (30.87%) of CHD diagnosed before delivery and 1184 cases (76.83%) were TOP. The 3 major subtypes were atrial septal defect (ASD) (42.81%), patent ductus arteriosus (PDA) (16.07%), and VSDs (15.21%).The total prevalence of CHD in Hunan Province and the rate of TOP for CHD was high, especially for early-gestation fetuses. Pregnancies in urban women, male PIs, and maternal age were the risk factors for CHDs. Among early-gestation fetuses, the most common types were VSD, TOF, and ASD, and among PIs, the most common types were ASD, PDA, and VSD.
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Affiliation(s)
| | - Junqun Fang
- Department of Health management, Maternal and Child Health Hospital of Hunan Province
| | - Zhiyu Liu
- Department of Information Management
| | - Hua Wang
- Department of Health management, Maternal and Child Health Hospital of Hunan Province
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, P.R. China
| | - Zhenqiu Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, P.R. China
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Summers AD, Reefhuis J, Taliano J, Rasmussen SA. Nongenetic risk factors for holoprosencephaly: An updated review of the epidemiologic literature. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018; 178:151-164. [PMID: 29761639 DOI: 10.1002/ajmg.c.31614] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 12/17/2022]
Abstract
Holoprosencephaly (HPE) is a major structural birth defect of the brain that occurs in approximately 1 in 10,000 live births. Although some genetic causes of HPE are known, a substantial proportion of cases have an unknown etiology. Due to the low birth prevalence and rarity of exposure to many potential risk factors for HPE, few epidemiologic studies have had sufficient sample size to examine risk factors. A 2010 review of the literature identified several risk factors that had been consistently identified as occurring more frequently among cases of HPE, including maternal diabetes, twinning, and a predominance of females, while also identifying a number of potential risk factors that had been less widely studied. In this article, we summarize a systematic literature review conducted to update the evidence for nongenetic risk factors for HPE.
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Affiliation(s)
- April D Summers
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennita Reefhuis
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joanna Taliano
- LAC Group, Contractor to US Centers for Disease Control and Prevention, Library Science Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Atlanta, Georgia
| | - Sonja A Rasmussen
- Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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The Prevalence of Major Congenital Anomalies Among Live Births in Birjand, Iran. ACTA ACUST UNITED AC 2018. [DOI: 10.5812/modernc.81084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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48
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Gaspard O, Vanderzwalmen P, Wirleitner B, Ravet S, Wenders F, Eichel V, Mocková A, Spitzer D, Jouan C, Gridelet V, Martens H, Henry L, Zech H, d'Hauterive SP, Nisolle M. Impact of high magnification sperm selection on neonatal outcomes: a retrospective study. J Assist Reprod Genet 2018; 35:1113-1121. [PMID: 29607458 DOI: 10.1007/s10815-018-1167-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/16/2018] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The aim of this study was to compare the effect of the deselection of spermatozoa presenting vacuole-like structures using IMSI (intracytoplasmic morphologically selected sperm injection) with ICSI (intracytoplasmic sperm injection) by means of neonatal outcomes. METHODS In a retrospective two-center analysis, a total of 848 successful IMSI or ICSI cycles ending with a live birth, induced abortion, or intrauterine fetal death (IUFD) were included. RESULTS The IMSI and ICSI groups included 332 and 655 babies or fetuses, respectively. The parents were older in the IMSI group than in the ICSI group (mothers were 35.1 vs 32.9 years, and fathers were 39.1 vs 36.2 years). The multiple pregnancy rate was higher in the IMSI group. The mean pregnancy duration and mean birth weight were almost identical in both groups. There was no significant difference in major congenital malformations between the two groups. However, this rate was decreased in the IMSI group compared to that in the ICSI group (1.8 vs 3.2%), the difference being mainly found in singletons (1.4 vs 3.3%). Boys were more often affected than girls in both groups. The percentages of chromosomal abnormalities did not differ between the IMSI and ICSI groups (0.6 and 0.8%). The reported congenital malformations mainly affected the heart, urogenital, and musculoskeletal systems. CONCLUSIONS In the present study, the malformation rates observed in the IMSI and ICSI groups were not significantly different, even if slightly lower after IMSI. However, the observed difference followed the same trends observed in previous reports, indicating the possible impact of IMSI on decreasing congenital malformation occurrences. This highlights the necessity to prospectively evaluate the impact of IMSI on neonatal outcome after IVF treatment.
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Affiliation(s)
- Olivier Gaspard
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium.
| | | | | | - Stéphanie Ravet
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Frédéric Wenders
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | | | - Alice Mocková
- Department of Neonatology, Faculty of Medicine in Pilsen and University Hospital, Charles University in Prague, Prague, Czech Republic
| | | | - Caroline Jouan
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Virginie Gridelet
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium.,GIGA I3, Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Henri Martens
- GIGA I3, Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Laurie Henry
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Herbert Zech
- IVF-Centers Prof. Zech, Bregenz, Austria.,IVF-Centers Prof. Zech, Salzburg, Austria
| | - Sophie Perrier d'Hauterive
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Michelle Nisolle
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
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49
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Yoo BW. Epidemiology of Congenital Heart Disease with Emphasis on Sex-Related Aspects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1065:49-59. [DOI: 10.1007/978-3-319-77932-4_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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50
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Bishop C, Small N, Mason D, Corry P, Wright J, Parslow RC, Bittles AH, Sheridan E. Improving case ascertainment of congenital anomalies: findings from a prospective birth cohort with detailed primary care record linkage. BMJ Paediatr Open 2017; 1:e000171. [PMID: 29637167 PMCID: PMC5862215 DOI: 10.1136/bmjpo-2017-000171] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/12/2017] [Accepted: 10/18/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Congenital anomalies (CAs) are a common cause of infant death and disability. We linked children from a large birth cohort to a routine primary care database to detect CA diagnoses from birth to age 5 years. There could be evidence of underreporting by CA registries as they estimate that only 2% of CA registrations occur after age 1 year. METHODS CA cases were identified by linking children from a prospective birth cohort to primary care records. CAs were classified according to the European Surveillance of CA guidelines. We calculated rates of CAs by using a bodily system group for children aged 0 to <5 years, together with risk ratios (RRs) with 95% CIs for maternal risk factors. RESULTS Routinely collected primary care data increased the ascertainment of children with CAs from 432.9 per 10 000 live births under 1 year to 620.6 per 10 000 live births under 5 years. Consanguinity was a risk factor for Pakistani mothers (multivariable RR 1.87, 95% CI 1.46 to 2.83), and maternal age >34 years was a risk factor for mothers of other ethnicities (multivariable RR 2.19, 95% CI 1.36 to 3.54). Education was associated with a lower risk (multivariable RR 0.78, 95% CI 0.62 to 0.98). CONCLUSION 98% of UK CA registrations relate to diagnoses made in the first year of life. Our data suggest that this leads to incomplete case ascertainment with a further 30% identified after age 1 year in our study. Risk factors for CAs identified up to age 1 year persist up to 5 years. National registries should consider using routine data linkage to provide more complete case ascertainment after infancy.
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Affiliation(s)
- Chrissy Bishop
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Peter Corry
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Roger C Parslow
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.,Division of Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - Alan H Bittles
- Centre for Comparative Genomics, Murdoch University, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Eamonn Sheridan
- Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
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