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Damkjær M. Causal pathways of cerebral palsy in individuals with congenital anomalies: A cardiologist's perspective. Dev Med Child Neurol 2024. [PMID: 39233580 DOI: 10.1111/dmcn.16077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024]
Affiliation(s)
- Mads Damkjær
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
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Bruckner TA, Trinh NTH, Lelong N, Madani K, Slama R, Given J, Khoshnood B. Climate Change and Congenital Anomalies: A Population-Based Study of the Effect of Prolonged Extreme Heat Exposure on the Risk of Neural Tube Defects in France. Birth Defects Res 2024; 116:e2397. [PMID: 39215441 DOI: 10.1002/bdr2.2397] [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: 04/14/2024] [Revised: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Exposure to long-lasting extreme ambient temperatures in the periconceptional or early pregnancy period might increase the risk of neural tube defects (NTDs). We tested whether prolonged severe heat exposure as experienced during the 2003 extreme heatwave in France, affected the risk of NTDs. METHODS We retrieved NTD cases spanning from January 1994 to December 2018 from the Paris Registry of Congenital Malformations. The 2003 heatwave was characterized by the long duration and high intensity of nine consecutive days with temperatures ≥35°C. We classified monthly conceptions occurring in August 2003 as "exposed" to prolonged extreme heat around conception (i.e., periconceptional period). We assessed whether the risk of NTDs among cohorts exposed to the prolonged severe heatwave of 2003 in the periconceptional period differed from expected values using Poisson/negative binomial regression. FINDINGS We identified 1272 NTD cases from January 1994 to December 2018, yielding a monthly mean count of 4.24. Ten NTD cases occurred among births conceived in August 2003. The risk of NTD was increased in the cohort with periconceptional exposure to the August 2003 heatwave (relative risk = 2.14, 95% confidence interval: 1.46 to 3.13), compared to non-exposed cohorts. Sensitivity analyses excluding July and September months or restricting to summer months yielded consistent findings. INTERPRETATION Evidence from the "natural experiment" of an extreme climate event suggests an elevated risk of NTDs following exposure to prolonged extreme heat during the periconceptional period.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, University of California, Irvine, California, USA
| | - Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Nathalie Lelong
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
| | - Kaveh Madani
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Richmond Hill, Ontario, Canada
| | - Rémy Slama
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Joanne Given
- Institute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Babak Khoshnood
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
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3
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Santoro M, Mezzasalma L, Coi A, Pierini A. Orofacial Clefts and Maternal Risk Factors: A Population-Based Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:819. [PMID: 39062268 PMCID: PMC11274858 DOI: 10.3390/children11070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/26/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND/OBJECTIVES Orofacial clefts (OFCs) are some of the most common congenital anomalies worldwide. The aim of this case-control study was to evaluate the association of OFCs with selected maternal characteristics. METHODS Data on isolated non-syndromic cases of OFCs were extracted from the population-based registry of congenital anomalies of Tuscany. A sample of live-born infants without any congenital anomaly was used as the control group. We investigated the association with sex and some maternal characteristics: age, body mass index, smoking, and education. Adjusted odds ratios (OR) were calculated using a logistic regression model. Analyses were performed for the total OFCs and separately for cleft lip (CL) and cleft palate (CP). RESULTS Data on 219 cases and 37,988 controls were analyzed. A higher proportion of males (57.9%) was observed, particularly for CL. A decreasing trend among the maternal age classes was observed (OR:0.81 (95%CI 0.70-0.94)). Underweight mothers had a higher prevalence of OFCs, in particular for CL (OR:1.88 (95%CI 1.08-3.26)). CONCLUSIONS We found an association of OFCs with lower maternal age. The association with maternal age remains controversial and further epidemiological evidence is needed through multicenter studies. We observed that CL was more common in underweight mothers, suggesting actions of primary prevention.
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Affiliation(s)
- Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Lorena Mezzasalma
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
- Foundation Gabriele Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
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Glinianaia SV, Tan J, Morris JK, Brigden J, Evans HER, Loane M, Neville AJ, Rankin J. Academic achievement at ages 11 and 16 in children born with congenital anomalies in England: A multi-registry linked cohort study. Paediatr Perinat Epidemiol 2024; 38:411-425. [PMID: 38318667 DOI: 10.1111/ppe.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Children born with major congenital anomalies (CAs) have lower academic achievement compared with their peers, but the existing evidence is restricted to a number of specific CAs. OBJECTIVES To investigate academic outcomes at ages 11 and 16 in children with major isolated structural CAs and children with Down or Turner syndromes. METHODS This population-based cohort study linked data on approximately 11,000 school-aged children born with major CAs in 1994-2004 registered by four regional CA registries in England with education data from the National Pupil Database (NPD). The comparison group was a random sample of children without major CAs from the background population recorded in the NPD that were frequency matched (5:1) to children with CAs by birth year, sex and geographical area. RESULTS Overall, 71.9%, 73.0% and 80.9% of children with isolated structural CAs achieved the expected attainment level at age 11 compared to 78.3%, 80.6% and 86.7% of the comparison group in English language, Mathematics and Science, respectively. Children with nervous system CAs as a whole had the lowest proportion who achieved the expected attainment at age 11. At age 16, 46.9% of children with CAs achieved the expected level compared to 52.5% of their peers. Major CAs were associated with being up to 9% (95% confidence interval [CI] 8%, 11%) and 12% (95% CI 9%, 14%) less likely to achieve expected levels at ages 11 and 16, respectively, after adjustment for socioeconomic deprivation. CONCLUSIONS Although many children with isolated CAs achieved the expected academic level at ages 11 and 16, they were at higher risk of underachievement compared to their peers. These stark yet cautiously encouraging results are important for counselling parents of children with specific CAs and also highlight the possible need for special education support to reduce potential academic difficulties.
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Affiliation(s)
- Svetlana V Glinianaia
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Joachim Tan
- Population Health Research Institute, St George's, University of London, London, UK
- NIHR GOSH Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Joan K Morris
- Population Health Research Institute, St George's, University of London, London, UK
| | - Jo Brigden
- Population Health Research Institute, St George's, University of London, London, UK
| | - Hannah E R Evans
- Population Health Research Institute, St George's, University of London, London, UK
| | - Maria Loane
- Faculty of Life and Health Sciences, Ulster University, Belfast, UK
| | - Amanda J Neville
- Center for Clinical and Epidemiological Research, University of Ferrara, Ferrara, Emilia-Romagna, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Moura SRB, Nakachima LR, Santos JBGD, Belloti JC, Fernandes CH, Faloppa F, Moraes VYD, Sabongi RG. Prevalence of Congenital Anomalies of the Upper Limbs in Brazil: a descriptive cross-sectional study. SAO PAULO MED J 2024; 142:e2023349. [PMID: 38896746 DOI: 10.1590/1516-3180.2023.0349.r1.08042024] [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] [Received: 09/30/2023] [Accepted: 04/08/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Congenital Anomalies of the Upper Limb (CAUL) are a group of structural or functional abnormalities that develop during intrauterine life and can lead to limb dysfunction. OBJECTIVES To analyze the prevalence of congenital anomalies of the upper limbs in Brazil and assess maternal and neonatal variables. DESIGN AND SETTING A cross-sectional, descriptive study was conducted on congenital upper limb malformations among live births across Brazil. METHODS The study spanned from 2010 to 2019. Data were sourced from the Department of Informatics of the Unified Health System (DATASUS) and the Live Birth Information System (SINASC) portal. Analyses focused on the information reported in field 41 of the Live Birth Declaration Form entered into the computerized system. RESULTS The most common anomaly in Brazil was supernumerary fingers, classified as ICD-Q69.0, affecting 11,708 children, with a prevalence of 4.02 per 10,000 live births. Mothers aged over 40 years had a 36% higher prevalence of having children with CAUL than mothers under 40 years old (OR = 1.36; 95% CI 1.19-1.56). Newborns weighing ≥ 2,499 g were 2.64 times more likely to have CAUL compared to those weighing ≥ 2,500 g (OR = 2.64; 95% CI 2.55-2.73). CONCLUSION There was an observed increase in the reporting of CAUL cases over the decade studied. This trend serves as an alert for health agencies, as understanding the prevalence of CAUL and its associated factors is crucial for preventive medicine.
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Affiliation(s)
- Samuel Ricardo Batista Moura
- Hand Surgeon, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo (SP), Brazil
| | - Luis Renato Nakachima
- Adjunct Professor, Department of Orthopedics and Traumatology. Discipline of Hand and Upper Limb Surgery, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPMUNIFESP), São Paulo (SP), Brazil
| | - João Baptista Gomes Dos Santos
- Adjunct Professor, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPMUNIFESP), São Paulo (SP), Brazil
| | - João Carlos Belloti
- Adjunct Professor, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPMUNIFESP), São Paulo (SP), Brazil
| | - Carlos Henrique Fernandes
- Adjunct Professor, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPMUNIFESP), São Paulo (SP), Brazil
| | - Flavio Faloppa
- Full Professor, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPMUNIFESP), São Paulo (SP), Brazil
| | - Vinicius Ynoe de Moraes
- Orthopedic Surgeon, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPMUNIFESP), São Paulo (SP), Brazil
| | - Rodrigo Guerra Sabongi
- Hand Surgeon, Department of Orthopedics and Traumatology, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo (SP), Brazil
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Schultewolter JH, Rissmann A, von Schweinitz D, Frühwald M, Blattmann C, Fischer L, Lange BS, Wessalowski R, Fröhlich B, Behnisch W, Schmid I, Reinhard H, Dürken M, Hundsdörfer P, Heimbrodt M, Vokuhl C, Schönberger S, Schneider DT, Seitz G, Looijenga L, Göbel U, von Kries R, Reutter H, Calaminus G. Non-Syndromic and Syndromic Defects in Children with Extracranial Germ Cell Tumors: Data of 2610 Children Registered with the German MAKEI 96/MAHO 98 Registry Compared to the General Population. Cancers (Basel) 2024; 16:2157. [PMID: 38893276 PMCID: PMC11172205 DOI: 10.3390/cancers16112157] [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: 04/19/2024] [Revised: 05/23/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
GCTs are developmental tumors and are likely to reflect ontogenetic and teratogenetic determinants. The objective of this study was to identify syndromes with or without congenital anomalies and non-syndromic defects as potential risk factors. Patients with extracranial GCTs (eGCTs) registered in MAKEI 96/MAHO 98 between 1996 and 2017 were included. According to Teilum's holistic concept, malignant and benign teratomas were registered. We used a case-control study design with Orphanet as a reference group for syndromic defects and the Mainz birth registry (EUROCAT) for congenital anomalies at birth. Co-occurring genetic syndromes and/or congenital anomalies were assessed accordingly. Odds ratios and 95% confidence intervals were calculated and p-values for Fisher's exact test with Bonferroni correction if needed. A strong association was confirmed for Swyer (OR 338.6, 95% CI 43.7-2623.6) and Currarino syndrome (OR 34.2, 95% CI 13.2-88.6). We additionally found 16 isolated cases of eGCT with a wide range of syndromes. However, these were not found to be significantly associated following Bonferroni correction. Most of these cases pertained to girls. Regarding non-syndromic defects, no association with eGCTs could be identified. In our study, we confirmed a strong association for Swyer and Currarino syndromes with additional congenital anomalies.
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Affiliation(s)
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto-von-Guericke University, 39106 Magdeburg, Germany;
| | - Dietrich von Schweinitz
- Dr. von Haunersches Kinderspital, Department of Paediatric Surgery, University of Munich, 80539 Munich, Germany;
| | - Michael Frühwald
- Department of Pediatric and Adolescent Medicine, University Medical Center Augsburg, 86159 Augsburg, Germany;
| | - Claudia Blattmann
- Centre for Childhood, Adolescents and Female Medicine, Paediatrics 5 (Oncology, Hämatology, Immunology), Olgahospital Klinikum Stuttgart, 70174 Stuttgart, Germany;
| | - Lars Fischer
- Clinic for Childhood and Adolescent Medicine, Paediatric Oncology, University Hospital Leipzig (Universitätsklinikum Leipzig AöR), 04103 Leipzig, Germany;
| | - Björn Sönke Lange
- Clinic for Childhood and Adolescent Medicine, Paediatric Haematology and Oncology, University Hospital Dresden, 01307 Dresden, Germany;
| | - Rüdiger Wessalowski
- Clinic for Paediatric Hematology, Oncology and Immunology, University Childrens Hospital Düsseldorf, 40225 Düsseldorf, Germany; (R.W.); (U.G.)
| | - Birgit Fröhlich
- Clinic for Paediatric Hematology and Oncology, University of Münster, 48149 Münster, Germany;
| | - Wolfgang Behnisch
- Department of Paediatric Haematology and Oncology, University Childrens Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Irene Schmid
- Dr. von Haunersches Kinderspital, Department of Paediatric Haematology and Oncology, University of Munich, 80539 Munich, Germany;
| | - Harald Reinhard
- Department of Paediatric Haematology and Oncology, Asklepios Hospital Sankt Augustin, 53757 St. Augustin, Germany;
| | - Matthias Dürken
- Clinic for Childhood and Adolescent Medicine, Paediatric Haematology and Oncology, Medical Faculty Mannheim, University of Heidelberg, 69117 Heidelberg, Germany;
| | - Patrick Hundsdörfer
- Clinic for Childhood and Adolescent Medicine, Oncology Haematology, HELIOS Clinic Berlin-Buch, 13125 Berlin, Germany;
| | - Martin Heimbrodt
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.H.); (G.C.)
| | - Christian Vokuhl
- Department of Pathology, Section Paidopathology, University Hospital Bonn, 53127 Bonn, Germany;
| | - Stefan Schönberger
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Dominik T. Schneider
- Clinic of Paediatrics, Klinikum Dortmund, University Witten/Herdecke, 58448 Witten, Germany;
| | - Guido Seitz
- Department of Pediatric Surgery and Urology, University Hospital Giessen-Marburg, Campus Marburg, 35037 Marburg, Germany;
- Department of Pediatric Surgery, University Hospital Giessen-Marburg, Campus Giessen, 35392 Giessen, Germany
| | - Leendert Looijenga
- Princess Máxima Center for Pediatric Oncology, 3584 Utrecht, The Netherlands;
| | - Ulrich Göbel
- Clinic for Paediatric Hematology, Oncology and Immunology, University Childrens Hospital Düsseldorf, 40225 Düsseldorf, Germany; (R.W.); (U.G.)
| | - Rüdiger von Kries
- Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, LMU Munich, 80539 Munich, Germany;
| | - Heiko Reutter
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany;
| | - Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.H.); (G.C.)
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Madadi-Sanjani O, Ure BM. Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications. Eur J Pediatr Surg 2024; 34:182-188. [PMID: 37871645 DOI: 10.1055/a-2196-1755] [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: 10/25/2023]
Abstract
Procedure-related registries in general surgical practice offer a platform for prospective trials, the pooling of data, and detailed outcome analysis. Recommendations by the Idea, Development, Exploration, Assessment, and Long-term follow-up (IDEAL) collaboration and Outcome4Medicine have further improved the uniform reporting of complications and adverse events.In the pediatric surgical network, disease-specific registries for rare and inherited congenital anomalies are gaining importance, fostering international collaborations on studies of low-incidence diseases. However, to date, reporting of complications in the pediatric surgical registries has been inconsistent. Therefore, the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA) recently endorsed the validation of the first severity grading system for children. The planned reform of the European Paediatric Surgical Audit (EPSA) registry, which includes the implementation of the Clavien-Madadi classification, represents a further effort to establish uniform outcome reporting.This article provides an overview of experiences with surgical registries and complication reporting, along with the potential application of this knowledge to future pediatric surgical practice.
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Affiliation(s)
| | - Benno M Ure
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
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Tan J, Glinianaia SV, Rankin J, Pierini A, Santoro M, Coi A, Garne E, Loane M, Given JE, Brigden J, Ballardini E, Cavero-Carbonell C, de Walle HEK, García-Villodre L, Gatt M, Gissler M, Heino A, Jordan S, Khoshnood B, Klungsoyr K, Lelong N, Lutke RL, Neville AJ, Tucker D, Urhoj SK, Wellesley D, Morris JK. Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population-based cohort study. Paediatr Perinat Epidemiol 2023; 37:679-690. [PMID: 37817457 DOI: 10.1111/ppe.13010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Preterm birth and young maternal age are known risk factors for infant and childhood mortality. There is limited knowledge of the impact of these risk factors in children born with major congenital anomalies (CAs), who have inherently higher risks of death compared with other children. OBJECTIVES To investigate the risk factors for mortality up to age 10 years in children born with specific major CAs. METHODS This population-based cohort study involved 150,198 livebirths from 1995 to 2014 in 13 European CA registries linked to mortality data. Cox proportional hazards models estimated the association of gestational age, maternal age and child's sex with death <1 year and 1-9 years for the whole cohort and by CA subgroup. Hazard ratios (HR) from each registry were pooled using multivariate meta-analysis. RESULTS Preterm birth had a dose-response association with mortality; compared with infants born at 37+ weeks gestation, those born at <28, 28-31 and 32-36 weeks had 14.88 (95% CI 12.57, 17.62), 8.39 (95% CI 7.16, 9.85) and 3.88 (95% CI 3.40, 4.43) times higher risk of death <1 year, respectively. The corresponding risks at 1-9 years were 4.99 (95% CI 2.94, 8.48), 3.09 (95% CI 2.28, 4.18) and 2.04 (95% CI 1.69, 2.46) times higher, respectively. Maternal age <20 years (versus 20-34 years) was a risk factor for death <1 year (HR 1.30, 95% CI 1.09, 1.54) and 1-9 years (HR 1.58, 95% CI 1.19, 2.10). Females had 1.22 (95% CI 1.07, 1.39) times higher risk of death between 1 and 9 years than males. CONCLUSION Preterm birth was associated with considerably higher infant and childhood mortality in children with CAs, comparable to estimates reported elsewhere for the background population. Additional risk factors included young maternal age and female sex. Information on risk factors could benefit clinical care and guide counselling of parents following CA diagnoses.
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Affiliation(s)
- Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | | | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Maria Loane
- Faculty of Life and Health Sciences, Ulster University, Coleraine, UK
| | - Joanne E Given
- Faculty of Life and Health Sciences, Ulster University, Coleraine, UK
| | - Joanna Brigden
- Population Health Research Institute, St George's University of London, London, UK
| | - Elisa Ballardini
- Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Hermien E K de Walle
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Laura García-Villodre
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, Tal-Pietà, Malta
| | - Mika Gissler
- Department of Knowledge Brokers, THL 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
| | - Anna Heino
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sue Jordan
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Babak Khoshnood
- Université Paris Cité, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France
| | - Kari Klungsoyr
- 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
| | - Nathalie Lelong
- Université Paris Cité, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France
| | - Renée L Lutke
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Amanda J Neville
- IMER Registry (Emilia Romagna Registry of Birth Defects), Center for Clinical and Epidemiological Research, University of Ferrara and Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
| | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Knowledge and Research, Public Health Wales, Swansea, UK
| | - Stine K Urhoj
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Diana Wellesley
- University of Southampton and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Joan K Morris
- Population Health Research Institute, St George's University of London, London, UK
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Rissmann A, Tan J, Glinianaia SV, Rankin J, Pierini A, Santoro M, Coi A, Garne E, Loane M, Given J, Reid A, Aizpurua A, Akhmedzhanova D, Ballardini E, Barisic I, Cavero-Carbonell C, de Walle HEK, Gatt M, Gissler M, Heino A, Jordan S, Urhoj SK, Klungsøyr K, Lutke R, Mokoroa O, Neville AJ, Thayer DS, Wellesley DG, Yevtushok L, Zurriaga O, Morris J. Causes of death in children with congenital anomalies up to age 10 in eight European countries. BMJ Paediatr Open 2023; 7:e001617. [PMID: 37353235 PMCID: PMC10367017 DOI: 10.1136/bmjpo-2022-001617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/20/2022] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Congenital anomalies (CAs) increase the risk of death during infancy and childhood. This study aimed to evaluate the accuracy of using death certificates to estimate the burden of CAs on mortality for children under 10 years old. METHODS Children born alive with a major CA between 1 January 1995 and 31 December 2014, from 13 population-based European CA registries were linked to mortality records up to their 10th birthday or 31 December 2015, whichever was earlier. RESULTS In total 4199 neonatal, 2100 postneonatal and 1087 deaths in children aged 1-9 years were reported. The underlying cause of death was a CA in 71% (95% CI 64% to 78%) of neonatal and 68% (95% CI 61% to 74%) of postneonatal infant deaths. For neonatal deaths the proportions varied by registry from 45% to 89% and by anomaly from 53% for Down syndrome to 94% for tetralogy of Fallot. In children aged 1-9, 49% (95% CI 42% to 57%) were attributed to a CA. Comparing mortality in children with anomalies to population mortality predicts that over 90% of all deaths at all ages are attributable to the anomalies. The specific CA was often not reported on the death certificate, even for lethal anomalies such as trisomy 13 (only 80% included the code for trisomy 13). CONCLUSIONS Data on the underlying cause of death from death certificates alone are not sufficient to evaluate the burden of CAs on infant and childhood mortality across countries and over time. Linked data from CA registries and death certificates are necessary for obtaining accurate estimates.
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Affiliation(s)
- Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto von Guericke Universitat Magdeburg, Magdeburg, Germany
| | - Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | | | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anna Pierini
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital - University Hospital of Southern Denmark, Kolding, Denmark
| | - Maria Loane
- Centre for Maternal, Fetal and Infant Research, Institute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Joanne Given
- Centre for Maternal, Fetal and Infant Research, Institute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Abigail Reid
- Population Health Research Institute, St George's University of London, London, UK
| | - Amaia Aizpurua
- Health Division of Gipuzkoa, Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Diana Akhmedzhanova
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - Elisa Ballardini
- Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Dep. of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ingeborg Barisic
- Centre of Excellence for Reproductive and Regenerative Medicine, Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia
| | - Clara Cavero-Carbonell
- Rare Diseases Research Join Unit, Foundation for the Promotion of Health and Biomedical Research and Universitat de Valencia, Valencia, Spain
| | | | - Miriam Gatt
- Malta Congenital Anomalies Register, Directorate for Health Information and Research, Tal-Pietà, Malta
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anna Heino
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sue Jordan
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Stine Kjaer Urhoj
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital - University Hospital of Southern Denmark, Kolding, Denmark
- Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Medical Birth Registry, Nasjonalt folkehelseinstitutt, Bergen, Norway
| | - Renee Lutke
- Department of Genetics, Groningen University, Groningen, The Netherlands
| | - Olatz Mokoroa
- Health Division of Gipuzkoa, Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Amanda Julie Neville
- IMER Registry, Centre for Clinical and Epidemiological Research, University of Ferrara and Azienda Ospedaliero Universitario di Ferrara, Ferrara, Italy
| | - Daniel S Thayer
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Diana G Wellesley
- University of Southampton and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Lyubov Yevtushok
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - Oscar Zurriaga
- Rare Diseases Research Join Unit, Foundation for the Promotion of Health and Biomedical Research and Universitat de Valencia, Valencia, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Morris
- Population Health Research Institute, St George's University of London, London, UK
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10
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Bergman JEH, Barišić I, Addor MC, Braz P, Cavero-Carbonell C, Draper ES, Echevarría-González-de-Garibay LJ, Gatt M, Haeusler M, Khoshnood B, Klungsøyr K, Kurinczuk JJ, Latos-Bielenska A, Luyt K, Martin D, Mullaney C, Nelen V, Neville AJ, O'Mahony MT, Perthus I, Pierini A, Randrianaivo H, Rankin J, Rissmann A, Rouget F, Sayers G, Schaub B, Stevens S, Tucker D, Verellen-Dumoulin C, Wiesel A, Gerkes EH, Perraud A, Loane MA, Wellesley D, de Walle HEK. Amniotic band syndrome and limb body wall complex in Europe 1980-2019. Am J Med Genet A 2023; 191:995-1006. [PMID: 36584346 DOI: 10.1002/ajmg.a.63107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/29/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
Amniotic band syndrome (ABS) and limb body wall complex (LBWC) have an overlapping phenotype of multiple congenital anomalies and their etiology is unknown. We aimed to determine the prevalence of ABS and LBWC in Europe from 1980 to 2019 and to describe the spectrum of congenital anomalies. In addition, we investigated maternal age and multiple birth as possible risk factors for the occurrence of ABS and LBWC. We used data from the European surveillance of congenital anomalies (EUROCAT) network including data from 30 registries over 1980-2019. We included all pregnancy outcomes, including live births, stillbirths, and terminations of pregnancy for fetal anomalies. ABS and LBWC cases were extracted from the central EUROCAT database using coding information responses from the registries. In total, 866 ABS cases and 451 LBWC cases were included in this study. The mean prevalence was 0.53/10,000 births for ABS and 0.34/10,000 births for LBWC during the 40 years. Prevalence of both ABS and LBWC was lower in the 1980s and higher in the United Kingdom. Limb anomalies and neural tube defects were commonly seen in ABS, whereas in LBWC abdominal and thoracic wall defects and limb anomalies were most prevalent. Twinning was confirmed as a risk factor for both ABS and LBWC. This study includes the largest cohort of ABS and LBWC cases ever reported over a large time period using standardized EUROCAT data. Prevalence, clinical characteristics, and the phenotypic spectrum are described, and twinning is confirmed as a risk factor.
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Affiliation(s)
- Jorieke E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ingeborg Barišić
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | - Paula Braz
- RENAC-Registo Nacional de Anomalias Congénitas, Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of the Research in Healthcare and Biomedicine, Valencia, Spain
| | | | | | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, G'mangia, Malta
| | - Martin Haeusler
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Babak Khoshnood
- Université de Paris Cité, Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOPé), CRESS, INSERM, INRA, Paris, France
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anna Latos-Bielenska
- Polish Registry of Congenital Malformations, Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Karen Luyt
- South West Congenital Anomaly Register (SWCAR), Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Carmel Mullaney
- Department of Public Health, HSE South East Area, Dublin, Ireland
| | - Vera Nelen
- Provincial Institute of Hygiene, Antwerp, Belgium
| | - Amanda J Neville
- IMER Registry, Centre for Clinical and Epidemiological Research, University of Ferrara and Azienda Ospedaliero Universitario di Ferrara, Ferrara, Italy
| | - Mary T O'Mahony
- Department of Public Health HSE-South, St Finbarr's Hospital, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Hanitra Randrianaivo
- Unit of Genetic Medical and Register of Congenital Malformations, CHU St Pierre La Reunion, Réunion, France
| | - Judith Rankin
- South West Congenital Anomaly Register (SWCAR), Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
| | - Gerardine Sayers
- National Health Intelligence Unit, R&D Health Service Executive, Dublin, Ireland
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | | | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Wales, Swansea, UK
| | | | - Awi Wiesel
- Births Registry Mainz Model, University of Mainz Medical Center, Mainz, Germany
| | - Erica H Gerkes
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annie Perraud
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Maria A Loane
- Faculty of Life & Health Sciences, Ulster University, Northern Ireland, UK
| | - Diana Wellesley
- Faculty of Medicine and Wessex Clinical Genetics Service, Princess Anne Hospital, University Hospital Southampton, Southampton, UK
| | - Hermien E K de Walle
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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11
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Coi A, Barisic I, Garne E, Pierini A, Addor MC, Aizpurua Atxega A, Ballardini E, Braz P, Broughan JM, Cavero-Carbonell C, de Walle HEK, Draper ES, Gatt M, Häusler M, Kinsner-Ovaskainen A, Kurinczuk JJ, Lelong N, Luyt K, Mezzasalma L, Mullaney C, Nelen V, Odak L, O'Mahony MT, Perthus I, Randrianaivo H, Rankin J, Rissmann A, Rouget F, Schaub B, Tucker D, Wellesley D, Wiśniewska K, Yevtushok L, Santoro M. Epidemiology of aplasia cutis congenita: A population-based study in Europe. J Eur Acad Dermatol Venereol 2023; 37:581-589. [PMID: 36300660 DOI: 10.1111/jdv.18690] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aplasia cutis congenita (ACC) is a rare congenital anomaly characterized by localized or widespread absence of skin at birth, mainly affecting the scalp. Most information about ACC exists as individual case reports and medium-sized studies. OBJECTIVES This study aimed to investigate the epidemiology of ACC, using data from a large European network of population-based registries for congenital anomalies (EUROCAT). METHODS Twenty-eight EUROCAT population-based registries in 16 European countries were involved. Poisson regression models were exploited to estimate the overall and live birth prevalence, to test time trends in prevalence between four 5-year periods and to evaluate the impact of the change of coding for ACC from the unspecific ICD9-BPA code to the specific ICD10 code. Proportions of ACC cases associated with other anomalies were reported. RESULTS Five hundred cases were identified in the period 1998-2017 (prevalence: 5.10 per 100,000 births). Prevalence across 5-year periods did not differ significantly and no significant differences were evident due to the change from ICD9 to ICD10 in ACC coding. Heterogeneity in prevalence was observed across registries. The scalp was the most common site for ACC (96.4%) and associated congenital anomalies were present in 33.8% of cases. Patau and Adams-Oliver syndromes were the most frequent among the associated chromosomal anomalies (88.3%) and the associated genetic syndromes (57.7%), respectively. 16% of cases were associated with limb anomalies and 15.4% with congenital heart defects. A family history of ACC was found in 2% of cases. CONCLUSION To our knowledge, this is the only population-based study on ACC. The EUROCAT methodologies provide reliable prevalence estimates and proportions of associated anomalies.
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Affiliation(s)
- Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Ingeborg Barisic
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | - Amaia Aizpurua Atxega
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Donostia-San Sebastian, Spain
| | - Elisa Ballardini
- Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Jennifer M Broughan
- National Congenital Anomaly and Rare Disease Registration Service, National Disease Registration Service, NHS Digital, Leeds, UK
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Hermien E K de Walle
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elizabeth S Draper
- Department Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, G'Mangia, Malta
| | | | | | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nathalie Lelong
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Paris, France
| | - Karen Luyt
- South West Congenital Anomaly Register, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lorena Mezzasalma
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Carmel Mullaney
- Department of Public Health, HSE South East, Lacken, Kilkenny, Ireland
| | - Vera Nelen
- Provincial Institute of Hygiene, Antwerp, Belgium
| | - Ljubica Odak
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Mary T O'Mahony
- Department of Public Health, HSE South (Cork & Kerry), Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Hanitra Randrianaivo
- Register of Congenital Malformations Isle of Reunion Island, CHU St Pierre, la Reunion, Reunion, France
| | - Judith Rankin
- National Congenital Anomaly and Rare Disease Registration Service, National Disease Registration Service, NHS Digital, Leeds, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Wales, Swansea, UK
| | - Diana Wellesley
- University Hospital Southampton, Faculty of Medicine and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Katarzyna Wiśniewska
- Epidemiology Unit, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Lyubov Yevtushok
- OMNI-Net Ukraine Birth Defects Program and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
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12
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Morris JK, Wellesley D, Limb E, Bergman JEH, Kinsner-Ovaskainen A, Addor MC, Broughan JM, Cavero-Carbonell C, Dias CM, Echevarría-González-de-Garibay LJ, Gatt M, Haeusler M, Barisic I, Klungsoyr K, Lelong N, Materna-Kiryluk A, Neville A, Nelen V, O'Mahony MT, Perthus I, Pierini A, Rankin J, Rissmann A, Rouget F, Sayers G, Stevens S, Tucker D, Garne E. Prevalence of vascular disruption anomalies and association with young maternal age: A EUROCAT study to compare the United Kingdom with other European countries. Birth Defects Res 2022; 114:1417-1426. [PMID: 36369770 PMCID: PMC10099853 DOI: 10.1002/bdr2.2122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 10/17/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Younger mothers are at a greater risk of having a pregnancy with gastroschisis and the risk is higher in the United Kingdom than other European countries. Gastroschisis is thought to be a vascular disruption anomaly and the aim of this study was to analyze the prevalence of other possible vascular disruption anomalies to determine whether both the younger maternal age and the UK associations also occur with these anomalies. METHODS All pregnancies with anomalies considered potentially due to vascular disruption from January 1, 2005 to December 31, 2017 from 26 European population-based congenital anomaly registries who were members of EUROCAT were analyzed. Multilevel models were used to allow for differences between registries when analyzing associations with maternal age, year of birth and whether the registry was in the United Kingdom. RESULTS There were 5,220 cases with potential vascular disruption anomalies, excluding chromosomal and genetic conditions, with a prevalence of 8.85 per 10,000 births in the United Kingdom and 5.44 in the other European countries. The prevalence per 10,000 births of gastroschisis (4.45 vs. 1.56) and congenital constriction bands (0.83 vs. 0.42) was significantly higher in the United Kingdom, even after adjusting for maternal age. However, transverse limb reduction defects had a similar prevalence (2.16 vs. 2.14 per 10,000). The expected increased prevalence in younger mothers was observed for vascular disruption anomalies overall and for the individual anomalies: gastroschisis and congenital constriction bands. CONCLUSION Vascular disruption anomalies that had an increased risk for younger mothers (such as gastroschisis) had a higher maternal age standardized prevalence in the United Kingdom, while vascular disruption anomalies with weaker associations with younger mothers (such as transverse limb reduction defects) did not have an increased prevalence in the United Kingdom, which may indicate a different etiology for these anomalies.
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Affiliation(s)
- Joan K Morris
- St George's, University of London, London, United Kingdom
| | - Diana Wellesley
- Clinical Genetics, University of Southampton and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Elizabeth Limb
- St George's, University of London, London, United Kingdom
| | - Jorieke E H Bergman
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | | | - Marie Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | | | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Carlos M Dias
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge; Av padre Cruz, Lisbon, Portugal
| | | | - Miriam Gatt
- Directorate for Health Information and Research, Malta Congenital Anomalies Registry, G'Mangia, Malta
| | | | - Ingeborg Barisic
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Kari Klungsoyr
- 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
| | - Nathalie Lelong
- Université de Paris, INSERM U1153, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France
| | - Anna Materna-Kiryluk
- Polish Registry of Congenital Malformations, Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Amanda Neville
- Center for Clinical and Epidemiological Research, University of Ferrara, Ferrara, Italy
| | - Vera Nelen
- Provincial Institute for Hygiene, Antwerp, Belgium
| | - Mary T O'Mahony
- Department of Public Health, Health Service Executive-South, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, CNRS-UMR 6602, Institut Pascal, Axe TGI, équipe PEPRADE, Clermont-Ferrand, France
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Geraldine Sayers
- Health Intelligence, Research and Development Health Service Executive, Dublin, Ireland
| | - Sarah Stevens
- National Disease Registration Service, NHS Digital, Leeds, United Kingdom
| | - David Tucker
- Public Health Knowledge and Research, Public Health Wales, Singleton Hospital, Swansea, United Kingdom
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
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13
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Sobkowski M, Pięta B, Sowińska A, Grabowska M, Koch-Brzozowska K, Wilczak M, Bień A. SARS-CoV-2 in Pregnancy-A Retrospective Analysis of Selected Maternal and Fetal Laboratory Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15307. [PMID: 36430023 PMCID: PMC9690975 DOI: 10.3390/ijerph192215307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Pregnant women and their neonates belong to the group of individuals with elevated risk for COVID-19 infection. Data on the course of the disease and how it affects the pregnancy and neonatal wellbeing remain conflicting. The aim of the study was to evaluate the effect of SARS CoV-2 infection on the mode of delivery, neonatal condition and selected maternal and fetal laboratory parameters. This was a single-center retrospective case-control study. This dataset was generated using electronic medical records collected by medical personnel. Two groups of patients, hospitalized between April, 2020 and February, 2021, were included in the study: study group (304)-pregnant women with SARS-CoV-2 and control group (N = 329)-healthy pregnant women or parturients. Mothers with a severe course of COVID-19 had higher activated partial thromboplastin-APTT (p = 0.02), C-Reactive Protein-CRP (p = 0.00) and procalcitonin (p = 0.032) levels as compared to pregnant women with mild or moderate course of the disease. Neonates born to SARS-CoV-2-infected mothers presented with worse condition at 1 and 5 minutes of life (p = 0.000 and 0.00, respectively) and lower Arterial Blood Gas-ABG pH scores (p = 0.016). Elective cesarean section is the most common mode of delivery for SARS-CoV2-infected mothers. Emergency cesarean sections are performed at earlier gestational age as compared to vaginal delivery and elective cesarean section. Lower Apgar scores were observed in neonates born to SARS-CoV-2-infected mothers who required oxygen therapy and whose procalcitonin levels were elevated. There is a relationship between more severe course of COVID-19 and APTT, as well as CRP and procalcitonin levels.
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Affiliation(s)
- Maciej Sobkowski
- Department of Mother and Child Health, Poznan University of Medical Sciences, Polna Street 33, 60-535 Poznań, Poland
| | - Beata Pięta
- Department of Mother and Child Health, Poznan University of Medical Sciences, Polna Street 33, 60-535 Poznań, Poland
| | - Anna Sowińska
- Department of Informatics and Statistics, University of Medical Sciences, Rokietnicka Street 7, 60-806 Poznań, Poland
| | - Marlena Grabowska
- Gynecological and Obstetric Hospital of the University of Medical Sciences in Poznan, Polna Street 33, 60-535 Poznań, Poland
| | | | - Maciej Wilczak
- Department of Mother and Child Health, Poznan University of Medical Sciences, Polna Street 33, 60-535 Poznań, Poland
| | - Agnieszka Bień
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4/6 Staszica St., 20-081 Lublin, Poland
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Santoro M, Coi A, Pierini A, Rankin J, Glinianaia SV, Tan J, Reid A, Garne E, Loane M, Given J, Aizpurua A, Astolfi G, Barisic I, Cavero‐Carbonell C, de Walle HEK, Den Hond E, García‐Villodre L, Gatt M, Gissler M, Jordan S, Khoshnood B, Kiuru‐Kuhlefelt S, Klungsøyr K, Lelong N, Lutke R, Mokoroa O, Nelen V, Neville AJ, Odak L, Rissmann A, Scanlon I, Urhoj SK, Wellesley D, Wertelecki W, Yevtushok L, Morris JK. Temporal and geographical variations in survival of children born with congenital anomalies in Europe: A multi-registry cohort study. Paediatr Perinat Epidemiol 2022; 36:792-803. [PMID: 35675091 PMCID: PMC9796712 DOI: 10.1111/ppe.12884] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/22/2022] [Accepted: 04/03/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Congenital anomalies are a major cause of perinatal, neonatal and infant mortality. OBJECTIVES The aim was to investigate temporal changes and geographical variation in survival of children with major congenital anomalies (CA) in different European areas. METHODS In this population-based linkage cohort study, 17 CA registries members of EUROCAT, the European network for the surveillance of CAs, successfully linked data on 115,219 live births with CAs to mortality records. Registries estimated Kaplan-Meier survival at 28 days and 5 years of age and fitted Cox's proportional hazards models comparing mortality at 1 year and 1-9 years of age for children born during 2005-2014 with those born during 1995-2004. The hazard ratios (HR) from each registry were combined centrally using a random-effects model. The 5-year survival conditional on having survived to 28 days of age was calculated. RESULTS The overall risk of death by 1 year of age for children born with any major CA in 2005-2014 decreased compared to 1995-2004 (HR 0.68, 95% confidence interval [CI] 0.53, 0.89). Survival at 5 years of age ranged between registries from 97.6% to 87.0%. The lowest survival was observed for the registry of OMNI-Net (Ukraine) (87.0%, 95% CI 86.1, 87.9). CONCLUSIONS Survival of children with CAs improved for births in 2005-2014 compared with 1995-2004. The use of CA registry data linked to mortality data enables investigation of survival of children with CAs. Factors such as defining major CAs, proportion of terminations of pregnancy for foetal anomaly, source of mortality data and linkage methods are important to consider in the design of future studies and in the interpretation of the results on survival of children with CAs.
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Affiliation(s)
- Michele Santoro
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical PhysiologyNational Research CouncilPisaItaly
| | - Alessio Coi
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical PhysiologyNational Research CouncilPisaItaly
| | - Anna Pierini
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical PhysiologyNational Research CouncilPisaItaly
- Fondazione Toscana Gabriele MonasterioPisaItaly
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Svetlana V. Glinianaia
- Population Health Sciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Joachim Tan
- Population Health Research Institute, St George'sUniversity of LondonLondonUK
| | - Abigail Reid
- Population Health Research Institute, St George'sUniversity of LondonLondonUK
| | - Ester Garne
- Paediatric DepartmentHospital LillebaeltKoldingDenmark
| | - Maria Loane
- Faculty of Life and Health SciencesUlster UniversityColeraineUK
| | - Joanne Given
- Faculty of Life and Health SciencesUlster UniversityColeraineUK
| | - Amaia Aizpurua
- Public Health Division of GipuzkoaBioDonostia Research InstituteSan SebastianSpain
| | - Gianni Astolfi
- IMER RegistryDepartment of Neuroscience and RehabilitationUniversity of FerraraFerraraItaly
| | - Ingeborg Barisic
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative MedicineMedical School University of ZagrebZagrebCroatia
| | - Clara Cavero‐Carbonell
- Rare Diseases Research UnitFoundation for the Promotion of Health and Biomedical Research in the Valencian RegionValenciaSpain
| | - Hermien E. K. de Walle
- Department of Genetics, University Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | | | - Laura García‐Villodre
- Rare Diseases Research UnitFoundation for the Promotion of Health and Biomedical Research in the Valencian RegionValenciaSpain
| | - Miriam Gatt
- Malta Congenital Anomalies RegistryDirectorate for Health Information and ResearchPietaMalta
| | - Mika Gissler
- THL Finnish Institute for Health and WelfareInformation Services DepartmentHelsinkiFinland
| | - Sue Jordan
- Faculty of Medicine, Health & Life ScienceSwansea UniversitySwanseaUK
| | | | - Sonja Kiuru‐Kuhlefelt
- THL Finnish Institute for Health and WelfareInformation Services DepartmentHelsinkiFinland
| | - Kari Klungsøyr
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
- Division of Mental and Physical HealthNorwegian Institute of Public HealthBergenNorway
| | | | - Renée Lutke
- Department of Genetics, University Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Olatz Mokoroa
- Public Health Division of GipuzkoaBioDonostia Research InstituteSan SebastianSpain
| | - Vera Nelen
- Provincial Institute for HygieneAntwerpBelgium
| | - Amanda J. Neville
- Imer registry Centre for Epidemiology and Clinical Research University of Ferrara and Azienda Ospedaliera Universitaria di FerraraFerraraItaly
| | - Ljubica Odak
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative MedicineMedical School University of ZagrebZagrebCroatia
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony‐AnhaltMedical Faculty Otto‐von‐Guericke‐University MagdeburgMagdeburgGermany
| | - Ieuan Scanlon
- Faculty of Medicine, Health & Life ScienceSwansea UniversitySwanseaUK
| | | | - Diana Wellesley
- Faculty of MedicineUniversity of Southampton and Wessex Clinical Genetics Service, Princess Anne HospitalSouthamptonUK
| | | | | | - Joan K. Morris
- Population Health Research Institute, St George'sUniversity of LondonLondonUK
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Negrato CA, Marques PR, Leite HB, Torigoe CN, Silva BF, Costa K, Kamei JM, Zampa CL, Toni ACRG, Pereira ICGS, Heinzelmann GL, Zajdenverg L. Glycemic and nonglycemic mechanisms of congenital malformations in hyperglycemic pregnancies: a narrative review. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:908-918. [PMID: 36191262 PMCID: PMC10118772 DOI: 10.20945/2359-3997000000521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Congenital malformations are more frequently found among children born to mothers with diabetes than in the background population. There are several complex mechanisms involved in the development of congenital malformations in the offspring of mothers with hyperglycemia, such as the overexpression of glucose transporters (GLUTs) 1 and 2, the increased activity of the hexosamine biosynthetic pathway and the reduced expression of the PAX3 gene with a consequent increase in p53 protein expression. These alterations can lead to increased glucose and free radical concentrations in the embryo, thus promoting the process of apoptosis and causing malformation. The most frequent malformations found in the offspring of mothers with diabetes are heart and neural tube defects, urinary tract and kidney malformations, and cleft lip with or without cleft palate. Strict glycemic control should be obtained before and during pregnancy, aiming to avoid or minimize the risk of congenital malformations in the offspring. Beyond hyperglycemia, several factors may also be associated with increased risks of malformations in the offspring of these women, such as obesity, multiple pregnancies, advanced maternal age, folic acid deficiency, use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, assisted reproduction techniques, and exposure to different types of environmental pollutants.
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16
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Episiotomy for Medical Indications during Vaginal Birth-Retrospective Analysis of Risk Factors Determining the Performance of This Procedure. J Clin Med 2022; 11:jcm11154334. [PMID: 35893429 PMCID: PMC9368956 DOI: 10.3390/jcm11154334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/30/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023] Open
Abstract
The WHO (World Health Organization) recommends that the percentage of perineal incisions should not exceed 10%, indicating that this is a good goal to achieve, despite the fact that it is still a frequently used medical intervention in Poland. The risk factors for perineal incision that have been analyzed so far in the literature allow, among others, to limit the frequency of performing this procedure. Are they still valid? Have there been new risk factors that we should take into account? We have conducted this study to find the risk factors for performing perineal incision that would reduce the frequency of this procedure. The aim of the study was to check whether the risk factors that were analyzed in the literature are still valid, to find new risk factors for perineal incisions and to compare them among Polish women. This was a single-center retrospective case-control study. The electronic patient records of Saint Sophia's Hospital in Warsaw, Poland, a tertiary hospital was used to create an anonymous retrospective database of all deliveries from 2015 to 2020. The study included the analysis of two groups, the study group of patients who had had an episiotomy, and the control group-patients without an episiotomy in cases where an episiotomy was indicated. A logistic regression model was developed to assess the risk factors for perineal laceration. Independent risk factors for episiotomy in labor include oxytocin use in the second stage of labor (OR (Odds Ratio) = 6.00; 95% CI (Confidence Interval): 4.76-7.58), the supply of oxytocin in the first and the second stage of labor (OR = 3.18; 95% CI: 2.90-3.49), oxytocin use in the first stage of labor (OR = 2.72; 95% CI: 2.52-3.51), state after cesarean section (OR = 2.97; 95% CI: 2.52-3.51), epidural anesthesia use (OR = 1.77; 95% CI: 1.62-1.93), male gender (OR = 1.10; 95% CI: 1.02-1.19), and prolonged second stage of labor (OR = 1.01; 95% CI: 1.01-1.01). A protective factor against the use of an episiotomy was delivery in the Birth Centre (OR = 0.43; 95% CI: 0.37-0.51) and mulitpara (OR = 0.31; 95% CI: 0.27-0.35). To reduce the frequency of an episiotomy, it is necessary consider the risk factors of performing this procedure in everyday practice, e.g., limiting the use of oxytocin or promoting alternative places of delivery.
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Dibello D, Torelli L, Di Carlo V, d’Adamo AP, Faletra F, Mangogna A, Colin G. Incidence of Congenital Clubfoot: Preliminary Data from Italian CeDAP Registry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095406. [PMID: 35564801 PMCID: PMC9105829 DOI: 10.3390/ijerph19095406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: We find the incidence of clubfoot in Italy from "Certificate of Delivery Care Registry (CeDAP)", a database of the Italian Ministry of Health, the most comprehensive public data available for this purpose. (2) Methods: The CeDAP registry is a web system that provides epidemiological and sociodemographic information about newborns. It started on 1 January 2002, following the ministerial Decree no. 349 of 16 July 2001. The certificate is structured into six sections; each collects specific information referring to the birthplace, parents, pregnancy, childbirth, newborn, and the possible presence of congenital malformations or the causes of neonatal mortality. The midwife or the doctor draws up the certificate no later than ten days after birth. Each region transmits the data every six months to the Ministry of Health. The period between 2013 and 2017 has been selected for the study, with every Italian region's data. We conducted a retrospective descriptive study. (3) Results: The overall rate in northern Italy is 1.09 (with some exceptions described), but we think it is essential to reevaluate this number again, given more accurate data collections by every Italian hospital. (4) Conclusions: This study intends to build a framework for future epidemiologic studies about clubfoot in Italy.
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Affiliation(s)
- Daniela Dibello
- Unit of Paediatric Orthopaedics and Traumatology, Giovanni XXIII Children’s Hospital, Via Giovanni Amendola, 70126 Bari, Italy;
| | - Lucio Torelli
- Clinical Department of Medical, Surgical and Health Sciences University of Trieste, Strada di Fiume, 34149 Trieste, Italy; (L.T.); (A.P.d.)
| | - Valentina Di Carlo
- Unit of Paediatric Orthopaedics and Traumatology, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Via dell’Istria, 34137 Trieste, Italy
- Correspondence: ; Tel.: +39-040-3785372
| | - Adamo Pio d’Adamo
- Clinical Department of Medical, Surgical and Health Sciences University of Trieste, Strada di Fiume, 34149 Trieste, Italy; (L.T.); (A.P.d.)
- Medical Genetics Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Via dell’Istria, 34137 Trieste, Italy; (F.F.); (A.M.)
| | - Flavio Faletra
- Medical Genetics Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Via dell’Istria, 34137 Trieste, Italy; (F.F.); (A.M.)
| | - Alessandro Mangogna
- Medical Genetics Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Via dell’Istria, 34137 Trieste, Italy; (F.F.); (A.M.)
| | - Giulia Colin
- Unit of Orthopaedics and Traumatology, University of Trieste, Strada di Fiume, 34149 Trieste, Italy;
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18
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Damkjaer M, Urhoj SK, Tan J, Briggs G, Loane M, Given JE, Barrachina-Bonet L, Cavero-Carbonell C, Coi A, Neville AJ, Heino A, Kiuru-Kuhlefelt S, Jordan S, Scanlon I, Pierini A, Puccini A, Garne E, Morris JK. Prescription of cardiovascular medication in children with congenital heart defects across six European Regions from 2000 to 2014: data from the EUROlinkCAT population-based cohort study. BMJ Open 2022; 12:e057400. [PMID: 35450908 PMCID: PMC9024225 DOI: 10.1136/bmjopen-2021-057400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Advances in surgical management strategies have substantially reduced fatality from congenital heart defects (CHD). Decreased infant mortality might be expected, consequentially to result in greater morbidity in older children due to complications later in childhood and adolescence. This study aims to evaluate the use of cardiovascular medication (CVM) as an indicator of disease burden in children born with CHD in the first 10 years of life. DESIGN Population-based cohort study. SETTING Six population-based registries from the European Surveillance of Congenital Anomalies (EUROCAT) network participated. Data from live born children with major congenital anomalies (CA) born from 2000 to 2014 were linked to prescription databases. Four groups of children were analysed: CA, CHD, severe CHD (sCHD) and ventricular septal defect (VSD) without sCHD. Live born children without CA were included as reference group. PARTICIPANTS We obtained data on 61 038 children born with a CA, including 19 678 with CHD, 3392 with sCHD, 12 728 children with VSD without sCHD, and 1 725 496 reference children. RESULTS Children born with sCHD were the most likely to receive a CVM prescription (42.9%, 95% CI, 26.3 to 58.5) in the first year of life compared with 13.3% (6.7 to 22.0) of children with any CHD, 5.9% (3.7 to 8.7) of children with any CA and 0.1% (0.0 to 0.1) of reference children. Medication was less likely to be prescribed after the first year of life for sCHD; 18.8% (14.8 to 23.1) for children 1-4 years and 15.8% (12.0 to 20.1) 5-9 years. Children with sCHD were most likely to receive a diuretic (36.4%, 18.6 to 54.5), an antihypertensive (6.9%, 3.7 to 11.3) or a beta-blocker (5.5%, 2.9 to9.2). CONCLUSION Almost half of all children with sCHD were prescribed CVM in their first year of life. For all four groups of children with anomalies, the proportion of children with a CVM prescription decreased with age.
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Affiliation(s)
- Mads Damkjaer
- Department of Paediatrics, Sygehus Lillebalt Kolding Sygehus, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark
| | - Stine Kjaer Urhoj
- Department of Paediatrics, Sygehus Lillebalt Kolding Sygehus, Kolding, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | - Gillian Briggs
- Population Health Research Institute, St George's University of London, London, UK
| | - Maria Loane
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Joanne Emma Given
- Ulster University Faculty of Life and Health Sciences, Coleraine, UK
| | - Laia Barrachina-Bonet
- Rare Diseases Research Unit, Foundation for the Promotion of the Research in Healthcare and Biomedicine, Valencia, Spain
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of the Research in Healthcare and Biomedicine, Valencia, Spain
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Amanda J Neville
- Registro IMER, University of Ferrara, Ferrara, Emilia-Romagna, Italy
| | - Anna Heino
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Susan Jordan
- Faculty of Medicine, Health & Life Sciences, Swansea University, Swansea, Wales
| | - Ieuan Scanlon
- Faculty of Medicine, Health & Life Sciences, Swansea University, Swansea, Wales
| | - Anna Pierini
- Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Aurora Puccini
- Drug and Medical Device Area, Emilia Romagna Health Department, Emilia-Romagna Regional Healthcare Services, Bologna, Emilia-Romagna, Italy
| | - Ester Garne
- Department of Paediatrics, Sygehus Lillebalt Kolding Sygehus, Kolding, Denmark
| | - Joan K Morris
- Population Health Research Institute, St George's University of London, London, UK
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19
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Coi A, Santoro M, Pierini A, Rankin J, Glinianaia SV, Tan J, Reid AK, Garne E, Loane M, Given J, Ballardini E, Cavero-Carbonell C, de Walle HEK, Gatt M, García-Villodre L, Gissler M, Jordan S, Kiuru-Kuhlefelt S, Kjaer Urhoj S, Klungsøyr K, Lelong N, Lutke LR, Neville AJ, Rahshenas M, Scanlon I, Wellesley D, Morris JK. Survival of children with rare structural congenital anomalies: a multi-registry cohort study. Orphanet J Rare Dis 2022; 17:142. [PMID: 35351164 PMCID: PMC8966236 DOI: 10.1186/s13023-022-02292-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital anomalies are the leading cause of perinatal, neonatal and infant mortality in developed countries. Large long-term follow-up studies investigating survival beyond the first year of life in children with rare congenital anomalies are costly and sufficiently large standardized cohorts are difficult to obtain due to the rarity of some anomalies. This study aimed to investigate the survival up to 10 years of age of children born with a rare structural congenital anomaly in the period 1995-2014 in Western Europe. METHODS Live births from thirteen EUROCAT (European network for the epidemiological surveillance of congenital anomalies) population-based registries were linked to mortality records. Survival for 12,685 live births with one of the 31 investigated rare structural congenital anomalies (CAs) was estimated at 1 week, 4 weeks and 1, 5 and 10 years of age within each registry and combined across Europe using random effects meta-analyses. Differences between registries were evaluated for the eight rare CAs with at least 500 live births. RESULTS Amongst the investigated CAs, arhinencephaly/holoprosencephaly had the lowest survival at all ages (58.1%, 95% Confidence Interval (CI): 44.3-76.2% at 1 week; 47.4%, CI: 36.4-61.6% at 1 year; 35.6%, CI: 22.2-56.9% at 10 years). Overall, children with rare CAs of the digestive system had the highest survival (> 95% at 1 week, > 84% at 10 years). Most deaths occurred within the first four weeks of life, resulting in a 10-year survival conditional on surviving 4 weeks of over 95% for 17 out of 31 rare CAs. A moderate variability in survival between participating registries was observed for the eight selected rare CAs. CONCLUSIONS Pooling standardised data across 13 European CA registries and the linkage to mortality data enabled reliable survival estimates to be obtained at five ages up to ten years. Such estimates are useful for clinical practice and parental counselling.
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Affiliation(s)
- Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, 56124, Pisa, Italy.
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, 56124, Pisa, Italy
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, 56124, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Svetlana V Glinianaia
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | - Abigail-Kate Reid
- Population Health Research Institute, St George's University of London, London, UK
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt, Kolding, Denmark
| | - Maria Loane
- Faculty of Life and Health Sciences, Ulster University, Belfast, Northern Ireland, UK
| | - Joanne Given
- Faculty of Life and Health Sciences, Ulster University, Belfast, Northern Ireland, UK
| | - Elisa Ballardini
- Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Hermien E K de Walle
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Miriam Gatt
- Malta Congenital Anomalies Register, Directorate of Health Information and Research, Pieta, Malta
| | - Laura García-Villodre
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Mika Gissler
- Information Services Department, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sue Jordan
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales, UK
| | - Sonja Kiuru-Kuhlefelt
- Information Services Department, THL Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stine Kjaer Urhoj
- Paediatric Department, Hospital Lillebaelt, Kolding, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Nathalie Lelong
- Center of Research in Epidemiology and StatisticS/CRESS/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Université de Paris, Paris, France
| | - L Renée Lutke
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Amanda J Neville
- IMER Registry (Emila Romagna Registry of Birth Defects), Center for Clinical and Epidemiological Research, University of Ferrara Azienda Ospedaliero- Universitaria di Ferrara, Ferrara, Italy
| | - Makan Rahshenas
- Center of Research in Epidemiology and StatisticS/CRESS/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Université de Paris, Paris, France
| | - Ieuan Scanlon
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales, UK
| | - Diana Wellesley
- Wessex Clinical Genetics Service, Princess Anne Hospital, Faculty of Medicine, University Hospital Southampton, Southampton, UK
| | - Joan K Morris
- Population Health Research Institute, St George's University of London, London, UK
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Mezzasalma L, Santoro M, Coi A, Pierini A. Association between maternal body mass index and congenital anomalies: A case-control study in Tuscany (Italy). Birth Defects Res 2021; 114:116-123. [PMID: 34913275 DOI: 10.1002/bdr2.1970] [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: 10/21/2021] [Accepted: 11/30/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the relationship between prepregnancy maternal body mass index (BMI) and congenital anomalies (CAs). DESIGN Case-control study on data collected by the registry of CAs of Tuscany (Italy) and birth certificates from 2005 to 2017. MAIN EXPOSURE Maternal prepregnancy BMI. MAIN OUTCOME MEASURES Any major CAs and groups of organ-specific anomalies. Odds ratios (ORs) were estimated using logistic regression models adjusted for maternal factors. RESULTS Maternal BMI ≥25 was significantly associated with all nervous system anomalies (OR = 1.61, 95% confidence interval [95% CI] 1.13-2.29) and with neural tube defects (OR = 2.03, 95% CI 1.00-4.12); maternal underweight was significantly associated with orofacial clefts (OR = 1.67, 95% CI 1.12-2.48). After stratification by education, in the low education group, mothers with BMI ≥25 had an increased risk of nervous system anomalies (OR = 2.19, 95% CI 1.01-4.76), whereas underweight mothers had an increased risk of nervous system anomalies (OR = 3.89, 95% CI 1.44-10.53), orofacial clefts (OR = 2.59, 95% CI 1.24-5.42), and urinary anomalies (OR = 1.74, 95% CI 1.07-2.82). In the medium/high education group, the only significantly increased risk was found in mothers with BMI ≥25 for nervous system anomalies (OR = 1.50, 95% CI 1.00-2.25). CONCLUSION Main results have shown a positive association of maternal BMI ≥25 with nervous system anomalies and maternal underweight with orofacial clefts. The study has also evidenced the impact of social status and provided clues to the role of maternal ethnic background.
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Affiliation(s)
- Lorena Mezzasalma
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Council of Research, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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21
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Meißner Y, Strangfeld A. [Insights into pregnancy and breastfeeding in inflammatory rheumatic diseases through observational data]. Z Rheumatol 2021; 80:733-742. [PMID: 34535821 DOI: 10.1007/s00393-021-01082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/24/2022]
Abstract
Information on pregnancy and breastfeeding in women with chronic inflammatory rheumatic diseases is relevant for a successful pregnancy and also for maternal and child health. In general, pregnant and breastfeeding women are excluded from randomized clinical trials and therefore evidence for clinical care and counselling has to be generated from observational studies. In the past decades, various data collections have been established for this purpose in addition to the existing spontaneous reporting systems initiated by drug authorities, with the aim of monitoring the teratogenic risk of a drug. Health insurance claims data, electronic health records and Scandinavian registers are also increasingly being used for research on pregnancy-associated events; however, all these data sources lack the inclusion of the maternal disease, especially with respect to its inflammatory component. Established cohort studies, biologics and disease registries record disease activity but are not designed for pregnancy-specific questions. Pregnancy registries and studies in rheumatology close this gap. In order to be able to make a better assessment of the possibilities and limitations of existing data sources on pregnancy and lactation, they are presented in detail in the following review including their respective advantages and disadvantages and examples from rheumatology are given. In addition, existing collaborations as well as studies for investigating the influence of paternal rheumatic disease are highlighted.
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Affiliation(s)
- Yvette Meißner
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Anja Strangfeld
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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22
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Santoro M, Coi A, Barišić I, Pierini A, Addor MC, Baldacci S, Ballardini E, Boban L, Braz P, Cavero-Carbonell C, de Walle HEK, Draper ES, Gatt M, Haeusler M, Klungsøyr K, Kurinczuk JJ, Materna-Kiryluk A, Lanzoni M, Lelong N, Luyt K, Mokoroa O, Mullaney C, Nelen V, O'Mahony MT, Perthus I, Randrianaivo H, Rankin J, Rissmann A, Rouget F, Schaub B, Tucker D, Wellesley D, Zymak-Zakutnia N, Garne E. Epidemiology of Pierre-Robin sequence in Europe: A population-based EUROCAT study. Paediatr Perinat Epidemiol 2021; 35:530-539. [PMID: 34132407 DOI: 10.1111/ppe.12776] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pierre Robin sequence (PRS) is a rare congenital anomaly. Respiratory disorders and feeding difficulties represent the main burden. OBJECTIVE The aim of this study was to investigate the epidemiology of PRS using a cohort of cases from EUROCAT, the European network of population-based registries of congenital anomalies. METHODS We analysed cases of PRS born in the period 1998-2017 collected by 29 population-based congenital anomaly registries in 17 different countries. We calculated prevalence estimates, prenatal detection rate, survival up to 1 week, and proportions of associated anomalies. The effect of maternal age was tested using a Poisson regression model. RESULTS Out of 11 669 155 surveyed births, a total of 1294 cases of PRS were identified. The estimate of the overall prevalence was 12.0 per 100 000 births (95% CI 9.9, 14.5). There was a total of 882 (68.2%) isolated cases, and the prevalence was 7.8 per 100 000 births (95% CI 6.7, 9.2). A total of 250 cases (19.3%) were associated with other structural congenital anomalies, 77 cases (6.0%) were associated with chromosomal anomalies and 77 (6.0%) with genetic syndromes. The prenatal detection rate in isolated cases was 12.0% (95% CI 9.8, 14.5) and increased to 16.0% (95% CI 12.7, 19.7) in the sub-period 2008-2017. The prevalence rate ratio of non-chromosomal cases with maternal age ≥35 was higher than in cases with maternal age <25 for total (PRR 1.26, 95% CI 1.05, 1.51) and isolated cases (PRR 1.33, 95% CI 1.00, 1.64). Survival of chromosomal cases (94.2%) and multiple anomaly cases (95.3%) were lower than survival of isolated cases (99.4%). CONCLUSIONS This epidemiological study using a large series of cases of PRS provides insights into the epidemiological profile of PRS in Europe. We observed an association with higher maternal age, but further investigations are needed to test potential risk factors for PRS.
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Affiliation(s)
- Michele Santoro
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Alessio Coi
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Ingeborg Barišić
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Anna Pierini
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Marie-Claude Addor
- Department of Woman-Mother-Child University Medical Center CHUV Lausanne, Switzerland
| | - Silvia Baldacci
- Unit of Epidemiology of Rare diseases and Congenital anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Elisa Ballardini
- Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Dep. of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ljubica Boban
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Hermien E K de Walle
- University Medical Center Groningen, Department of Genetics, University of Groningen, Groningen, the Netherlands
| | - Elizabeth S Draper
- Department Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, G'Mangia, Malta
| | | | - 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
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anna Materna-Kiryluk
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Monica Lanzoni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Nathalie Lelong
- Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université de Paris, Paris, France
| | - Karen Luyt
- South West Congenital Anomaly Register, Bristol Medical School, University of Bristol, Bristol, UK
| | - Olatz Mokoroa
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Donostia-San Sebastian, Spain
| | - Carmel Mullaney
- Department of Public Health, HSE South East, Lacken, Kilkenny, Ireland
| | - Vera Nelen
- Provincial Institute of Hygiene, Antwerp, Belgium
| | - Mary T O'Mahony
- Department of Public Health, HSE South (Cork & Kerry), Ireland
| | - Isabelle Perthus
- Auvergne registry of congenital anomalies (CEMC-Auvergne), Department of clinical genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Hanitra Randrianaivo
- Register of Congenital Malformations Isle of Reunion Island, CHU St Pierre, la Reunion, France
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University/National Congenital Anomaly and Rare Disease Registration Service (NCARDRS), Public Health England, Newcastle upon Tyne, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Malformations, CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Wales, Swansea, UK
| | - Diana Wellesley
- Wessex Clinical Genetics Service, University Hospitals Southampton, Southampton, UK
| | | | - Ester Garne
- Paediatric Department, Hospital Lillebaelt, Kolding, Denmark
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23
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Observed birth prevalence of congenital anomalies among live births at a regional facility in KwaZulu Natal Province, South Africa. PLoS One 2021; 16:e0255456. [PMID: 34343223 PMCID: PMC8330889 DOI: 10.1371/journal.pone.0255456] [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: 11/30/2020] [Accepted: 07/16/2021] [Indexed: 11/21/2022] Open
Abstract
Congenital disorders (CDs), defined as abnormalities in structure or function present at birth, are an important contributor to the disease burden in developing countries. The size and extent of the problem in South Africa (SA) are unknown due to the lack of recent, reliable, observed data on CDs. To address this empirical data gap, this study aimed to measure the birth prevalence of congenital anomalies (a sub-set of CDs) and to describe the pattern of these anomalies at a regional hospital in KwaZulu Natal (KZN), SA. A retrospective, observational, descriptive review of congenital anomalies diagnosed within the neonatal service at Edendale Hospital (EDH), KZN was undertaken between January and December 2018. All EDH in-house live births diagnosed and notified with congenital anomalies by discharge were included. Stillbirths, other pregnancy losses and out-born neonates were excluded. Data were actively collected from the birth register, neonatal admission register, and the individual paper-based surveillance tool developed by the National Department of Health. The in-facility birth prevalence rate for congenital anomalies was 15.57 per 1 000 live births. The most observed system was musculoskeletal (32%) followed by circulatory system anomalies (19%). When the observed birth prevalence rates of key congenital anomalies were compared with previously published, modelled South African data, no significant difference was found. This study responds to the paucity of birth prevalence data on CDs overall and offers evidence that obvious, structural CDs (congenital anomalies) need to be addressed in the SA public health system.
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Kajdy A, Feduniw S, Modzelewski J, Sys D, Filipecka-Tyczka D, Muzyka-Placzyńska K, Kiczmer P, Grabowski B, Rabijewski M. Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies-A Single-Center Retrospective Cohort Study. CHILDREN-BASEL 2021; 8:children8060522. [PMID: 34205263 PMCID: PMC8234699 DOI: 10.3390/children8060522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022]
Abstract
(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR.
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Affiliation(s)
- Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
- Correspondence: ; Tel.: +48-22-2559-918
| | - Stepan Feduniw
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
| | - Jan Modzelewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
| | - Dorota Sys
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
| | - Dagmara Filipecka-Tyczka
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
| | - Katarzyna Muzyka-Placzyńska
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
| | - Paweł Kiczmer
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | | | - Michał Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (S.F.); (J.M.); (D.S.); (D.F.-T.); (K.M.-P.); (M.R.)
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Challis P, Nydert P, Håkansson S, Norman M. Association of Adherence to Surfactant Best Practice Uses With Clinical Outcomes Among Neonates in Sweden. JAMA Netw Open 2021; 4:e217269. [PMID: 33950208 PMCID: PMC8100866 DOI: 10.1001/jamanetworkopen.2021.7269] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE While surfactant therapy for respiratory distress syndrome (RDS) in preterm infants has been evaluated in clinical trials, less is known about how surfactant is used outside such a framework. OBJECTIVE To evaluate registered use, off-label use, and omissions of surfactant treatment by gestational age (GA) and associations with outcomes, mainly among very preterm infants (GA <32 weeks). DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study used registry data for 97 377 infants born in Sweden between 2009 and 2018. Infants did not have malformations and were admitted for neonatal care. Data analysis was conducted from June 2019 to June 2020. EXPOSURES Timing and number of surfactant administrations, off-label use, and omission of use. Registered use was defined by drug label (1-3 administrations for RDS). Omissions were defined as surfactant not administered despite mechanical ventilation for RDS. MAIN OUTCOME AND MEASURES In-hospital survival, pneumothorax, intraventricular hemorrhage grade 3 to 4, duration of mechanical ventilation, use of postnatal systemic corticosteroids for lung disease, treatment with supplemental oxygen at 28 days' postnatal age and at 36 weeks' postmenstrual age. Odds ratios (ORs) were calculated and adjusted for any prenatal corticosteroid treatment, cesarean delivery, GA, infant sex, Apgar score at 10 minutes, and birth weight z score of less than -2. RESULTS In total, 7980 surfactant administrations were given to 5209 infants (2233 [42.9%] girls; 2976 [57.1%] boys): 629 (12.1%) born at full term, 691 (13.3%) at 32 to 36 weeks' GA, 1544 (29.6%) at 28 to 31 weeks' GA, and 2345 (45.0%) at less than 28 weeks' GA. Overall, 977 infants (18.8%) received off-label use. In 1364 of 3508 infants (38.9%) with GA of 22 to 31 weeks, the first administration of surfactant was given more than 2 hours after birth, and this was associated with higher odds of pneumothorax (adjusted OR [aOR], 2.59; 95% CI, 1.76-3.83), intraventricular hemorrhage grades 3 to 4 (aOR, 1.71; 95% CI, 1.23-2.39), receipt of postnatal corticosteroids (aOR, 1.57; 95% CI, 1.22-2.03), and longer duration of assisted ventilation (aOR, 1.34; 95% CI, 1.04-1.72) but also higher survival (aOR, 1.45; 95% CI, 1.10-1.91) than among infants treated within 2 hours of birth. In 146 infants (2.8%), the recommended maximum of 3 surfactant administrations was exceeded but without associated improvements in outcome. Omission of surfactant treatment occurred in 203 of 3551 infants (5.7%) who were receiving mechanical ventilation and was associated with lower survival (aOR, 0.49; 95% CI, 0.30-0.82). In full-term infants, 336 (53.4%) of those receiving surfactant had a diagnosis of meconium aspiration syndrome. Surfactant for meconium aspiration was not associated with improved neonatal outcomes. CONCLUSIONS AND RELEVANCE In this study, adherence to best practices and labels for surfactant use in newborn infants varied, with important clinical implications for neonatal outcomes.
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Affiliation(s)
- Pontus Challis
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
| | - Per Nydert
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Stellan Håkansson
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
| | - Mikael Norman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
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The Differences of Population Birth Defects in Epidemiology Analysis between the Rural and Urban Areas of Hunan Province in China, 2014-2018. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2732983. [PMID: 33969116 PMCID: PMC8081611 DOI: 10.1155/2021/2732983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/25/2021] [Accepted: 04/10/2021] [Indexed: 11/17/2022]
Abstract
Objectives To compare the differences of epidemiology analysis in population birth defects (BDs) between the rural and urban areas of Hunan Province in China. Methods The data of population-based BDs in Liuyang county (rural) and Shifeng district (urban) in Hunan Province for 2014-2018 were analyzed. BD prevalence rates, percentage change, and annual percentage change (APC) by sex and age were calculated to evaluate time trends. Risk factors associated with BDs were assessed using simple and multiple logistic regression analyses. Results The BD prevalence rate per 10,000 perinatal infants (PIs) was 220.54 (95% CI: 211.26-230.13) in Liuyang and 181.14 (95% CI: 161.18-202.87) in Shifeng. Significant decreasing trends in BD prevalence rates were noted in the female PIs (APC = -9.31, P = 0.044) and the total BD prevalence rate in Shifeng (APC = -14.14, P = 0.039). Risk factors for BDs were as follows: rural area, male PIs, PIs with gestational age < 37 weeks, PIs with birth weight < 2500 g, and migrant pregnancies. Conclusions We should focus on rural areas, reduce the prevalence of premature and low birth weight infants, and provide maternal healthcare services for migrant pregnancies for BD prevention from the perspective of population-based BD surveillance.
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27
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Morris JK, Addor MC, Ballardini E, Barisic I, Barrachina-Bonet L, Braz P, Cavero-Carbonell C, Den Hond E, Garne E, Gatt M, Haeusler M, Khoshnood B, Lelong N, Kinsner-Ovaskainen A, Kiuru-Kuhlefelt S, Klungsoyr K, Latos-Bielenska A, Limb E, O'Mahony MT, Perthus I, Pierini A, Rankin J, Rissmann A, Rouget F, Sayers G, Sipek A, Stevens S, Tucker D, Verellen-Dumoulin C, de Walle HEK, Wellesley D, Wertelecki W, Bermejo-Sanchez E. Prevention of Neural Tube Defects in Europe: A Public Health Failure. Front Pediatr 2021; 9:647038. [PMID: 34249803 PMCID: PMC8264257 DOI: 10.3389/fped.2021.647038] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Thirty years ago it was demonstrated that folic acid taken before pregnancy and in early pregnancy reduced the risk of a neural tube defect (NTD). Despite Public Health Initiatives across Europe recommending that women take 0.4 mg folic acid before becoming pregnant and during the first trimester, the prevalence of NTD pregnancies has not materially decreased in the EU since 1998, in contrast to the dramatic fall observed in the USA. This study aimed to estimate the number of NTD pregnancies that would have been prevented if flour had been fortified with folic acid in Europe from 1998 as it had been in the USA. Design and Setting: The number of NTD pregnancies from 1998 to 2017 that would have been prevented if folic acid fortification had been implemented in the 28 countries who were members of the European Union in 2019 was predicted was predicted using data on NTD prevalence from 35 EUROCAT congenital anomaly registries and literature searches for population serum folate levels and folic acid supplementation. Results: From 1998 to 2017 an estimated 95,213 NTD pregnancies occurred amongst 104 million births in the 28 countries in the EU, a prevalence of 0.92 per 1,000 births. The median serum folate level in Europe over this time period was estimated to be 14.1 μg/L. There is a lack of information about women taking folic acid supplements before becoming pregnant and during the first trimester of pregnancy, with one meta-analysis indicating that around 25% of women did so. An estimated 14,600 NTD pregnancies may have been prevented if the European countries had implemented fortification at the level adopted by the USA in 1998 and 25% of women took folic acid supplements. An estimated 19,500 NTD pregnancies would have been prevented if no women took folic acid supplements. Conclusions: This study suggests that failure to implement mandatory folic acid fortification in the 28 European countries has caused, and continues to cause, neural tube defects to occur in almost 1,000 pregnancies every year.
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Affiliation(s)
- Joan K Morris
- Population Health Research Institute, St. George's, University of London, London, United Kingdom
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Hospital Center, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Elisa Ballardini
- Indagine Sulle Malformazioni Congenite in Emilia-Romagna (IMER) Registry (Emilia Romagna Registry of Birth Defects) Neonatal Intensive Care Unit, Pediatric Section Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ingeborg Barisic
- Centre of Excellence for Reproductive and Regenerative Medicine, Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia
| | - Laia Barrachina-Bonet
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Elly Den Hond
- Health Department, Provincial Institute of Hygiene, Antwerp, Belgium
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
| | - Miriam Gatt
- Directorate for Health Information and Research, Pietà, Malta
| | - Martin Haeusler
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Babak Khoshnood
- Université de Paris, Center of Research in Epidemiology and StatisticS/CRESS/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | - Nathalie Lelong
- Université de Paris, Center of Research in Epidemiology and StatisticS/CRESS/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | | | - Sonja Kiuru-Kuhlefelt
- Finnish Institute for Health and Welfare Terveyden Ja Hyvinvoinnin Laitos (THL), Register of Congenital Malformations, Helsinki, Finland
| | - Kari Klungsoyr
- 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
| | - Anna Latos-Bielenska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Elizabeth Limb
- Population Health Research Institute, St. George's, University of London, London, United Kingdom
| | - Mary T O'Mahony
- Health Service Executive-South, Department of Public Health, St. Finbarr's Hospital, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, CHU Estaing, Clermont-Ferrand, France
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke-University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Gerardine Sayers
- Health Intelligence R&D Health Service Executive, Dublin, Ireland
| | - Antonin Sipek
- Department of Medical Biology and Genetics, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czechia
| | | | - David Tucker
- Congenital Anomaly Register and Information Service for Wales, Public Health Wales Knowledge Directorate, Singleton Hospital, Swansea, United Kingdom
| | | | - Hermien E K de Walle
- Department of Genetics, Eurocat Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Diana Wellesley
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | | | - Eva Bermejo-Sanchez
- Spanish Collaborative Study of Congenital Malformations (ECEMC), Unidad de Investigación sobre Anomalías Congénitas, Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid, Spain
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28
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van de Putte R, van Rooij IALM, Haanappel CP, Marcelis CLM, Brunner HG, Addor MC, Cavero-Carbonell C, Dias CM, Draper ES, Etxebarriarteun L, Gatt M, Khoshnood B, Kinsner-Ovaskainen A, Klungsoyr K, Kurinczuk JJ, Latos-Bielenska A, Luyt K, O'Mahony MT, Miller N, Mullaney C, Nelen V, Neville AJ, Perthus I, Pierini A, Randrianaivo H, Rankin J, Rissmann A, Rouget F, Schaub B, Tucker D, Wellesley D, Wiesel A, Zymak-Zakutnia N, Loane M, Barisic I, de Walle HEK, Bergman JEH, Roeleveld N. Maternal risk factors for the VACTERL association: A EUROCAT case-control study. Birth Defects Res 2020; 112:688-698. [PMID: 32319733 PMCID: PMC7319423 DOI: 10.1002/bdr2.1686] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/28/2020] [Accepted: 04/07/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The VACTERL association (VACTERL) is the nonrandom occurrence of at least three of these congenital anomalies: vertebral, anal, cardiac, tracheoesophageal, renal, and limb anomalies. Despite suggestions for involvement of several genes and nongenetic risk factors from small studies, the etiology of VACTERL remains largely unknown. OBJECTIVE To identify maternal risk factors for VACTERL in offspring in a large European study. METHODS A case-control study was performed using data from 28 EUROCAT registries over the period 1997-2015 with case and control ascertainment through hospital records, birth and death certificates, questionnaires, and/or postmortem examinations. Cases were diagnosed with VACTERL, while controls had a genetic syndrome and/or chromosomal abnormality. Data collected included type of birth defect and maternal characteristics, such as age, use of assisted reproductive techniques (ART), and chronic illnesses. Multivariable logistic regression analyses were performed to estimate confounder adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). RESULTS The study population consisted of 329 VACTERL cases and 49,724 controls with recognized syndromes or chromosomal abnormality. For couples who conceived through ART, we found an increased risk of VACTERL (aOR 2.3 [95% CI 1.3, 3.9]) in offspring. Pregestational diabetes (aOR 3.1 [95% CI 1.1, 8.6]) and chronic lower obstructive pulmonary diseases (aOR 3.9 [95% CI 2.2, 6.7]) also increased the risk of having a child with VACTERL. Twin pregnancies were not associated with VACTERL (aOR 0.6 [95% CI 0.3, 1.4]). CONCLUSION We identified several maternal risk factors for VACTERL in offspring befitting a multifactorial etiology.
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Affiliation(s)
- Romy van de Putte
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc), Nijmegen, The Netherlands
| | - Iris A L M van Rooij
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc), Nijmegen, The Netherlands.,Paediatric Surgery, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Cynthia P Haanappel
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc), Nijmegen, The Netherlands
| | | | - Han G Brunner
- Department of Human Genetics, Nijmegen, The Netherlands.,Department of Clinical Genetics and School for Oncology & Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Carlos M Dias
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | | | - Larraitz Etxebarriarteun
- Department of Health, Public Health Service, Basque Government Basque Country, Vitoria-Gasteiz, Spain
| | - Miriam Gatt
- Malta Congenital Anomalies Register, Directorate for Health Information and Research, Pietà, Malta
| | - Babak Khoshnood
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | | | - Kari Klungsoyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Jenny J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Karen Luyt
- South West Congenital Anomaly Register (SWCAR), Bristol Medical School, University of Bristol, Bristol, UK
| | - Mary T O'Mahony
- Department of Public Health, Health Service Executive - South, Cork, Ireland
| | - Nicola Miller
- National Congenital Anomaly and Rare Disease Registration Service, Public Health England, Newcastle upon Tyne, UK
| | - Carmel Mullaney
- Department of Public Health, Health Service Executive - South East, Kilkenny, Ireland
| | - Vera Nelen
- Provinciaal Instituut voor Hygiene (PIH), Antwerp, Belgium
| | - Amanda J Neville
- Registro IMER - IMER Registry (Emilia Romagna Registry of Birth Defects), Center for Clinical and Epidemiological Research, University of Ferrara, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Isabelle Perthus
- Auvergne registry of congenital anomalies (CEMC-Auvergne), Department of clinical genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Anna Pierini
- Tuscany Registry of Congenital Defects (RTDC), Institute of Clinical Physiology - National Research Council / Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Hanitra Randrianaivo
- Register of congenital malformations of Reunion Island, CHU Réunion, St Pierre, France
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of congenital anomalies, CHU Rennes, University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Rennes, France
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | - David Tucker
- CARIS, Public Health Wales, Singleton Hospital, Swansea, UK
| | - Diana Wellesley
- Wessex Clinical Genetics Department, Princess Anne Hospital, Southampton, UK
| | - Awi Wiesel
- Department of Pediatrics, Birth Registry Mainz Model, University Medical Center of Mainz, Mainz, Germany
| | - Natalya Zymak-Zakutnia
- OMNI-Net Ukraine Birth Defects Program and Khmelnytsky City Children's Hospital, Khmelnytsky, Ukraine
| | - Maria Loane
- Centre for Maternal, Fetal and lnfant Research, lnstitute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Ingeborg Barisic
- Centre of Excellence for Reproductive and Regenerative Medicine, Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia
| | - Hermien E K de Walle
- Department of Genetics, EUROCAT Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jorieke E H Bergman
- Department of Genetics, EUROCAT Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc), Nijmegen, The Netherlands
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29
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Farr A, Wachutka E, Bettelheim D, Windsperger K, Farr S. Perinatal outcomes of infants with congenital limb malformations: an observational study from a tertiary referral center in Central Europe. BMC Pregnancy Childbirth 2020; 20:35. [PMID: 31931744 PMCID: PMC6958570 DOI: 10.1186/s12884-020-2720-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 01/03/2020] [Indexed: 01/03/2023] Open
Abstract
Background Congenital limb malformations are rare, and their perinatal outcomes are not well described. This study analyzed the perinatal outcomes of infants with congenital limb malformations. Methods All infants with congenital limb malformations who underwent prenatal assessment and delivery at our tertiary referral center from 2004 through 2017 were retrospectively identified. Neonatal outcome parameters were assessed, and the predictors of worse perinatal outcomes were determined. Results One hundred twenty-four cases of congenital limb malformations were identified, of which 104 (83.9%) were analyzed. The upper limb was affected in 15 patients (14.4%), the lower limb in 49 (47.1%), and both limbs in 40 (38.5%) patients. A fetal syndrome was identified in 66 patients (63.5%); clubfoot and longitudinal reduction defects were the most frequent malformations. In total, 38 patients (36.5%) underwent termination, seven (6.7%) had stillbirth, and 59 (56.7%) had live-born delivery. Rates of preterm delivery and transfer to the Neonatal Intensive Care Unit were 42.4 and 25.4%, respectively. Localization of the malformation was a determinant of perinatal outcome (P = .006) and preterm delivery (P = .046). Conclusions Congenital limb malformations frequently occur bilaterally and are associated with poor perinatal outcomes, including high rates of stillbirth and preterm delivery. Multidisciplinary care and referral to a perinatal center are warranted.
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Affiliation(s)
- Alex Farr
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Eva Wachutka
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Dieter Bettelheim
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Karin Windsperger
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Sebastian Farr
- Department of Pediatric Orthopedics and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, Vienna, Austria
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30
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Bremm JM, Cardoso-dos-Santos AC, Magalhães VS, Medeiros-de-Souza AC, Alves RFS, Araujo VEMD, Macario EM, Oliveira WKD, Schüler-Faccini L, Sanseverino MTV, França GVAD. Anomalias congênitas na perspectiva da vigilância em saúde: compilação de uma lista com base na CID-10. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2020; 29:e2020164. [DOI: 10.1590/s1679-49742020000500015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Propor uma lista de anomalias congênitas com códigos correspondentes na Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde – 10ᵃ Revisão (CID-10), visando a aplicação no âmbito da vigilância em saúde. Métodos: Em dezembro de 2019, realizou-se busca nas seguintes fontes de dados: CID-10; CID-11; anomalias monitoradas por três modelos de vigilância; base de informações sobre doenças raras (Orphanet). Realizou-se extração das anomalias a partir dessas fontes, processamento para correspondência com base na CID-10 e compilação mediante revisão manual. Resultados: Foram identificados 898 códigos, dos quais 619 (68,9%) constavam no capítulo XVII da CID-10. Dos 279 códigos de outros capítulos, 19 foram exclusivos da busca na CID-11, 72 dos modelos de vigilância, 79 da Orphanet e 36 da busca de termos na CID-10. Conclusão: Os códigos que constam do capítulo XVII da CID-10 não captam a totalidade das anomalias congênitas, indicando a necessidade de adoção de uma lista ampliada.
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31
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Coi A, Santoro M, Garne E, Pierini A, Addor MC, Alessandri JL, Bergman JEH, Bianchi F, Boban L, Braz P, Cavero-Carbonell C, Gatt M, Haeusler M, Klungsøyr K, Kurinczuk JJ, Lanzoni M, Lelong N, Luyt K, Mokoroa O, Mullaney C, Nelen V, Neville AJ, O'Mahony MT, Perthus I, Rankin J, Rissmann A, Rouget F, Schaub B, Tucker D, Wellesley D, Wisniewska K, Zymak-Zakutnia N, Barišić I. Epidemiology of achondroplasia: A population-based study in Europe. Am J Med Genet A 2019; 179:1791-1798. [PMID: 31294928 DOI: 10.1002/ajmg.a.61289] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/20/2019] [Accepted: 06/23/2019] [Indexed: 01/06/2023]
Abstract
Achondroplasia is a rare genetic disorder resulting in short-limb skeletal dysplasia. We present the largest European population-based epidemiological study to date using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network. All cases of achondroplasia notified to 28 EUROCAT registries (1991-2015) were included in the study. Prevalence, birth outcomes, prenatal diagnosis, associated anomalies, and the impact of paternal and maternal age on de novo achondroplasia were presented. The study population consisted of 434 achondroplasia cases with a prevalence of 3.72 per 100,000 births (95%CIs: 3.14-4.39). There were 350 live births, 82 terminations of pregnancy after prenatal diagnosis, and two fetal deaths. The prenatal detection rate was significantly higher in recent years (71% in 2011-2015 vs. 36% in 1991-1995). Major associated congenital anomalies were present in 10% of cases. About 20% of cases were familial. After adjusting for maternal age, fathers >34 years had a significantly higher risk of having infants with de novo achondroplasia than younger fathers. Prevalence was stable over time, but regional differences were observed. All pregnancy outcomes were included in the prevalence estimate with 80.6% being live born. The study confirmed the increased risk for older fathers of having infants with de novo achondroplasia.
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Affiliation(s)
- Alessio Coi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Michele Santoro
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt, Kolding, Denmark
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | - Jean-Luc Alessandri
- Pole Femme-Mère-Enfants, CHR Felix Guyon, CHU La Réunion, Saint-Denis, La Réunion, France
| | - Jorieke E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Fabrizio Bianchi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Ljubica Boban
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Miriam Gatt
- Malta Congenital Anomalies Register, Directorate for Health Information and Research, Guardamangia, Malta
| | | | - 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
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Monica Lanzoni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Nathalie Lelong
- Paris Registry of Congenital Malformations, Inserm UMR 1153-Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France
| | - Karen Luyt
- South West Congenital Anomaly Register (SWCAR), Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Olatz Mokoroa
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Donostia-San Sebastian, Spain
| | - Carmel Mullaney
- HSE South East Area, Department of Public Health, Kilkenny, Ireland
| | - Vera Nelen
- Provinciaal Instituut voor Hygiene (PIH), Antwerp, Belgium
| | - Amanda J Neville
- IMER Registry (Emilia Romagna Registry of Birth Defects), Center for Clinical and Epidemiological Research, University of Ferrara Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Mary T O'Mahony
- HSE South (Cork & Kerry), Department of Public Health, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Judith Rankin
- Institute of Health & Society, Newcastle University/National Congenital Anomaly and Rare Disease Registration Service (NCARDRS), Public Health England, Newcastle upon Tyne, United Kingdom
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Malformations, CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Wales, Swansea, United Kingdom
| | - Diana Wellesley
- Wessex Clinical Genetics Service, University Hospitals Southampton, Southampton, United Kingdom
| | - Katarzyna Wisniewska
- Department of Preventive Medicine, Epidemiology Unit, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Ingeborg Barišić
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
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