Gross congenital malformation at birth in a government hospital.

A hospital-based cross-sectional study was undertaken to determine proportion of gross congenital malformation (GCMF) occurring at intramural births. Rate of GCMF was found to be 16.4/1000 consecutive singleton births (>28 weeks) with three leading malformation as anencephaly (44.68%), talipes equinovarus (17.02%) and meningomyelocele (10.63%). Higher risk of malformed births were noticed amongst un-booked (2.07%) in-comparison to booked (1.01%) mothers; women with low level of education (up to 8 years [2.14%] vs. at least 9 years of schooling [0.82%]); gravida status of at least 3 (2.69%) followed by 1 (1.43%) and 2 (1.0%) respectively; pre-term (5.13%) vs. term (0.66%); cesarean section (4.36%) versus vaginal delivery (0.62%). Mortality was significantly higher among congenitally malformed (17.35%) than normal (0.34%) newborns. With-in study limitation, emergence of neural tube defect as the single largest category of congenital malformation indicates maternal malnutrition (especially folic acid) that needs appropriate attention and management.

Rates of selected birth defects in relation to folic acid fortification, Hawaii, 1986-2002.

Because of studies suggesting that folic acid use reduces risk of various birth defects, the Unites States fortified enriched cereal grains with folic acid in 1998. To determine whether this fortification reduced rates for birth defects in Hawaii, rates were calculated before and after fortification. Of the 19 birth defects categories studied, the rates for 16 were lower after fortification.

Incidence of major congenital malformations in a region of Bosnia and Herzegovina allegedly polluted with depleted uranium.

OBJECTIVES: To determine the prevalence of major congenital malformations in West Herzegovina, a part of Bosnia and Herzegovina, immediately and five years after 1991-1995 military activities, which allegedly included the use of weapons with depleted uranium. METHODS: The study included all live-born and stillborn neonates and excluded all aborted fetuses in two one-year cohorts (1995 and 2000) of neonates in the Maternity Ward of the Mostar University Hospital. Malformations were recorded according to the recommendations of the EUROCAT protocol. RESULTS: Major malformations were found in 40 (2.16%) out of 1,853 neonates in 1995 (95% confidence interval [CI], 1.49-2.82%) and in 33 (2.26%) out of 1,463 neonates five years later (95% CI, 1.50-3.01%), ie, at comparable prevalence. In both cohorts, anomalies of the musculoskeletal system were the most common, followed by anomalies of the digestive system (in 1995) and the cardiovascular system (in 2000). The prevalence of malformations and the organ systems involved were essentially comparable with those in other populations not affected by military activities. CONCLUSION: Despite alleged environmental pollution in some regions of the former Yugoslavia, which was attributed to military activities and the presence of depleted uranium (the "Balkan syndrome"), there was no significant postwar increase in the prevalence of congenital malformations.

The Metropolitan Atlanta Congenital Defects Program: 35 years of birth defects surveillance at the Centers for Disease Control and Prevention.

BACKGROUND: The Metropolitan Atlanta Congenital Defects Program (MACDP) is a population-based birth defects surveillance program administered by the Centers for Disease Control and Prevention (CDC) that has been collecting, analyzing, and interpreting birth defects surveillance data since 1967. This paper presents an overview of MACDP current methods and accomplishments over the past 35 years. METHODS: MACDP actively monitors major birth defects among infants born to residents of five counties of metropolitan Atlanta, an area with approximately 50,000 annual births. Cases are ascertained from multiple sources, coded using a modified British Pediatric Association six-digit code, and reviewed and classified by clinical geneticists. RESULTS: MACDP has monitored trends in birth defects rates and has served as a case registry for descriptive, risk factor, and prognostic studies of birth defects, including studies of Agent Orange exposure among Vietnam War veterans, maternal use of multivitamins, diabetes, febrile illnesses, and survival of children with neural tube defects. MACDP has served as a data source for one of the centers participating in the National Birth Defects Prevention Study, and for developing and evaluating neural tube defects prevention strategies related to the periconceptional use of folic acid supplements. CONCLUSIONS: Since its inception, MACDP has served as a resource for the development of uniform methods and approaches to birth defect surveillance across the United States and in many other countries, monitoring birth defects rates, and as a case registry for various descriptive, etiologic, and survival studies of birth defects. MACDP has also served as a training ground for a large number of professionals active in birth defects epidemiology.

Cigarette, alcohol, and coffee consumption and congenital defects.

We analyzed data from a survey of occupational and other factors and pregnancy outcome to assess the effects of cigarette, alcohol, and coffee consumption. There was no evidence of an association between any congenital defect and smoking. Results for alcohol and coffee consumption were largely negative, but there was a weak association with musculoskeletal defects in babies born to women who drank one or more alcoholic drinks a day.