Ethnic differences in congenital malformations in the Netherlands: analyses of a 5-year birth cohort.

Congenital malformations are among the major causes of perinatal mortality and morbidity at present. Research into the ethnic diversity of congenital malformations can form a basis both for aetiological studies and for health care advice and planning. This study compared the overall prevalence of congenital malformations, the prevalence in different organ systems and of several specific malformations between different maternal ethnic groups in the Netherlands using a 5-year national birth cohort (1996-2000) containing 881 800 births. Maternal ethnic groups considered were Dutch; Mediterranean (Moroccan/Turkish); other European; Black; Hindu and Asian. Mediterranean women had a 20% higher risk of having a child with a congenital malformation than Dutch women (age-adjusted OR = 1.21 [95% CI 1.16, 1.27]). They showed an increased risk of malformations in several organ systems such as the central nervous system and sensory organs, the urogenital system and skin and abdominal wall. Further, they had an increased risk of the group of chromosomal malformations/multiple malformations/syndromes. For the specific group of multiple malformations the maternal age adjusted OR was 1.80 [95% CI 1.47, 2.20]. The Black group showed a significantly increased risk of skeletal and muscular malformations (age adjusted OR = 1.76 [95% CI 1.53, 2.02]) with a sixfold increased risk of polydactyly compared with the Dutch group. For Mediterranean women, the largest and fastest growing group of immigrants in the Netherlands, this study demonstrated an increased risk of congenital malformations.

[Increased risk of hepatitis B due to incomplete or untimely immunisation in one-quarter of infants of hepatitis-B-virus carriers]. / Verhoogd risico op hepatitis B door onvolledige of ontijdige immunisatie bij een kwart van de zuigelingen van hepatitis-B-virusdraagsters.

OBJECTIVE: To determine the frequency of an increased risk of infection in children of hepatitis-B-virus carriers due to incomplete or untimely hepatitis-B immunisation. DESIGN: Descriptive. METHOD: Dates of birth and hepatitis-B immunisations were collected for all documented children of hepatitis-B-virus carriers in the vaccination registers, born in 2000 in The Netherlands. To assess the possible increased risk of infection, criteria were drawn up for the completeness and timeliness of the immunisations and on the basis of these the number of children who possibly had an increased risk of infection was determined. RESULTS: In total, 731 of the 769 children (95%) had received hepatitis-B immunoglobulins and at least 3 vaccinations. For 200 children (26%) the deviation from the immunisation schedule was so great that the child was possibly (temporarily) inadequately protected. CONCLUSION: A quarter of the children of hepatitis-B-virus carriers were immunised incompletely or at the wrong time. This calls for an adjustment of the immunisation schedule and national guidelines in which the responsibilities and tasks are clearly defined.

Ethene and other biomarkers of oxidative stress in hypertensive disorders of pregnancy.

OBJECTIVE: An increase in reactive oxygen species (ROS) and lipid peroxides and a comprised antioxidant status has been implicated in the pathophysiology of severe preeclampsia. This study investigates whether oxidative stress and impaired antioxidant systems also contribute to milder forms of hypertensive disorders in pregnancy. Furthermore, ethene in exhaled air, a noninvasive measure for oxidative stress, was evaluated and compared with two other more established biomarkers. METHODS: Ethene in exhaled air, plasma protein carbonyls, and the ratio of free glutathione/oxidized glutathione (GSHfree/GSHox) as markers for oxidative stress as well as the antioxidants vitamins C and E, uric acid, glutathione, and the oxygen radical absorbance capacity (ORAC) in plasma were measured in 30 healthy nonpregnant, 14 normal pregnant, 9 women with pregnancy-induced hypertension (PIH), and 14 preeclamptic women. Pregnant participants were measured during pregnancy and after delivery. RESULTS: Women suffering from PIH and preeclampsia showed higher levels of the antioxidants vitamin E and uric acid, and lower levels of vitamin C compared with normal pregnant and nonpregnant women. All markers for oxidative stress were comparable between groups. Ethene levels showed a positive correlation with protein carbonyls but no correlation could be demonstrated with the free glutathione/oxidised glutathione ratio. CONCLUSIONS: PIH and preeclampsia are associated with minor alterations in antioxidant levels without signs of oxidative stress. Detection of ethene in exhaled air seems a promising noninvasive method to study lipid peroxidation but further research in more severe preeclampsia is needed.