Edad materna y malformaciones congénitas: Un registro de 35 años: 1970-2005: [revisión] / The association between maternal age and congenital malformations: [review]

Background: There is an association between extreme maternal ages and the risk of congenital malformations. This is specially true for chromosomal abnormalities among women of advanced ages and disruptive malformation among teenage mothers. Aim: To determine the association between maternal ages and incidence of congenital malformations at the obstetric ward of a clinical hospital. To compare these figures with those of Chile. Material and methods: The hospital registries of the Latin American Collaborative Study of Congenital Malformations (ECLAMC) between 1996 and 2005, were consulted. This is a database of all marformations detected in newborns at the hospital. Results: An overall prevalence of malformations of8,4 percent was detected at the hospital. There is a significantly lower frequency of mothers aged less than 20 years than in the rest of Chile. Mothers aged between 20 and 29 years have the lower frequency of malformed children. Women aged íess than 20 years and over 39 years of age, account for 56 percent of malformed children. Maternal ages and the rates of malformations, increased in a parallel fashion at a rate of 0.2 years and 2.2 malformed children per 1,000 born alive, per calendar year, respectively. Conclusions: The association between prevalence rates of congenital malformations and maternal age is U chaped with a higher proportion of malformed children among women aged íess than 20 years or more than 39 years.

[Effects of folic acid fortification in the rates of malformations at birth in Chile]. / Efecto de la fortificación de la harina con ácido fólico sobre la evolución de las tasas de prevalencia al nacimiento de malformaciones congénitas en los hospitales chilenos del ECLAMC.

BACKGROUND: The effects of folic acid fortification on neural tube defects is well known. Other reports show a beneficial effect of the fortification on orofacial clefts, urinary malformations and defects caused by limb reduction. AIM: To determine the changes in prevalence of congenital malformations after the start of flour folic acid fortification in Chile. MATERIAL AND METHODS: The rates of 22 malformations occurring in the maternity of the University of Chile Clinical Hospital and other Chilean hospitals participating in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) were compared before and after the start of flour folic acid fortification. RESULTS: After the start of folic acid fortification a significant reduction in the rates of anencephalia, spina bifida and diaphragmatic hernia, was observed. The rates of all other malformations remained stable or increased. The rates of all malformations at the University of Chile Clinical Hospital had a steady increase until 2005 and were significantly higher than in the rest of hospitals participating in ECLAMC. CONCLUSIONS: Folic acid fortification was associated with an expected reduction in rates of spina bifida and anencephalia and an unexpected reduction in the rates of diaphragmatic hernia.

Efecto de la fortificación de la harina con ácido fólico sobre la evolución de las tasas de prevalencia al nacimiento de malformaciones congénitas en los hospitales chilenos del ECLAMC / Effects of folic acid fortification in the rates of malformations at birth in Chile

Background: The effects of folic acid fortification on neural tube defects is well known. Other reports show a beneficial effect of the fortification on orofacial clefts, urinary malformations and defects caused by limb reduction. Aim: To determine the changes in prevalence of congenital malformations after the start of flour folic acid fortification in Chile. Material and methods: The rates of 22 malformations occurring in the maternity of the University of Chile Clinical Hospital and other Chilean hospitals participating in the Latin American Collaborative Study of Congenital Malformations (ECLAMC) were compared before and after the start of flour folic acid fortification. Results: After the start of folic acid fortification a significant reduction in the rates of anencephalia, spina bifida and diaphragmatic hernia, was observed. The rates of all other malformations remained stable or increased. The rates of all malformations at the University of Chile Clinical Hospital had a steady increase until 2005 and were significantly higher than in the rest of hospitals participating in ECLAMC. Conclusions: Folic acid fortification was associated with an expected reduction in rates of spina bifida and anencephalia and an unexpected reduction in the rates of diaphragmatic hernia.

[The association between maternal age and congenital malformations]. / Edad materna y malformaciones congénitas: un registro de 35 años. 1970-2005.

BACKGROUND: There is an association between extreme maternal ages and the risk of congenital malformations. This is specially true for chromosomal abnormalities among women of advanced ages and disruptive malformation among teenage mothers. AIM: To determine the association between maternal ages and incidence of congenital malformations at the obstetric ward of a clinical hospital. To compare these figures with those of Chile. MATERIAL AND METHODS: The hospital registries of the Latin American Collaborative Study of Congenital Malformations (ECLAMC) between 1996 and 2005, were consulted. This is a database of all malformations detected in newborns at the hospital. RESULTS: An overall prevalence of malformations of 8,4% was detected at the hospital. There is a significantly lower frequency of mothers aged less than 20 years than in the rest of Chile. Mothers aged between 20 and 29 years have the lower frequency of malformed children. Women aged less than 20 years and over 39 years of age account for 56% of malformed children. Maternal ages and the rates of malformations, increased in a parallel fashion at a rate of 0.2 years and 2.2 malformed children per 1,000 born alive, per calendar year, respectively. CONCLUSIONS: The association between prevalence rates of congenital malformations and maternal age is U shaped with a higher proportion of malformed children among women aged less than 20 years or more than 39 years.

Prevalencia de defectos de la pared abdominal al nacer: estudio ECLAMC / Prevalence of abdominal wall defects in newborns: ECLAMC Study, 1982-2005

Introducción: Onfalocele y gastrosquisis son los defectos de la pared abdominal (DPA) más frecuentes. Ambos necesitan un diagnóstico precoz y tratamiento quirúrgico oportuno para sobrevivir. Objetivos: Determinar la prevalencia al nacimiento de los DPA en la maternidad del Hospital Clínico de la Universidad de Chile (HCUCH) y compararla con la del total de maternidades chilenas (MCh) y los resultados del Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC). Resultados: La prevalencia global de onfalocele fue de 3,4/ 10 000 nacimientos y 3,8/10 000 para gastrosquisis. La prevalencia de onfalocele fue 9/10.000 en HCUCH y 2,77/10 000 en MCh (p = 0,006) y la de gastrosquisis fue 1,9/10 000 en HCUCH y 1,1/10 000 en MCh (p = 0,036). El promedio de edad materna fue 24,2 años para gastrosquisis y 33,6 para onfalocele (p < 0,004). La sobrevida de gastrosquisis fue 100 por ciento versus 31,7 por ciento en onfalocele (p < 0,0425). Todos los RN con onfalocele, salvo uno, presentaban asociación con otras MC graves. El peso de nacimiento y edad gestacional fueron significativamente menores en onfalocele. Conclusión: La prevalencia de DPA fue significativamente mayor en el HCUCH que en el resto de las maternidades chilenas. Gastrosquisis se presentó en hijos de mujeres más jóvenes y onfalocele en las de mayor edad.