Pregnancy Experience after Delivery of a Child with a Major Birth Defect: A Population Study

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 59-65
Author(s):  
Margarett K. Davis ◽  
Muin J. Khoury ◽  
J. David Erickson
Keyword(s):  
Birth Defects ◽  
Reproductive Behavior ◽  
Birth Defect ◽  
Large Population ◽  
Population Based ◽  
Subsequent Pregnancy ◽  
Pregnancy Rates ◽  
Wide Range ◽  
First Year Of Life ◽  
And Control

Objective. Data from a large population-based, case-control study were analyzed to determine whether women giving birth to children with major birth defects have different subsequent pregnancy patterns than those giving birth to live-born babies without defects. Other studies examining this phenomenon have been smaller, have not been population-based, or have not addressed the different effects that a wide range of major defects might have on mothers' subsequent pregnancy rates. Methods. Mothers of 4918 infants with major birth defects born from 1968 through 1980 in metropolitan Atlanta were compared with mothers of 3029 control infants, frequency-matched on birth year, birth hospital, and race. Results. The pregnancy rate in the first 3 years after the index birth was higher among case mothers (36%) than among control mothers (30%, P < .0001). This excess was seen for mothers of stillborn case infants (64%) and mothers of case infants who died in infancy (58%), but not for mothers of case infants who survived the first year of life (31%). Pregnancy rates varied by birth defect type. Maternal and infant factors varied among case and control subjects and influenced subsequent pregnancy rates. Conclusion. The reproductive behavior observed in this study supports the theory that mothers of nonsurviving children with birth defects compensate by acting to "replace" the lost child. Reproductive behavior was also strongly associated with having completed a previous pregnancy and by the type of birth defect.

scholarly journals Fish consumption prior to pregnancy and pregnancy outcomes in the National Birth Defects Prevention Study, 1997–2011

2018 ◽  
Vol 22 (2) ◽  
pp. 336-343
Author(s):  
Renata H Benjamin ◽  
Laura E Mitchell ◽  
Mark A Canfield ◽  
Adrienne T Hoyt ◽  
Dejian Lai ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Fish Consumption ◽  
Large Population ◽  
Population Based ◽  
Prevention Study ◽  
Preparation Methods ◽  
The Usa ◽  
Early Preterm Birth

AbstractObjectiveTo evaluate the relationships between maternal fish consumption and pregnancy outcomes in a large, population-based sample of women in the USA.DesignWe collected average fish consumption prior to pregnancy using a modified version of the semi-quantitative Willett FFQ. We estimated adjusted OR (aOR) and 95 % CI for associations between different levels of fish consumption and preterm birth (<37 weeks), early preterm birth (<32 and <35 weeks) and small-for-gestational-age infants (SGA; <10th percentile).SettingThe National Birth Defects Prevention Study (NBDPS).SubjectsControl mother–infant pairs with estimated delivery dates between 1997 and 2011 (n 10 919).ResultsNo significant associations were observed between fish consumption and preterm birth or early preterm birth (aOR = 0·7–1·0 and 0·7–0·9, respectively). The odds of having an SGA infant were elevated (aOR = 2·1; 95 % CI 1·2, 3·4) among women with daily fish consumption compared with women consuming fish less than once per month. No associations were observed between other levels of fish consumption and SGA (aOR = 0·8–1·0).ConclusionsHigh intake of fish was associated with twofold higher odds of having an SGA infant, while moderate fish consumption prior to pregnancy was not associated with preterm or SGA. Our study, like many other studies in this area, lacked information regarding preparation methods and the specific types of fish consumed. Future studies should incorporate information on nutrient and contaminant contents, preparation methods and biomarkers to assess these relationships.

scholarly journals Maternal occupational exposure to solvents and gastroschisis in offspring - National Birth Defects Prevention Study 1997–2011

2020 ◽  
Vol 77 (3) ◽  
pp. 172-178 ◽  
Author(s):  
Nynke Spinder ◽  
Lynn M Almli ◽  
Tania A Desrosiers ◽  
Kathryn E Arnold ◽  
Jorieke E H Bergman ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Birth Defects ◽  
Maternal Age ◽  
Large Population ◽  
First Trimester ◽  
Population Based ◽  
Cumulative Exposure ◽  
Surveillance Systems ◽  
Prevention Study ◽  
Solvent Exposure

ObjectivesThe aim of this study was to assess the association between maternal occupational exposure to solvents and gastroschisis in offspring.MethodsWe used data from the National Birth Defects Prevention Study, a large population-based case-control study of major birth defects conducted in 10 US states from 1997 to 2011. Infants with gastroschisis were ascertained by active birth defects surveillance systems. Control infants without major birth defects were selected from vital records or birth hospital records. Self-reported maternal occupational histories were collected by telephone interview. Industrial hygienists reviewed this information to estimate exposure to aromatic, chlorinated and petroleum-based solvents from 1 month before conception through the first trimester of pregnancy. Cumulative exposure to solvents was estimated for the same period accounting for estimated exposure intensity and frequency, job duration and hours worked per week. ORs and 95% CIs were estimated to assess the association between exposure to any solvents or solvent classes, and gastroschisis risk.ResultsAmong 879 cases and 7817 controls, the overall prevalence of periconceptional solvent exposure was 7.3% and 7.4%, respectively. Exposure to any solvent versus no exposure to solvents was not associated with gastroschisis after adjusting for maternal age (OR 1.00, 95% CI 0.75 to 1.32), nor was an association noted for solvent classes. There was no exposure-response relationship between estimated cumulative solvent exposure and gastroschisis after adjusting for maternal age.ConclusionOur study found no association between maternal occupational solvent exposure and gastroschisis in offspring. Further research is needed to understand risk factors for gastroschisis.

Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review

Cephalalgia ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 409-425 ◽  
Author(s):  
Maria L Westergaard ◽  
Ebba Holme Hansen ◽  
Charlotte Glümer ◽  
Jes Olesen ◽  
Rigmor H Jensen
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Large Population ◽  
Population Based ◽  
Case Definition ◽  
Practical Case ◽  
Case Definitions ◽  
Wide Range ◽  
Concurrent Medication ◽  
Over Time

Background Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta. Methods A systematic literature search was conducted to identify MOH prevalence studies. Findings were summarized according to diagnostic criteria. Results Twenty-seven studies were included. The commonly used case definition for MOH was headache ≥15 days/month with concurrent medication overuse ≥3 months. There were varying definitions for what was considered as overuse. Studies that all used ICHD-2 criteria showed a wide range of prevalence among adults: 0.5%–7.2%. Conclusions There are limits to comparing prevalence of MOH across studies and over time. The wide range of reported prevalence might not only be due to changing criteria, but also the diversity of countries now publishing data. The criterion “headache occurring on ≥15 days per month” with concurrent medication overuse can be applied in population-based studies. However, the new requirement that a respondent must have “a preexisting headache disorder” has not been previously validated. Exclusion of other headache diagnoses by expert evaluation and ancillary examinations is not feasible in large population-based studies.

scholarly journals The Constances cohort

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Z Zins
Keyword(s):  
Public Health ◽  
Health Research ◽  
Neuropsychological Testing ◽  
Large Population ◽  
Public Health Research ◽  
Population Based ◽  
Industrial Companies ◽  
Wide Range ◽  
Public Health Institutions

Abstract The overarching objective of CONSTANCES is to constitute a research infrastructure based on a large population-based cohort to serve as a versatile, high quality and efficient platform for population health research. Constances is designed as a representative sample of 200,000 adults aged 18-69 at inception living in different regions of France. CONSTANCES, which is accessible to the national and international research community, enables the conduct of valid and well-powered studies in a wide range of scientific domains. For each participant, it combines detailed data collection at baseline, englobing lifestyle, environmental, social, and medical history information, with medical examinations, neuropsychological testing with the added advantage of linkage with two major national administrative data bases (SNDS and CNAV). Further, CONSTANCES collects information about changing lifestyles, environments, health behaviors and health conditions on a prospective ongoing basis. A biobank of blood and urine samples is in the process of being constituted. As of April 2018, 85 nested projects designed by French and international teams in many areas of biomedical and public health research were initiated. Constances participates in several French and international consortiums. We established relationships with public health institutions and industrial companies. In the next years, we plan to continue longitudinal follow-up CONSTANCES along the same lines by extending the follow-up of the cohort and by developing innovative new themes prioritizing the strengthening of certain “niches” where CONSTANCES can have international leadership.

Parental mental illness and fatal birth defects in a national birth cohort

2007 ◽  
Vol 38 (10) ◽  
pp. 1495-1503 ◽  
Author(s):  
R. T. Webb ◽  
A. R. Pickles ◽  
S. A. King-Hele ◽  
L. Appleby ◽  
P. B. Mortensen ◽  
...  
Keyword(s):  
Mental Illness ◽  
Birth Cohort ◽  
Birth Defects ◽  
Birth Defect ◽  
Population Based ◽  
Parental Mental Illness ◽  
Risk Of Death ◽  
Maternal Illness ◽  
Relative Risks ◽  
History Of

BackgroundFew large studies describe links between maternal mental illness and risk of major birth defect in offspring. Evidence is sparser still for how effects vary between maternal diagnoses and no previous study has assessed risk with paternal illnesses.MethodA population-based birth cohort was created by linking Danish national registers. We identified all singleton live births during 1973–1998 (n=1.45 m), all parental psychiatric admissions from 1969 onwards, and all fatal birth defects until 1 January 1999. Linkage and case ascertainment were almost complete. Relative risks were estimated using Poisson regression.ResultsRisk of fatal birth defect was elevated in relation to history of any maternal admission and also with affective disorders specifically, although the strongest effect found was with maternal schizophrenia. The rate was more than doubled in this group compared to the general population [relative risk (RR) 2.34, 95% confidence interval (CI) 1.45–3.77], which also represented a significant excess risk compared with all other admitted maternal disorders (p=0.018). Risk of death from causes other than birth defect was no higher with schizophrenia than with other maternal conditions. There was no elevation in risk of fatal birth defect if the father was admitted with schizophrenia or any other psychiatric diagnosis.ConclusionsThere are many possible explanations for a higher risk of fatal birth defect with maternal schizophrenia and affective disorder. These include genetic effects directly linked with maternal illness, lifestyle factors (diet, smoking, alcohol and drugs), poor antenatal care, psychotropic medication toxicity, and gene–environment interactions. Further research is needed to elucidate the causal mechanisms.

Folic acid supplementation and risk for foetal abdominal wall defects in China: Results from a large population-based intervention cohort study

2021 ◽  
pp. 1-20
Author(s):  
Jufen Liu ◽  
Zhiwen Li ◽  
Rongwei Ye ◽  
Aiguo Ren ◽  
Jianmeng Liu
Keyword(s):  
Cohort Study ◽  
Folic Acid ◽  
Abdominal Wall ◽  
Birth Defects ◽  
Southern China ◽  
Large Population ◽  
Northern China ◽  
Population Based ◽  
Abdominal Wall Defects ◽  
Birth Prevalence

Abstract Folic acid (FA) can reduce the risk for selected birth defects other than neural tube defects (NTDs). We examined whether FA has preventive effects against foetal abdominal wall defects (AWDs) in a unique intervention cohort in China. Birth outcomes of 247 831 singleton births from a population-based cohort study with detailed preconceptional FA intake information were collected in China in 1993-1996. Information on births at 20 complete gestational weeks, including live births, stillbirths, and pregnancy terminations, and all structural birth defects regardless of gestational week was recorded. The birth prevalence of omphalocele, gastroschisis, and total foetal AWDs was classified by maternal FA supplementation. The prevalence of total AWDs was 4.30 per 10 000 births among women who took FA compared to 13.46 per 10 000 births among those who did not take FA in northern China and 6.28 and 5.18 per 10 000 births, respectively, in southern China. The prevalence of omphalocele was 0.54 per 10 000 births among women who took FA compared to 3.74 per 10 000 births among those who did not take FA in northern China and 1.79 and 1.44 per 10 000 births, respectively, in southern China. FA supplementation significantly prevented total AWDs in multivariate analysis (relative risk=0.26, 95% confidence interval: 0.11-0.61) in northern China, although no preventive effect of FA on AWDs was observed in southern Chin. FA supplementation successfully reduced the prevalence of AWDs in northern China.

Birth Defect Co-Occurrence Patterns Among Infants With Cleft Lip and/or Palate

2021 ◽  
pp. 105566562110100
Author(s):  
Maria Luisa Navarro Sanchez ◽  
Renata H. Benjamin ◽  
Laura E. Mitchell ◽  
Peter H. Langlois ◽  
Mark A. Canfield ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Birth Defects ◽  
Birth Defect ◽  
Cleft Lip ◽  
Population Based ◽  
Orofacial Clefts ◽  
Developmental Mechanisms ◽  
Using Data ◽  
Occurrence Patterns ◽  
Population Based Registry

Objective: To investigate 2- to 5-way patterns of defects co-occurring with orofacial clefts using data from a population-based registry. Design: We used data from the Texas Birth Defects Registry for deliveries between 1999 and 2014 to Texas residents, including 1884 cases with cleft palate (CP) and 5289 cases with cleft lip with or without cleft palate (CL±P) without a known syndrome. We identified patterns of defects co-occurring with CP and with CL±P observed more frequently than would be expected if these defects occurred independently. We calculated adjusted observed-to-expected ( O/ E) ratios to account for the known tendency of birth defects to cluster nonspecifically. Results: Among infants without a syndrome, 23% with CP and 21% with CL±P had at least 1 additional congenital anomaly. Several combinations of defects were observed much more often than expected. For example, the combination of CL±P, congenital hydrocephaly, anophthalmia, and other nose anomalies had an O/ E ratio of 605. For both CP and CL±P, co-occurrence patterns with the highest O/ E ratios involved craniofacial and brain abnormalities, and many included the skeletal, cardiovascular, and renal systems. Conclusions: The patterns of defects we observed co-occurring with clefts more often than expected may help improve our understanding of the relationships between multiple defects. Further work to better understand some of the top defect combinations could reveal new phenotypic subgroups and increase our knowledge of the developmental mechanisms that underlie the respective defects.

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