Impact of pre-pregnancy diabetes mellitus on congenital anomalies, Canada, 2002–2012

Objective To examine the impact of pre-pregnancy diabetes mellitus (DM) on the population birth prevalence of congenital anomalies in Canada. Methods We carried out a population-based study of all women who delivered in Canadian hospitals (except those in the province of Quebec) between April 2002 and March 2013 and their live-born infants with a birth weight of 500 grams or more and/or a gestational age of 22 weeks or more. Pre-pregnancy type 1 or type 2 DM was identified using ICD-10 diagnostic codes. The association between DM and all congenital anomalies as well as specific congenital anomaly categories was estimated using adjusted odds ratios; the impact was calculated as a population attributable risk percent (PAR%). Results There were 118 892 infants with a congenital anomaly among 2 839 680 live births (41.9 per 1000). While the prevalence of any congenital anomaly declined from 50.7 per 1000 live births in 2002/03 to 41.5 per 1000 in 2012/13, the corresponding PAR% for a congenital anomaly related to pre-pregnancy DM rose from 0.6% (95% confidence interval [CI]: 0.4–0.8) to 1.2% (95% CI: 0.9–1.4). Specifically, the PAR% for congenital cardiovascular defects increased from 2.3% (95% CI: 1.7–2.9) to 4.2% (95% CI: 3.5–4.9) and for gastrointestinal defects from 0.8% (95% CI: 0.2–1.9) to 1.4% (95% CI: 0.7–2.6) over the study period. Conclusion Although there has been a relative decline in the prevalence of congenital anomalies in Canada, the proportion of congenital anomalies due to maternal prepregnancy DM has increased. Enhancement of preconception care initiatives for women with DM is recommended.

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Impact of Prenatal Screening and Diagnosis on the Epidemiology of Structural Congenital Anomalies

Journal of Medical Screening ◽

10.1177/096914139500200203 ◽

1995 ◽

Vol 2 (2) ◽

pp. 67-70 ◽

Cited By ~ 9

Author(s):

Chi Le-Ha ◽

David H Stone ◽

W Harper Gilmour

Keyword(s):

Congenital Anomaly ◽

Congenital Anomalies ◽

Prenatal Screening ◽

Renal Agenesis ◽

Secular Trends ◽

Health Board ◽

Abdominal Wall Defects ◽

Birth Prevalence ◽

Limb Reduction ◽

The Impact

Objective — To assess the impact of prenatal screening on the birth prevalence of three categories of structural congenital anomaly: abdominal wall defects (omphalocele and gastroschisis), renal agenesis/dysgenesis, and limb reduction defects. Setting — Glasgow, Scotland, United Kingdom. Methods — Data on the selected defects were obtained retrospectively from the population based Glasgow Register of Congenital Anomalies for the period 1980–91 inclusive. The register records all clinical or laboratory diagnoses of congenital anomaly in live births, stillbirths, and induced abortions occurring in women resident within the boundaries of the Greater Glasgow Health Board. The secular trends in the proportions of the defects diagnosed prenatally and terminated after screening, and in their prevalence at birth and during pregnancy, were examined. A total of 154845 births were surveyed: 309 cases were identified in the selected anomaly categories. Results — 83 cases of omphalocele/gastroschisis (5·4/10000 births), 92 cases of renal agenesis/dysgenesis (5·9/10000 births), and 134 cases of limb reduction defects (8·7/10000 births) were found. Marked increases occurred over the study period in the proportions of cases diagnosed prenatally but not in the proportions terminated. The greatest difference between the prevalence at birth and during pregnancy was found for omphalocele. There were no significant secular trends in the prevalence of the selected defects. Conclusions — Prenatal screening has made a limited epidemiological impact on the prevalence of these defects. It has been moderately (but inconsistently) effective in the avoidance of births of infants with omphalocele/gastroschisis and renal agenesis/dysgenesis but not of limb reduction defects. Future efforts should be directed towards improving the technical aspects of the ultrasonographic detection of fetal abnormalities and exploring in detail, locally, the reasons for the varying pattern of decision making about termination of pregnancy among prospective parents.

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Racial/ethnic differences in the birth prevalence of congenital anomalies in the United States

Journal of Perinatal Medicine ◽

10.1515/jpm-2013-0344 ◽

2015 ◽

Vol 43 (1) ◽

Cited By ~ 9

Author(s):

Alexander Egbe ◽

Simon Lee ◽

Deborah Ho ◽

Santosh Uppu ◽

Shubhika Srivastava

Keyword(s):

African Americans ◽

Ethnic Differences ◽

Congenital Anomalies ◽

Lower Risk ◽

The United States ◽

Population Based ◽

Social Differences ◽

Birth Prevalence ◽

Live Births ◽

Racial Ethnic

AbstractThis work aimed to analyze a single large representative population to determine racial/ethnic differences in the prevalence of congenital anomalies (CA).This is a population-based comprehensive analysis of racial/ethnic differences in the prevalence of CA diagnoses. We reviewed all live births in the 2008 Nationwide Inpatient Sample (NIS) database and determined the birth prevalence of 55 selected CA diagnoses in Caucasians. We then calculated the relative risk of these CA diagnoses in African American, Hispanics, and Asians relative to Caucasians.Overall CA prevalence was 29.2 per 1000 in a cohort of 1,048,252 live births, of which 51% were Caucasians. Compared with Caucasians, risk of overall CA was lower in African Americans (RR=0.9, CI: 0.8–0.9) and Hispanics (RR=0.9, CI: 0.8–0.9). Risk of overall CA was similar in Caucasians and Asians. Relative to the Caucasians, African Americans had lower risk of cardiac, genitourinary, and craniofacial CA but higher risk of musculoskeletal anomalies. Hispanics had lower risk of genitourinary and gastrointestinal CA. Asians had higher risk of craniofacial and musculoskeletal CA.Observed racial/ethnic differences in risk of CA may be related to genetic susceptibilities, cultural or social differences that could modify exposures, or many potential combinations between susceptibilities and exposures.

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Impact of Prenatal Diagnosis on the Birth Prevalence of Neural Tube Defects, Atlanta, 1990-4991

PEDIATRICS ◽

10.1542/peds.96.5.880 ◽

1995 ◽

Vol 96 (5) ◽

pp. 880-883

Author(s):

Helen E. Roberts ◽

Cynthia A. Moore ◽

Janet D. Cragan ◽

Paul M. Fernhoff ◽

Muin J. Khoury

Keyword(s):

Prenatal Diagnosis ◽

Neural Tube ◽

Neural Tube Defects ◽

Fetal Death ◽

Population Based ◽

Congenital Defects ◽

Substantial Impact ◽

Birth Prevalence ◽

Live Births ◽

The Impact

Objective. To determine the impact of prenatal diagnosis on the birth prevalence of neural tube defects (NTDs) in Atlanta during 1990 through 1991. Methods. Live-born and stillborn infants with NTDs who were at least 20 weeks' gestation were ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based birth defects registry. Prenatally diagnosed NTD-affected pregnancies were ascertained from the four perinatal centers and the three genetic laboratories operating in Atlanta during 1990 through 1991. Fetal death certificates were also reviewed for potential cases. Results. During 1990 through 1991, MACDP ascertained 59 NTD cases, for a birth prevalence of 0.77/1000 live births. During this period, an additional 28 NTD-affected pregnancies were detected prenatally and terminated before 20 weeks' gestation. The adjusted NTD rate during 1990 through 1991, which includes prenatally diagnosed cases, was 1.13/1000 live births. Conclusions. Prenatal diagnosis is making a substantial impact on the birth prevalence of NTDs in Atlanta. However, since NTD rates in Atlanta were 2 to 2.5 per 1000 live births in 1970, prenatal diagnosis and termination of pregnancy does not completely account for the declining rate of NTDs.

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Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2021-048744 ◽

2021 ◽

Vol 11 (5) ◽

pp. e048744

Author(s):

Andreea Bratu ◽

Taylor McLinden ◽

Katherine Kooij ◽

Monica Ye ◽

Jenny Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

British Columbia ◽

Cohort Study ◽

Population Based ◽

Incidence Rates ◽

Trend Test ◽

People Living With Hiv ◽

Age Related ◽

Hiv Serostatus ◽

The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

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Tetralogy of Fallot in infants less than one year old in the Valencia Region (Spain)

European Journal of Public Health ◽

10.1093/eurpub/ckz186.624 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Cavero Carbonell ◽

L Barrachina Bonet ◽

T Fernández Rojas ◽

S Moreno Marro ◽

L Páramo Rodríguez ◽

...

Keyword(s):

Tetralogy Of Fallot ◽

Congenital Anomalies ◽

Population Based ◽

Termination Of Pregnancy ◽

Fetal Anomaly ◽

Live Births ◽

Epidemiologic Surveillance ◽

Increasing Trend ◽

The Difference ◽

One Year

Abstract Background Tetralogy of Fallot (TF) is a rare disease characterized by the presence of 4 congenital heart defects (CHD). Objective: to describe the temporal trend and distribution of the TF in the Valencia Region (VR), in less than one year old, during the period 2007-2016. Methods Live births, stillbirths and termination of pregnancy due to fetal anomaly (TOPFA) between 2007-2016 with TF (code Q21.3 of the ICD10-BPA) were selected from the Congenital Anomalies (CA) population-based Registry of VR. The cases were confirmed through the review of clinical documentation. The prevalence of 10000 births with 95% confidence intervals (95%CI) was calculated for the period and for each year, and a descriptive analysis of sociodemographic and clinical variables was made. Results 146 cases were identified (45.2% male, 31.5% female and 23.3% unknown), 89.0% were simple pregnancies and 54.8% were diagnosed prenatally. The overall prevalence of TF was 3.0/10000 births (95%CI: 2.5-3.5), being 2015 the year with the highest prevalence (4.3/10000 births) and 2011 with the lowest (1.8/10000 births). These changes were mainly due to the increase and decrease in the number of TOPFA respectively. 74.7% were live births, 22.6% TOPFA and 2.7% stillbirths. The prevalence in live births was 2.2/10000 births (95%CI: 1.8-2.6) and in TOPFA it was 0.7/10000 births (95%CI: 0.4-0.9), identifying an increasing trend during the period in the last one. 11.0% of live births died during the first year of life. 45.9% of the cases had another CA associated with the TF, being CHD in 52.7% of cases. 66.4% of the mothers were over 30 years of age, being the most frequent those between 30-34 years (30.1%). Conclusions The prevalence obtained in the VR was lower than that of EUROCAT 3.5/10000 births (95%CI: 3.3-3.6) during the same period. EUROCAT has also identified the difference between the prevalence in live births (2.9 (95%CI: 2.8-3.0)) and TOPFA (0.5 (95%CI: 0.5-0.6)), and the increasing trend in the last one. Key messages The prevalence of Tetralogy of Fallot obtained in the VR was lower than that of EUROCAT (European network of population-based registries for the epidemiologic surveillance of congenital anomalies). EUROCAT has also identified the difference between the prevalence of Tetralogy of Fallot in live births and termination of pregnancy due to fetal anomaly, and the increasing trend in the last one.

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Comparing regional neonatal mortality rates: the influence of registration of births as live born for birth weight <500 g in Taiwan

BMJ Paediatrics Open ◽

10.1136/bmjpo-2019-000526 ◽

2019 ◽

Vol 3 (1) ◽

pp. e000526

Author(s):

Liang-Yi Wang ◽

Yu-Shan Chang ◽

Fu-Wen Liang ◽

Yung-Chieh Lin ◽

Yuh-Jyh Lin ◽

...

Keyword(s):

Birth Weight ◽

Neonatal Mortality ◽

Ecological Study ◽

Population Based ◽

Cross Sectional ◽

Neonatal Deaths ◽

Live Births ◽

Taipei City ◽

The Impact ◽

The City

ObjectiveTo investigate regional variation in the registration of births (still+live) as live born for birth weight <500 g and the impact on the city/county ranking of neonatal mortality rate (NMR) in Taiwan.DesignPopulation-based cross-sectional ecological study.Setting20 cities/counties in Taiwan.ParticipantsRegistered births for birth weight <500 g and neonatal deaths in 2015–2016.Main outcome measuresCity/county percentage of births <500 g registered as live born and ranking of city/county NMR (deaths per 1000 live births) including and excluding live births <500 g.ResultsThe percentage of births <500 g registered as live born ranged from 0% in Keelung City (0/26) and Penghu County (0/4) to 20% in Taipei City (112/558), 24% in Hsinchu County (5/21) and 28% in Hualien County (9/32). The change in city/county ranking of NMR from including to excluding live births <500 g was most prominent in Taipei City (from the 15th to the 1st) followed by Kaohsiung City (from the 18th to the 14th).ConclusionsThe city/county NMR in Taiwan is influenced by variation in the registration of live born for births with uncertain viability. We recommend presenting city/county NMR using both criteria (with or without minimum threshold of gestation period or birth weight) for better interpretation of the findings of comparisons of city/county NMR.

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Gastroschisis in Finland 1993 to 2014—Increasing Prevalence, High Rates of Abortion, and Survival: A Population-Based Study

European Journal of Pediatric Surgery ◽

10.1055/s-0039-3401797 ◽

2019 ◽

Vol 30 (06) ◽

pp. 536-540

Author(s):

Arimatias Raitio ◽

Asta Lahtinen ◽

Johanna Syvänen ◽

Teemu Kemppainen ◽

Eliisa Löyttyniemi ◽

...

Keyword(s):

Infant Mortality ◽

Live Birth ◽

Survival Rates ◽

Population Based ◽

Good Prognosis ◽

Associated Anomalies ◽

Population Based Study ◽

Birth Prevalence ◽

Live Births ◽

Total Prevalence

Abstract Introduction The study aims to assess the changes in prevalence and mortality of gastroschisis, and to identify associated anomalies. Materials and Methods It is a population-based nationwide study. All gastroschisis cases were identified in the Finnish Register of Congenital Malformations and the Care Register for Health Care from 1993 to 2014 including live births, stillbirths, and terminations of pregnancy due to fetal anomalies. Associated anomalies were recorded, and analyzed, and prevalence and infant mortality were calculated. Results There were 320 cases of gastroschisis; 235 (73%) live births, 16 (5%) stillbirths, and 69 (22%) terminations of pregnancy. Live birth prevalence of gastroschisis in Finland was lower than generally reported (1.73 in 10,000). However, due to relatively high rates of abortion, our total prevalence of 2.57/10,000 was similar with other reports. The most common risk factor was young maternal age. Babies with gastroschisis were born prematurely, on average on the 36th week and most are delivered by caesarean section. There was a significant increasing trend in live birth prevalence (p = 0.0018). Overall infant mortality was 7.7% (18/235), 7.2% (16/222) in simple gastroschisis and 15% (2/13) in complex gastroschisis. Associated anomalies were rare both in aborted fetuses and neonates, and there was only one case with a chromosomal abnormality. Conclusion Gastroschisis is usually an isolated anomaly with increasing birth prevalence and excellent survival rates. Regardless of the good prognosis, the abortion rates in Finland are higher than previously reported, and we hypothesize this to be due to lack of appropriate antenatal counselling.

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Which body mass index is best associated with risk of diabetes mellitus and hypertension in a Japanese-Brazilian population?

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007000200005 ◽

2007 ◽

Vol 23 (2) ◽

pp. 297-304 ◽

Cited By ~ 2

Author(s):

Rosana Farah Simony ◽

Suely Godoy Agostinho Gimeno ◽

Sandra Roberta Gouveia Ferreira ◽

Laércio Joel Franco

Keyword(s):

Diabetes Mellitus ◽

Body Mass Index ◽

Body Mass ◽

Sensitivity And Specificity ◽

Population Based ◽

Cross Sectional Study ◽

Odds Ratios ◽

Cross Sectional ◽

Japanese Brazilians ◽

The Impact

The objective of this study was to evaluate the impact of different body mass index (BMI) ranges associated with the risk of diabetes and hypertension in Japanese-Brazilians. This cross-sectional study was based on data from 1,330 Japanese-Brazilians > 30 years of age who participated in a population-based survey on the prevalence of diabetes mellitus and associated diseases. Glucose tolerance status was classified according to WHO criteria and blood pressure levels according to the VI-JNC. Odds ratios for diabetes and hypertension were calculated for different BMI ranges; for different BMIs, sensitivity and specificity for percentiles 25, 50, 75, 90 and 95 were obtained. Increased odds ratios for diabetes mellitus and hypertension were observed with BMI values > 25kg/m². The 50th percentile corresponded to the highest sensitivity and specificity for the identification of risk for both diseases. Our results suggest that BMI values proposed by WHO should also be useful for this group of Japanese descendants in the assessment of risk for DM and hypertension.

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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 ◽

10.1371/journal.pone.0255456 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255456

Author(s):

Muhammad Zubayr Saib ◽

Barnesh Lalloo Dhada ◽

Colleen Aldous ◽

Helen Louise Malherbe

Keyword(s):

South Africa ◽

Congenital Anomalies ◽

Circulatory System ◽

Birth Prevalence ◽

Live Births ◽

Department Of Health ◽

Significant Difference ◽

Kwazulu Natal ◽

Data Gap ◽

The Individual

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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Association of other congenital anomalies in children with cleft lip and palate: a prospective hospital based observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20191072 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1059

Author(s):

Padmasani Venkat Ramanan ◽

Rajesh Balan ◽

Jyotsna Murthy ◽

Syed Altaf Hussain

Keyword(s):

Congenital Anomaly ◽

Congenital Anomalies ◽

Congenital Malformations ◽

Congenital Heart ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Associated Anomalies ◽

Live Births ◽

Associated Malformations ◽

Syndrome Association

Background: Cleft lip and palate is a common congenital anomaly affecting approximately 1 in 700 live births in south Asia. It is often associated with syndromes and other malformations but the exact incidence of these in Asians is not known. The present study was carried out to determine the association of other congenital anomalies in children with cleft.Methods: The study was carried out in the patients attending the Cleft centre of our Hospital. They were examined for other major external congenital malformations and syndrome association. Where ever relevant, appropriate investigations were done.Results: Of the total of 2367 children examined, 262 (11.06%) had congenital malformations. Among the non-syndromic children, 9% had associated malformations. The commonest was congenital heart disease (1.4%) following by genitourinary and skeletal anomalies. The highest number of anomalies was seen in patients with cleft palate alone (24.89%). 1.4% patients had identifiable syndromes.Conclusions: The study emphasizes the need for a thorough examination of all children with cleft. The overall lower incidence of syndromic clefts and associated anomalies in present study suggests that other etiological factors may be involved in our country.

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