Trends in congenital anomalies in Europe from 1980 to 2012

Joan K. Morris*, Anna L. Springett, Ruth Greenlees, Maria Loane, Marie-Claude Addor, Larraitz Arriola, Ingeborg Barisic, Jorieke E. H. Bergmann, Melinda Csaky-Szunyogh, Carlos Dias, Elizabeth S. Draper, Ester Garne, Miriam Gatt, Babak Khoshnood, Kari Klungsoyr, Catherine Lynch, Robert McDonnell, Vera Nelen, Amanda J. Neville, Mary O'MahonyAnna Pierini, Annette Queisser-Luft, Hanitra Randrianaivo, Judith Rankin, Anke Rissmann, Jennifer Kurinczuk, David Tucker, Christine Verellen-Dumoulin, Diana Wellesley, Helen Dolk

*Corresponding author for this work

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Abstract

Background

Surveillance of congenital anomalies is important to identify potential teratogens.

Methods

This study analysed the prevalence of 61 congenital anomaly subgroups (excluding chromosomal) in 25 population-based EUROCAT registries (1980-2012). Live births, fetal deaths and terminations of pregnancy for fetal anomaly were analysed with multilevel random-effects Poisson regression models.

Results

Seventeen anomaly subgroups had statistically significant trends from 2003-2012; 12 increasing and 5 decreasing.

Conclusions

The annual increasing prevalence of severe congenital heart defects, single ventricle, atrioventricular septal defects and tetralogy of Fallot of 1.4% (95% CI: 0.7% to 2.0%), 4.6% (1.0% to 8.2%), 3.4% (1.3% to 5.5%) and 4.1% (2.4% to 5.7%) respectively may reflect increases in maternal obesity and diabetes (known risk factors). The increased prevalence of cystic adenomatous malformation of the lung [6.5% (3.5% to 9.4%)] and decreased prevalence of limb reduction defects [-2.8% (-4.2% to -1.5%)] are unexplained. For renal dysplasia and maternal infections, increasing trends may be explained by increased screening, and deceases in patent ductus arteriosus at term and increases in craniosynostosis, by improved follow up period after birth and improved diagnosis. For oesophageal atresia, duodenal atresia/stenosis and ano-rectal atresia/stenosis recent changes in prevalence appeared incidental when compared with larger long term fluctuations. For microcephaly and congenital hydronephrosis trends could not be interpreted due to discrepancies in diagnostic criteria. The trends for club foot and syndactyly disappeared once registries with disparate results were excluded. No decrease in neural tube defects was detected, despite efforts at prevention through folic acid supplementation.

Original languageEnglish
Article number0194986
Number of pages18
JournalPLoS ONE
Volume13
Issue number4
DOIs
Publication statusPublished - 5-Apr-2018

Keywords

  • NEURAL-TUBE DEFECTS
  • FOLIC-ACID FORTIFICATION
  • POPULATION-BASED EVALUATION
  • ZIKA VIRUS-INFECTION
  • HEART-DEFECTS
  • PREVALENCE
  • RISK
  • ASSOCIATION
  • REDUCTION
  • EUROCAT

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