A graph theory approach to analyze birth defect associations

Retrospective analysis of 2054 cases from 24 hospitals underwent ultrasonic consultation in a tertiary prenatal diagnosis center in Beijing, China

OBJECTIVES

To investigate the practices of prenatal ultrasound consultation in a region of the China and to describe the rate of concordance between the suspected anomaly and the final diagnosis of the referral examination.

METHODS

Retrospective study with all cases referred from 24 hospitals (Beijing, China) to a tertiary prenatal diagnosis center for ultrasonic consultation in 2018. The concordance between the suspected ultrasonic signs of fetal abnormalities of the referrer and the ultrasonic consultation results were evaluated and divided into full concordance, partial concordance, and discordance.

RESULTS

From 1938 patients with suspected ultrasonic signs, 2054 ultrasound consultation records were obtained. The most frequent anomalies for consultation in the first trimester (348, 91.3%) were cystic hygroma (CH), nuchal translucency (NT), or nuchal fold (NF) thickening, followed by signs of brain abnormalities in the second (173, 22.4%) and the third (182, 34.1%) trimester. The discordant rates of the first single signs were 19.8% for the first trimester, 41.6% for the second trimester, and 37.4% for the third trimester, respectively.

CONCLUSIONS

Our study demonstrated that the discordance of the first single signs was relatively low in the first trimester and higher in the second and third trimesters. The number of sonographers could be increased to ensure timeliness, strengthen training for those with poor concordance rates by referring to appropriate guidelines, and reduce ultrasonic consultation for those with high consistency after further research to save medical resources.

Epidemiology of Birth Defects in Eastern China and the Associated Risk Factors

BACKGROUND This study aimed to survey the overall situation of birth defects (BDs) among citizens of Hangzhou, China, and the risk factors of different BD types. MATERIAL AND METHODS We collected the data of 4349 perinatal infants with BDs in Hangzhou. The potentially associated risk factors of BDs were recorded and logistic regression analysis was used to predict the high incidence of BDs. RESULTS Among all perinatal infants with BDs, there were 4105 (94.3%) single births, 225 (5.2%) twin births, and 10 (0.2%) multiple births. In clinical outcomes, there were 2477 (57.0%) live births, 1806 (41.5%) dead fetuses, and 11 (0.3%) stillbirths. Down syndrome ranked first, accounting for 30.7% of the total births, followed by cleft lip and polydactyly. Low family income, nulliparity, high parity, high education level, and taking contraceptives in early pregnancy were found to be risk factors of Down syndrome. Low parity, low education level, and pesticide exposure were found to be risk factors of cleft lip. For polydactyly, young age of the mother and a parity above 0 were identified as risk factors. CONCLUSIONS Different risks factors can influence BD development and potentially help to predict specific BD types, such as demographic features and harmful exposure in early pregnancy.