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Estevam MV, Toniollo GH, Apparicio M. The most common congenital malformations in dogs: Literature review and practical guide. Res Vet Sci 2024; 171:105230. [PMID: 38492280 DOI: 10.1016/j.rvsc.2024.105230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Abstract
Congenital malformations can affect almost 7% of canine newborns. The increase of commercial dog breeding and inbreeding used to maintain the striking characteristics of each breed, the appearance of malformations has become increasingly common, especially in brachycephalic dogs. The causes are diverse, and include genetic, nutritional, iatrogenic, and infectious factors, often making it difficult to establish a cause-consequence relationship. The high mortality associated with malformations comes not only from the fact that some are incompatible with life, but also because even if many undergo surgical treatment or correction, they require specific management, monitoring, and clinical treatment for an indefinite period of time. The most common malformations such as cleft lip and palate, hydrocephalus and anasarca have been studied for a long time, and it is currently known that brachycephalic dogs have a greater predisposition, however, for other less common conditions as gastroschisis and hypospadias, there is only a few case reports. The appearance of congenital defects in a litter leads to financial losses for the breeder, emotional losses for the owner and the veterinarian and harms the well-being of that individual. For this reason, the aim of this review article is to gather relevant information on the characteristics, diagnosis, and management of the main malformations in puppies. It is essential that the veterinarian is prepared to diagnose and treat these conditions, reducing negative impacts on animals and owners.
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Affiliation(s)
- Marina Vilela Estevam
- Department of Pathology, Reproduction and One Health, São Paulo State University - FCAV Unesp, Jaboticabal, SP, Brazil
| | - Gilson Helio Toniollo
- Department of Pathology, Reproduction and One Health, São Paulo State University - FCAV Unesp, Jaboticabal, SP, Brazil
| | - Maricy Apparicio
- Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - FMVZ Unesp, Botucatu, SP, Brazil.
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Boudet-Berquier J, Demattei C, Guldner L, Gallay A, Manouvrier S, Botton J, Philippat C, Delva F, Bloch J, Semaille C, Odent S, Perthus I, Randrianaivo H, Babajko S, Barjat T, Beneteau C, Brennetot N, Garne E, Haddad G, Hocine M, Lacroix I, Leuraud K, Mench M, Morris J, Patrier S, Sartelet A, Verloes A, Bonaldi C, Le Barbier M, Gagnière B, Pépin P, Ollivier R, Bitoun M, King L, Guajardo-Villar A, Gomes E, Desenclos JC, Regnault N, Benachi A. A multidisciplinary and structured investigation of three suspected clusters of transverse upper limb reduction defects in France. Eur J Epidemiol 2024:10.1007/s10654-024-01125-5. [PMID: 38671254 DOI: 10.1007/s10654-024-01125-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Between 2019-2021, facing public concern, a scientific expert committee (SEC) reanalysed suspected clusters of transverse upper limb reduction defects (TULRD) in three administrative areas in France, where initial investigations had not identified any risk exposure. We share here the national approach we developed for managing suspicious clusters of the same group of congenital anomalies occurring in several areas. METHODS The SEC analysed the medical records of TURLD suspected cases and performed spatiotemporal analyses on confirmed cases. If the cluster was statistically significant and included at least three cases, the SEC reviewed exposures obtained from questionnaires, environmental databases, and a survey among farmers living near to cases' homes concerning their plant product use. RESULTS After case re-ascertainment, no statistically significant cluster was observed in the first administrative areas. In the second area, a cluster of four children born in two nearby towns over two years was confirmed, but as with the initial investigations, no exposure to a known risk factor explaining the number of cases in excess was identified. In the third area, a cluster including just two cases born the same year in the same town was confirmed. DISCUSSION Our experience highlights that in the event of suspicious clusters occurring in different areas of a country, a coordinated and standardised approach should be preferred.
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Affiliation(s)
- Julie Boudet-Berquier
- Non-Communicable Diseases and Injuries Department, Santé Publique France, Saint Maurice, France.
| | - Christophe Demattei
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nîmes, Nîmes, Languedoc-Roussillon, France
| | - Laurence Guldner
- Environment and Work Department, Santé Publique France, Saint Maurice, Health, France
| | - Anne Gallay
- Non-Communicable Diseases and Injuries Department, Santé Publique France, Saint Maurice, France
| | - Sylvie Manouvrier
- Reference Centre of Developmental Anomalies and Defect Syndromes, RADEME Maladies Rares du Développement Et du Métabolisme, Université Lille, 7364, Lille, EA, France
| | - Jérémie Botton
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance, Saint-Denis, France
- Faculty of Pharmacy, Paris-Saclay University, Orsay, France
| | - Claire Philippat
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, University Grenoble Alpes, Grenoble, France
| | - Fleur Delva
- INSERM, BPH, UMR1219, EPICENE Team, University of Bordeaux, Bordeaux, France
- Environmental and Occupational Health Department, Bordeaux University Hospital, 33000, Bordeaux, France
| | | | | | - Sylvie Odent
- Reference Centre of Developmental Anomalies and Defect Syndromes, Hôpital Sud, CHU de Rennes, Rennes, France
| | - Isabelle Perthus
- Auvergne registry of congenital anomalies (CEMC-Auvergne), Department of clinical genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Hanitra Randrianaivo
- La Réunion registry of congenital anomalies, Centre Hospitalier Universitaire de La Réunion, Île de la Réunion, France
| | - Sylvie Babajko
- Molecular Oral Pathophysiology Laboratory, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, 1138, Paris, France
- Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, Paris, France
- UR2496, Biomedical Research in Odontology, Université Paris Cité, Montrouge, France
| | - Tiphaine Barjat
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
- INSERM U1059 SAINBIOSE, Université Jean Monnet, Saint-Étienne, France
| | - Claire Beneteau
- Department of Human Genetics, University Hospital Hôtel Dieu, Nantes, France
| | - Naima Brennetot
- French National Reference for Children Limb Defect, Hôpitaux de Saint-Maurice, Saint Maurice, France
| | - Ester Garne
- Department of Pediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | | | - Mounia Hocine
- Conservatoire National des Arts et Métiers, Paris, France
| | - Isabelle Lacroix
- REGARDs Network, Pharmacologie Médicale et Clinique, CERPOP INSERM UMR 1295-SPHERE team, Faculté de Médecine Université de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Klervi Leuraud
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Michel Mench
- INRAE, BIOGECO, UMR 1202, University of Bordeaux, F‑33615, Pessac, France
| | - Joan Morris
- Population Health Research Institute, St George's University of London, London, UK
| | - Sophie Patrier
- Department of Pathology, Rouen University Hospital, Rouen, France
| | - Arnaud Sartelet
- Clinical Department of Ruminant, University of Liège, 4000, Liège, Belgium
| | - Alain Verloes
- Genetics Department, APHP, Robert-Debré University Hospital, Paris, France
| | - Christophe Bonaldi
- Methodology and Biostatistics Department, Santé Publique France, Saint Maurice, France
| | - Mélina Le Barbier
- Environment and Work Department, Santé Publique France, Saint Maurice, Health, France
| | | | - Philippe Pépin
- Cellule Auvergne-Rhône-Alpes, Santé Publique France, Clermont-Ferrand, France
| | - Ronan Ollivier
- Cellule Pays-de-la Loire, Santé Publique France,, Nantes, France
| | - Monique Bitoun
- Cellule Pays-de-la Loire, Santé Publique France,, Nantes, France
| | - Lisa King
- Cellule Pays-de-la Loire, Santé Publique France,, Nantes, France
| | | | - Eugenia Gomes
- Non-Communicable Diseases and Injuries Department, Santé Publique France, Saint Maurice, France
| | | | - Nolwenn Regnault
- Non-Communicable Diseases and Injuries Department, Santé Publique France, Saint Maurice, France
| | - Alexandra Benachi
- Department of Obstetrics and Gynecology, DMU Santé des femmes et des nouveau-nés, Hopital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris Saclay, Clamart, France
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Auger N, Arbour L, Lewin A, Brousseau É, Healy-Profitós J, Luu TM. Congenital anomalies during Covid-19: artifact of surveillance or a real TORCH? Eur J Epidemiol 2024:10.1007/s10654-024-01122-8. [PMID: 38589643 DOI: 10.1007/s10654-024-01122-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
Infections in the first trimester of pregnancy can be teratogenic, but the possibility that Covid-19 could lead to birth defects is unclear. We examined whether SARS-CoV-2 infection during pregnancy or exposure to pandemic conditions were associated with the risk of congenital anomalies. We carried out a retrospective study of 420,222 neonates born in Quebec, Canada in two time periods: prepandemic (January 1, 2017 to March 12, 2020) vs. pandemic (March 13, 2020 to March 31, 2022). We classified pandemic births as early (first trimester completed before the pandemic) or late (first trimester during the pandemic), and identified patients with SARS-CoV-2 infections during pregnancy. We applied (1) adjusted log-binomial regression models to assess the association between SARS-CoV-2 infection and congenital anomalies, and (2) autoregressive interrupted time series regression to analyze temporal trends in the monthly number of defects in all patients regardless of infection. In total, 29,263 newborns (7.0%) had a congenital anomaly. First trimester SARS-CoV-2 infections were not associated with a greater risk of birth defects compared with no infection (RR 1.07, 95% CI 0.59-1.95). However, births during the late pandemic period were more likely to be diagnosed with congenital microcephaly compared with prepandemic births (RR 1.44, 95% CI 1.21-1.71). Interrupted time series analysis confirmed that the frequency of microcephaly increased during the late pandemic period, whereas other anomalies did not. We conclude that Covid-19 is likely not teratogenic, but enhanced surveillance of anomalies among late pandemic births may have heightened the detection of infants with microcephaly.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, QC, Canada.
- Institut national de santé publique du Québec, Montreal, QC, Canada.
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Hema-Quebec, Montreal, QC, Canada
| | - Émilie Brousseau
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
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Schraw JM, Rudolph KE, Shumate CJ, Gribble MO. Direct potable reuse and birth defects prevalence in Texas: An augmented synthetic control method analysis of data from a population-based birth defects registry. Environ Epidemiol 2024; 8:e300. [PMID: 38617421 PMCID: PMC11008670 DOI: 10.1097/ee9.0000000000000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/12/2024] [Indexed: 04/16/2024] Open
Abstract
Background Direct potable reuse (DPR) involves adding purified wastewater that has not passed through an environmental buffer into a water distribution system. DPR may help address water shortages and is approved or is under consideration as a source of drinking water for several water-stressed population centers in the United States, however, there are no studies of health outcomes in populations who receive DPR drinking water. Our objective was to determine whether the introduction of DPR for certain public water systems in Texas was associated with changes in birth defect prevalence. Methods We obtained data on maternal characteristics for all live births and birth defects cases regardless of pregnancy outcome in Texas from 2003 to 2017 from the Texas Birth Defects Registry and birth and fetal death records. The ridge augmented synthetic control method was used to model changes in birth defect prevalence (per 10,000 live births) following the adoption of DPR by four Texas counties in mid-2013, with county-level data on maternal age, percent women without a high school diploma, percent who identified as Hispanic/Latina or non-Hispanic/Latina Black, and rural-urban continuum code as covariates. Results There were nonstatistically significant increases in prevalence of all birth defects collectively (average treatment effect in the treated = 53.6) and congenital heart disease (average treatment effect in the treated = 287.3) since June 2013. The estimated prevalence of neural tube defects was unchanged. Conclusions We estimated nonstatistically significant increases in birth defect prevalence following the implementation of DPR in four West Texas counties. Further research is warranted to inform water policy decisions.
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Affiliation(s)
- Jeremy M. Schraw
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Kara E. Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York
| | - Charles J. Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Matthew O. Gribble
- School of Medicine, University of California San Francisco, San Francisco, California
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Xie Y, Wu R, Li H, Dong W, Zhou G, Zhao H. Statistical methods for assessing the effects of de novo variants on birth defects. Hum Genomics 2024; 18:25. [PMID: 38486307 PMCID: PMC10938830 DOI: 10.1186/s40246-024-00590-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024] Open
Abstract
With the development of next-generation sequencing technology, de novo variants (DNVs) with deleterious effects can be identified and investigated for their effects on birth defects such as congenital heart disease (CHD). However, statistical power is still limited for such studies because of the small sample size due to the high cost of recruiting and sequencing samples and the low occurrence of DNVs. DNV analysis is further complicated by genetic heterogeneity across diseased individuals. Therefore, it is critical to jointly analyze DNVs with other types of genomic/biological information to improve statistical power to identify genes associated with birth defects. In this review, we discuss the general workflow, recent developments in statistical methods, and future directions for DNV analysis.
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Affiliation(s)
- Yuhan Xie
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
- Department of Genetics, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Ruoxuan Wu
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Hongyu Li
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Weilai Dong
- Department of Genetics, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Geyu Zhou
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA.
- Department of Genetics, Yale School of Medicine, New Haven, CT, 06520, USA.
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Tadesse AW, Ayano G, Dachew BA, Tusa BS, Damtie Y, Betts K, Alati R. The association between prenatal cannabis use and congenital birth defects in offspring: A cumulative meta-analysis. Neurotoxicol Teratol 2024; 102:107340. [PMID: 38460861 DOI: 10.1016/j.ntt.2024.107340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE To examine the association between prenatal cannabis use and structural birth defects in exposed offspring. METHODS In line with the preregistered protocol (PROSPERO: CRD42022368623), we systematically searched PubMed/Medline, CINHAL, EMBASE, Web of Science, ProQuest, Psych-Info, and Google Scholar for published articles until 25 January 2024. The methodological quality of the included studies was appraised by the Newcastle-Ottawa Quality Assessment Scale (NOS). A meta-analysis was carried out to report the pooled effect estimates from the included studies. We further performed subgroup, leave-one-out sensitivity, and meta-regression analyses, which increased the robustness of our findings. RESULTS In this cumulative meta-analysis, thirty-six observational studies, consisting of 18 case-control and 18 cohort studies, with 230, 816 cases of birth defects and 18,049,013 controls (healthy babies) were included in the final analysis. We found that offspring exposed to maternal prenatal cannabis are at greater risks of a wide range of structural birth defects: cardiovascular/heart [OR = 2.35: 95 % CI 1.63 - 3.39], gastrointestinal [OR = 2.42: 95 % CI 1.61 - 3.64], central nervous system [OR = 2.87: 95 % CI 1.51 - 5.46], genitourinary [OR = 2.39: 95 % CI 1.11 - 5.17], and any (unclassified) birth defects [OR = 1.25: 95 % CI 1.12 - 1.41]. CONCLUSION The findings from the current study suggest that maternal prenatal cannabis exposure is associated with a higher risk of different forms of structural birth defects in offspring. The findings underscore the significance of implementing preventive strategies, including enhanced preconception counselling, to address cannabis use during pregnancy and mitigate the risk of birth defects in offspring.
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Affiliation(s)
- Abay Woday Tadesse
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia; Samara University, College of Medicine and Health Sciences, Department of Public Health, 132, Semera, Ethiopia; Dream Science and Technology College, 1466 Dessie, Ethiopia.
| | - Getinet Ayano
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Berihun Assefa Dachew
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Biruk Shalmeno Tusa
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Yitayish Damtie
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Kim Betts
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Rosa Alati
- School of Population Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia; Institute for Social Sciences Research, The University of Queensland, 80 Meier's Rd, Indooroopilly, QLD 4068, Australia
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Okpara SE, Iloabachie IC, Mbanugo TH, Onyia EE, Okpara AC, Mbaeri IC, Mathew M, Uche EO. Seasonal trend in the occurrence of myelomeningocele in nigeria: a hypothesis of climate-induced oxidative stress. Childs Nerv Syst 2024; 40:707-713. [PMID: 37947860 DOI: 10.1007/s00381-023-06211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Myelomeningocele is the most severe birth defect compatible with long-term survival. It accounts for 5.7% of neurological surgeries in Nigeria. However, the exact cause of this neural tube defect remains unidentified. This study aims to determine if seasonal variation is a potential environmental contributor. METHOD This study prospectively recruited 242 children diagnosed with myelomeningocele at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria, between January 2010 and December 2022. Our primary outcome was the seasonal occurrence of myelomeningocele, while covariates included gender, birth order, maternal folic acid supplementation (FAS), and parental age. The estimated month of conception was derived from the mother's last menstrual period (LMP), and the occurrence of myelomeningocele across the various seasons in which these babies were conceived was assessed using the Lorenz curve and the Gini coefficient. RESULTS 242 patients were studied with a male-to-female ratio of 1.26. The majority of cases were lumbosacral (93.4%), and none of the mothers commenced FAS before conception. The highest proportion of cases (39.7%) occurred during the hottest period of the dry season (January-March), while the lowest proportion (15.7%) occurred during the early wet season (April-June). The Gini index of 0.29, and the Gini coefficient derived from 100,000 Monte Carlo simulations of 0.24, indicate a significant variation in the distribution of myelomeningocele cases across different seasons of conception. CONCLUSION The seasonal occurrence of myelomeningocele with a peak in January-March suggests a potential association with environmental factors including oxidative stress induced by solar radiation.
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Affiliation(s)
- Samuel E Okpara
- Neurosurgery Division, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
- Neurosurgery Division, Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi, Nigeria
| | - Izuchukwu C Iloabachie
- Neurosurgery Division, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria.
| | - Tochukwu H Mbanugo
- Neurosurgery Division, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
| | - Ephraim E Onyia
- Neurosurgery Division, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
| | - Amarachi C Okpara
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi, Nigeria
| | - Ikechi C Mbaeri
- Neurosurgery Division, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
- Neurosurgery Division, Department of Surgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi, Nigeria
| | - Mesi Mathew
- Department of Neurosurgery, Hull Royal Infirmary, Hull University Teaching Hospitals, Cottingham, UK
| | - Enoch O Uche
- Neurosurgery Division, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria
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Fisher SC, Romitti PA, Tracy M, Howley MM, Jabs EW, Browne ML. Associations between maternal periconceptional alcohol consumption and risk of omphalocele among offspring, National Birth Defects Prevention Study, 1997-2011. Prev Med 2024; 180:107891. [PMID: 38342385 DOI: 10.1016/j.ypmed.2024.107891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE Previous studies of alcohol consumption during pregnancy and omphalocele have produced mixed results. We updated an earlier analysis of National Birth Defects Prevention Study (NBDPS) data, adding six years of participants, to examine associations between maternal alcohol consumption and omphalocele. METHODS NBDPS was a multi-site, population-based case-control study in the United States. Cases were identified from birth defect surveillance programs in 10 states; controls were liveborn infants without a birth defect randomly selected from the same catchment areas. Mothers self-reported alcohol consumption during the periconceptional period (one month before through the third gestational month) via telephone interview. Our study included mothers of 410 omphalocele cases and 11,219 controls with estimated dates of delivery (EDDs) during 1997-2011. We used logistic regression to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for periconceptional alcohol consumption and omphalocele. We performed a probabilistic bias analysis to evaluate the impact of alcohol exposure misclassification on our results. RESULTS Overall, 44% of case and 38% of control mothers reported periconceptional alcohol consumption; 22% and 17%, respectively, reported binge drinking. Any maternal periconceptional alcohol consumption was associated with modestly increased odds of omphalocele (AOR 1.35, 95% CI 1.09, 1.68), as was binge drinking (AOR 1.47, 95% CI 1.08, 2.01). Our bias analysis yielded estimates further from the null. CONCLUSIONS We observed modest associations between maternal periconceptional alcohol consumption and omphalocele. Based on our bias analysis, studies of alcohol and birth defects not accounting for exposure misclassification may underestimate associations.
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Affiliation(s)
- Sarah C Fisher
- Birth Defects Registry, New York State Department of Health, Albany, NY, United States.
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, United States
| | - Meredith M Howley
- Birth Defects Registry, New York State Department of Health, Albany, NY, United States
| | - Ethylin Wang Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Clinical Genomics, Mayo Clinic, Rochester, MN, United States
| | - Marilyn L Browne
- Birth Defects Registry, New York State Department of Health, Albany, NY, United States; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, United States
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Kang LY, Guo ZR, Shang WJ, Cao GY, Zhang YP, Wang QM, Shen HP, Liang WN, Liu M. Perinatal prevalence of birth defects in the Mainland of China, 2000-2021: a systematic review and meta-analysis. World J Pediatr 2024:10.1007/s12519-023-00786-8. [PMID: 38340146 DOI: 10.1007/s12519-023-00786-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/06/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Although birth defects are of great concern globally, the latest national prevalence has not yet been quantified in China. We conducted a systematic review and meta-analysis to estimate the perinatal prevalence of birth defects in the Mainland of China between 2000 and 2021. METHODS We performed a systematic literature search of six databases for relevant articles published between January 1, 2000, and March 1, 2023. We included published studies that reported data on the perinatal prevalence of birth defects in the Mainland of China. The DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and its 95% confidence interval (CI). We also conducted subgroup analyses and univariable meta-regressions to explore differences in prevalence by time period, geographic region, and other characteristics. RESULTS We included 254 studies reporting the perinatal prevalence of birth defects and 86 studies reporting only the prevalence of specific types of birth defects. Based on 254 studies covering 74,307,037 perinatal births and 985,115 cases with birth defects, the pooled perinatal prevalence of birth defects was 122.54 (95% CI 116.20-128.89) per 10,000 perinatal births in the Mainland of China during 2000-2021. Overall, the perinatal prevalence of birth defects increased from 95.60 (86.51-104.69) per 10,000 in 2000-2004 to 208.94 (175.67-242.22) per 10,000 in 2020-2021. There were also significant disparities among different geographical regions. Congenital heart defects (33.35 per 10,000), clefts of the lip and/or palate (13.52 per 10,000), polydactyly (12.82 per 10,000), neural tube defects (12.82 per 10,000), and inborn errors of metabolism (11.41 per 10,000) were the five most common types of birth defects. The perinatal prevalence among males was significantly higher than that among females (β = 2.44 × 10-3, P = 0.003); a higher perinatal prevalence of birth defects was observed among perinatal births whose mothers were ≥ 35 years (β = 4.34 × 10-3, P < 0.001). CONCLUSION Comprehensive and sustained efforts are needed to strengthen surveillance and detection of birth defects, improve prenatal and postnatal healthcare, and promote rehabilitation, especially in underdeveloped areas.
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Affiliation(s)
- Liang-Yu Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Vanke School of Public Health, Tsinghua University, No. 1, Tsinghua Garden, Haidian District, Beijing, 100084, China
| | - Zi-Rui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Wei-Jing Shang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Gui-Ying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yi-Ping Zhang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, China
| | - Qiao-Mei Wang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, China
| | - Hai-Ping Shen
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, No. 1, Xizhimenwai South Road, Xicheng District, Beijing, China
| | - Wan-Nian Liang
- Vanke School of Public Health, Tsinghua University, No. 1, Tsinghua Garden, Haidian District, Beijing, 100084, China.
- Institute of Healthy China, Tsinghua University, No. 1, Tsinghua Garden, Haidian District, Beijing, 100084, China.
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education Beijing, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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Zhou Q, Dong G, Wang Q, Shen H, Zhang Y, Zhang S, Chen J, Li X. Preconception folic acid supplementation for the prevention of birth defects: a prospective, population-based cohort study in mainland China. BMC Pregnancy Childbirth 2024; 24:114. [PMID: 38321376 PMCID: PMC10845381 DOI: 10.1186/s12884-024-06283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 01/21/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Folic acid supplementation is recommended for reducing the risk of birth defects. We aimed to assess the protective association of periconception folic acid supplements with birth defects in real-world setting. METHODS This prospective, population-based cohort study utilized national preconception registered data of married Chinese couples planning a pregnancy within 6 months between 2010 and 2012 in Mainland China. Participated women are freely provided folic acid starting 3 months before conception till 3 months after conception. Birth defects were self-reported at 42 days postpartumn followup. R software (v4.0.2) was applied for statistical analyses. RESULTS Complete data of 567,547 couples with pregnancy outcomes and folic acid supplementation were extracted for final analysis. A total of 74.7% women were with folic acid supplementation, and 599 birth defects were self-reported. The odd of birth defects was lower among women taking folic acid compared to their counterparts not taking (0.102% vs 0.116%, P < 0.001). In the multiple logistic regression analyses, the odd of birth defects was lower among couples with maternal folic acid supplementation (OR = 0.78, 95%CI: 0.66-0.95, P = 0.011), especially decreased odd of neural tube defects (NTDs) (OR = 0.56, 95%CI: 0.39-0.82, P = 0.003). This association was confirmed by 1:4 and 1:10 case control analysis. Odds of birth defects were significantly lower among women with folic acid supplementation more than 3 months before pregnancy (P < 0.001), and moreover, the odds of cleft (P = 0.007) and NTDs (P = 0.007) were of notable decrease. CONCLUSION This retrospective case cohort study provides programmatic evidence for public health strategy-making to for reducing the risk of NTDs and clefts.
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Affiliation(s)
- Qiongjie Zhou
- Department of Obsterics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Guiying Dong
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Qiaomei Wang
- National Research Institute for Family Planning, No. 12, Dahuisi Road, Haidian District, Beijing, China
| | - Haiping Shen
- National Research Institute for Family Planning, No. 12, Dahuisi Road, Haidian District, Beijing, China
| | - Yiping Zhang
- National Research Institute for Family Planning, No. 12, Dahuisi Road, Haidian District, Beijing, China
| | - Shikun Zhang
- National Research Institute for Family Planning, No. 12, Dahuisi Road, Haidian District, Beijing, China
| | - Jingqi Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
| | - Xiaotian Li
- Department of Obsterics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.
- Department of Obsterics, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518028, Guangdong, China.
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11
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Banu T. Revising Destiny - Surgical Care in Birth Defects. J Pediatr Surg 2024; 59:177-181. [PMID: 37953161 DOI: 10.1016/j.jpedsurg.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023]
Abstract
Birth Defects are accountable for the substantial surgical burden of disease worldwide. It can bring upon death, chronic illness, disability [physical or mental or both], financial burden, social stigma, abandonment, feticide and Infanticide. Availing timely and safe surgery can minimize the potential fatalities and sufferings caused by birth defects. Yet surgery is not treated as essential for the management of birth defects, especially in lower middle-income countries. It causes potentially correctable conditions to exacerbate, which can lead to death or lifelong disabilities. Surgical care cannot only correct birth defects but also can avert potential Disability Adjusted Life Years (DALYs) and financial burden. Furthermore, surgical correction facilitates social inclusion. Such transformation can be equated to "Revising Destiny". A "whole of society" approach focused on surgical care is instrumental for addressing the health, financial, and social implications of birth defects. LEVEL OF EVIDENCE V: Expert Opinion.
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Affiliation(s)
- Tahmina Banu
- Chittagong Research Institute for Children Surgery (CRICS), Panchlaish, Chittagong 4203, Bangladesh.
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12
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Stoll C, Dott B, Alembik Y, Roth MP. Associated anomalies in anophthalmia and microphthalmia. Eur J Med Genet 2024; 67:104892. [PMID: 38110175 DOI: 10.1016/j.ejmg.2023.104892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/07/2023] [Accepted: 11/25/2023] [Indexed: 12/20/2023]
Abstract
Infants with anophthalmia and microphthalmia (an/microphthalmia) have often other associated congenital anomalies. The reported frequency and the types of these associated anomalies vary between different studies. The purpose of this investigation was to assess the frequency and the types of associated anomalies among cases with an/microphthalmia in a geographically well defined population of northeastern France of 387,067 consecutive pregnancies from 1979 to 2007. Of the 98 infants with an/microphthalmia born during this period (prevalence at birth of 2.53 per 10,000), 88.8 % had associated anomalies. Cases with associated anomalies were divided into recognizable conditions (25 (25.5%) cases with chromosomal and 17 (17.3%) cases with non chromosomal conditions), and non recognizable conditions (45-45.9%- cases with multiple congenital anomalies -MCA). Trisomy 13 and trisomy 18 were the most frequent chromosomal abnormalities. Amniotic bands sequence, oculo-auriculo-vertebral spectrum, CHARGE syndrome and VACTERL association were most often present in recognizable non chromosomal conditions. Anomalies in the musculoskeletal, cardiovascular and central nervous systems were the most common other anomalies in cases with MCA and non recognizable conditions. However, given the limitation of the limited numbers of cases there should be urging caution in interpreting these results. In conclusion the frequency of associated anomalies in infants with anophthalmia and microphthalmia emphasizes the need for a thorough investigation of these cases. Routine screening for other anomalies especially musculoskeletal, cardiac and central nervous systems anomalies may need to be considered in infants with anophthalmia and microphthalmia, and referral of these cases for genetic counselling seems warranty.
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Affiliation(s)
- Claude Stoll
- Laboratoire de Genetique Medicale, Faculte de Medecine, Strasbourg, France.
| | - Beatrice Dott
- Laboratoire de Genetique Medicale, Faculte de Medecine, Strasbourg, France
| | - Yves Alembik
- Laboratoire de Genetique Medicale, Faculte de Medecine, Strasbourg, France
| | - Marie-Paule Roth
- Laboratoire de Genetique Medicale, Faculte de Medecine, Strasbourg, France
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Liu XX, Zhao DY, Zhao X, Zhang XA, Yu ZL, Sun LH. The effect of China's birth policy changes on birth defects-A large hospital-based cross-sectional study. Int J Environ Health Res 2024; 34:1156-1167. [PMID: 37158781 DOI: 10.1080/09603123.2023.2207469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
A retrospective analysis of birth data hospital-based obtained from 14 monitoring areas in the Huaihe River Basin from 2009 to 2019 was conducted. Trend in the total prevalence of birth defects (BDs) and subgroups were analyzed using the Joinpoint Regression model. The incidence of BDs increased gradually from 118.87 per 10,000 in 2009 to 241.18 per 10,000 in 2019 (AAPC = 5.91, P < 0.001). Congenital heart diseases were the most common subtype of BDs. The proportion of maternal age younger than 25 decreased but the age 25-40 years increased significantly (AAPC<20=-5.58; AAPC20-24=-6.38; AAPC25-29 = 5.15; AAPC30-35 = 7.07; AAPC35-40 = 8.27; All P < 0.05). Compared with the one-child policy period, the risk of BDs was greater for groups among maternal age younger than 40 years during the partial and universal two-child policy period (P < 0.001). The incidence of BDs and the proportion of women with advanced maternal age in Huaihe River Basin is increasing. There was an interaction between changes in birth policy and the mother's age on the risk of BDs.
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Affiliation(s)
- Xin-Xin Liu
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dan-Yang Zhao
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xin Zhao
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiao-An Zhang
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Zeng-Li Yu
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Li-Huan Sun
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
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Heydari MH, Sadeghian A, Khadivi G, Mustafa HJ, Javinani A, Nadjmi N, Khojasteh A. Prevalence, trend, and associated risk factors for cleft lip with/without cleft palate: a national study on live births from 2016 to 2021. BMC Oral Health 2024; 24:36. [PMID: 38185687 PMCID: PMC10771673 DOI: 10.1186/s12903-023-03797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUNDS Cleft lip with or without cleft palate (CL/P) is the most common congenital craniofacial anomaly, including non-syndromic cleft lip with or without cleft palate and cleft palate only. Failure in the fusion of median and lateral nasal processes, the maxillary prominence, and soft tissues around the oral cavity can cause CL/P. Previously, the prevalence has been estimated to be 1 among every 1000 births in 2014 among American neonates and no other reports have been available since. Thus, this study aimed to calculate the prevalence and trend of isolated CL/P among American live births from 2016 to 2021 with its associated risk factors. METHODS AND MATERIALS In this cross-sectional population-based retrospective study, we used live birth data provided by the National Center for Health Statistics (NCHS) from the Center for Disease Control and Prevention (CDC). We calculated the prevalence per 10,000 live births of isolated (non-syndromic) CL/P from 2016 to 2021. To examine risk factors for developing isolated CL/P, we used logistic regression modelling. RESULTS The total prevalence per 10,000 births from 2016 to 2021 was 4.88 (4.79-4.97), for both sexes, and 5.96 (5.82-6.10) for males, and 3.75 (3.64-3.87) for females. The prevalence did not show any consistent linear decreasing or increasing pattern. We found significant association between increased odds of developing isolated CL/P among cases with 20 to 24 year-old mothers (OR = 1.07, 1.01-1.13, p = 0.013), mothers who smoked 11 to 20 cigarettes per day (OR = 1.46, 1.33-1.60, p < 0.001), mothers with extreme obesity (OR = 1.32, 1.21-1.43, p < 0.001), mothers with grade II obesity (OR = 1.32, 1.23-1.42, p < 0.001), mothers with pre-pregnancy hypertension (OR = 1.17, 1.04-1.31, p = 0.009), mothers with pre-pregnancy diabetes mellitus (OR = 1.96, 1.71-2.25, p < 0.001), and mothers who used assisted reproductive technology (OR = 1.40, 1.18-1.66, p < 0.001). CONCLUSIONS Our findings suggest a minuscule increase, albeit insignificant, in the trend of CL/P prevalence from 2016 to 2021. Developing CL/P had greater odds among mothers with pre-pregnancy diabetes, smoking, obesity, and pre-pregnancy hypertension mothers along with mothers who used assisted reproductive technology. Isolated CL/P had the highest prevalence in non-Hispanic Whites, American Indian or Alaskan Native and Native Hawaiian and Other Pacific Islanders.
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Affiliation(s)
- Mohammad-Hossein Heydari
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sadeghian
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran
| | - Gita Khadivi
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran
| | - Hiba J Mustafa
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Riley Children's and Indiana University Health Fetal Center, Indianapolis, IN, USA
| | - Ali Javinani
- Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nasser Nadjmi
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Arash Khojasteh
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Chamran Highway, Velenjak St, Tehran, Iran.
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Shan X, Aguilar S, Canon S. Hypospadias prevalence by severity and associated risk factors: A population-based active surveillance analysis. J Pediatr Urol 2023; 19:720.e1-720.e9. [PMID: 37640620 DOI: 10.1016/j.jpurol.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/02/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Hypospadias is one of the most common congenital anomalies. Trends of hypospadias prevalence by severity are not well reported. Most prevalence studies consist of pooled data from different countries or states suffer from low data quality due to inconsistent methodologies, limited variables, and lack of categorization of hypospadias severity. OBJECTIVE The objective of this study is to examine the prevalence of hypospadias by degrees of severity and associated risk factors using combined data sources from a stable and well-defined population. STUDY DESIGN The study population includes infants born with hypospadias to mothers residing in Arkansas from 1997 to 2016. Cases were identified from an active population-based surveillance program of birth defects. Identified hypospadias cases from surveillance data were linked to birth certificate and to a clinical database. These two data sources provide more details on the location of the defect and maternal and infant characteristics. The prevalence and 95% confidence intervals were calculated using total male live births as denominator. Chi-square test was used to assess the association of nominal variables. Logistic regression was used to calculate adjusted odds ratio. RESULTS A total 3230 hypospadias cases were identified from 1997 to 2016. The overall prevalence is 83.0 per 10,000 male births. A majority of cases (56.7%) were classified as first degree with the others having second degree (22.8%), third degree (4.7%) or not otherwise specified (15.6%). The highest prevalence of hypospadias was observed among Non-Hispanic whites. Higher prevalence also was observed among mothers in the older age group with no prenatal care in the first trimester and with gestational hypertension or diabetes. Premature or small for gestational age infants tend to have higher prevalence across all levels of severity. The number of hypospadias cases increased over time. After maternal age, race and education were adjusted, higher risk persisted for infants of restricted fetal growth, mothers with gestational hypertension or diabetes and the cohort of 2013-2016. CONCLUSION There is an increase of hypospadias cases in Arkansas. Several maternal and infant characteristics associated with higher prevalence for all levels of severity are worth further investigation.
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Affiliation(s)
- Xiaoyi Shan
- Arkansas Reproductive Health Monitoring System, Arkansas Children's Research Institute, Little Rock, AR, 72202, USA.
| | - Stephen Aguilar
- University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Stephen Canon
- Division of Urology, Arkansas Children's Hospital, Little Rock, AR, 72202, USA
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Walani SR, Penny N, Nakku D. The global challenges of surgical congenital anomalies: Evidence, models, and lessons. Semin Pediatr Surg 2023; 32:151348. [PMID: 38006693 DOI: 10.1016/j.sempedsurg.2023.151348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
The treatment of congenital anomalies (structural birth defects) is common to all the surgical sub-specialties dealing with children. Globally more than 90 % of all babies born with a congenital anomaly are born in middle-and-low-income countries where there is often limited access to needed surgical care. Challenges include lacks of early identification, registry and surveillance systems, missing referral pathways, shortage of trained surgical expertise and insufficient surgical infrastructure. Poverty, transportation logistics, financial constraints and social stigma are also serious barriers for families. There is, however, growing recognition of the priority to expand services, encouraged by the World Health Organization and other global players, and examples of successful models of care. Registry programs are growing, especially in Latin America. The Ponseti method of clubfoot care has been revolutionary on a global scale. The role of not-for-profit non-governmental-organizations has been instrumental in fundraising, training and logistical support as exemplified in the care of oro-facial clefts. Specialized "niche" hospitals are providing needed sub-specialist expertise. The way forward includes the need for effective partnerships, innovative methods to distribute care out from referral hospitals into the districts and the development of national plans embedded in national health policy.
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Affiliation(s)
| | - Norgrove Penny
- Branch for Global Surgical Care, University of British Columbia, Vancouver, Canada
| | - Doreen Nakku
- Department of Surgery, Mbarara University of Science and Technology (MUST) Mbarara, Uganda
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Wei W, Jiang W, Yang R, Cui W, Zhang L, Li Z. Analyzing the Trends and Causes of Birth Defects - Jinan City, Shandong Province, China, 2005-2022. China CDC Wkly 2023; 5:978-983. [PMID: 38023392 PMCID: PMC10652091 DOI: 10.46234/ccdcw2023.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/11/2023] [Indexed: 12/01/2023] Open
Abstract
What is already known about this topic? Numerous studies conducted in China have reported on the prevalence of birth defects (BDs). However, the limited surveillance periods in select studies curtail comprehensive trends and cause evaluation. Accordingly, the surveillance duration of BDs is extended, and a comprehensive analysis of their prevailing trends is conducted to provide a basis for government intervention and policy implementation. What is added by this report? There is a distinct increase in the incidence of BDs observed in Jinan. In rural areas, a pronounced upward trend was observed, and the increase was more rapid than in urban areas. BD prevalence among mothers over 35 years old and under 20 years old was substantially higher than BD prevalence rates in other maternal age brackets. Specifically, the period from 2005 to 2022 saw the prevalence of congenital heart disease surge, the fastest average annual growth rate among all birth defects. What are the implications for public health practice? It's essential to prioritize pregnant women in rural areas and those at both ends of the maternal age spectrum. Implementing comprehensive initiatives is crucial to address the high prevalence of congenital heart disease.
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Affiliation(s)
- Wei Wei
- Department of General management, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China
| | - Wei Jiang
- Department of Medical Service, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China
| | - Rui Yang
- Department of Outpatient, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China
| | - Wenchao Cui
- Department of Neonatology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China
| | - Lihua Zhang
- Department of Medicine, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China
| | - Zhongliang Li
- Department of Women Healthcare, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China
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Benjamin RH, Nguyen JM, Canfield MA, Shumate CJ, Agopian A. Survival of neonates, infants, and children with birth defects: a population-based study in Texas, 1999-2018. Lancet Reg Health Am 2023; 27:100617. [PMID: 37868647 PMCID: PMC10589744 DOI: 10.1016/j.lana.2023.100617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023]
Abstract
Background Birth defects are a leading cause of neonatal, infant, and childhood mortality, but recent population-based survival estimates for a spectrum in the U.S. are lacking. Methods Using the statewide Texas Birth Defects Registry (1999-2017 births) and vital records linkage to ascertain deaths, we conducted Kaplan-Meier analyses to estimate survival probabilities at 1, 7, and 28 days, and 1, 5, and 10 years. We evaluated survival in the full cohort of infants with any major defect and for 30 specific conditions. One-year survival analyses were stratified by gestational age, birth year, and case classification. Findings Among 246,394 live-born infants with any major defect, the estimated survival probabilities were 98.9% at 1 day, 95.0% at 1 year, and 93.9% at 10 years. Ten-year survival varied by condition, ranging from 36.9% for holoprosencephaly to 99.3% for pyloric stenosis. One-year survival was associated with increasing gestational age (e.g., increasing from 46.9% at <28 weeks to 95.8% at ≥37 weeks for spina bifida). One-year survival increased in more recent birth years for several defect categories (e.g., increasing from 86.0% among 1999-2004 births to 93.1% among 2014-2017 births for unilateral renal agenesis/dysgenesis) and was higher among infants with an isolated defect versus those with multiple defects. Interpretation This study describes short- and long-term survival outcomes from one of the largest population-based birth defect registries in the world and highlights improved survival over time for several conditions. Our results may lend insight into future healthcare initiatives aimed at reducing mortality in this population. Funding This study was funded in part by a Centers for Disease Control and Prevention (CDC) birth defects surveillance cooperative agreement with the Texas Department of State Health Services and Health Resources and Services Administration (HRSA) Block Grant funds.
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Affiliation(s)
- Renata H. Benjamin
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Joanne M. Nguyen
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - Charles J. Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - A.J. Agopian
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
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19
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Shaheen F, Humayoon QS, Malik S, Mumtaz S. Clinical and genetic attributes of congenital anomalies ascertained at a tertiary care hospital in Rawalpindi, Pakistan. Pak J Med Sci 2023; 39:1673-1679. [PMID: 37936764 PMCID: PMC10626060 DOI: 10.12669/pjms.39.6.7408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/15/2023] [Accepted: 08/02/2023] [Indexed: 11/09/2023] Open
Abstract
Objective Congenital anomalies (CA) or birth defects cause substantial healthcare burden in developing countries. There are few studies from Pakistan on the prevalence-pattern of CA. The purpose of this study was to determine the prevalence-pattern and genetic attributes of CA at a tertiary care facility in Rawalpindi, Pakistan. Methods In a cross-sectional study design, patients with CA were ascertained from Pediatric and Neonatal Section of Holy Family Hospital, Rawalpindi from March-2022 to June-2022. International Classification of Diseases (ICD-10) and Online Mendelian Inheritance in Man (OMIM) databases were utilized for uniformity in classification. The pattern of CA as well as familial/sporadic nature, syndromic/isolated presentations, and prenatal consanguinity were estimated. Descriptive summaries were generated. Results A total of 517 independent cases with certain types of CA were recruited. There were eight major and 70 minor categories. Among the major categories, neurological disorders (39.1%) were predominating followed by neuromuscular disorders (21.1%), limb defects (13.5%), musculoskeletal defects (7.4%), blood disorders (4.3%), orofacial defects (3.9%), metabolic disorders (3.7%), and Others (7.1%). The sporadic cases were in majority (72.5%) compared to familial cases (27.5%). Further, 63% patients had syndromic presentations and there were 37% cases with isolated appearances. A total of 70% cases had parental consanguinity. Conclusion The majority of anomalies were of preventable nature and certain healthcare measures including antinatal care and counseling can be adopted to minimize their burden. Additionally, there is an urgent need to raise awareness of the negative consequences of consanguineous marriages, which constitute a significant risk factor in cases with inherited CA.
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Affiliation(s)
- Fatima Shaheen
- Fatima Shaheen, M.Phil, Human Genetics Program, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Qaisar Shehzad Humayoon
- Qaisar Shehzad Humayoon, MBBS, FCPS Department of Pediatrics, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Sajid Malik
- Sajid Malik, PhD, Human Genetics Program, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sara Mumtaz
- Sara Mumtaz, PhD Human Genetics Section, National University of Medical Sciences, Rawalpindi, Pakistan
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20
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Namale-Matovu J, Kusolo R, Serunjogi R, Barlow-Mosha L, Mumpe-Mwanja D, Niombi N, Kalibbala D, Williamson D, Valencia D, Moore CA, Mwambi K, Nelson LJ, Namukanja-Mayambala PM, Williams JL, Mai CT, Qi YP, Musoke P. Strengthening capacity of health workers to diagnose birth defects in Ugandan hospitals from 2015 to 2021. BMC Med Educ 2023; 23:766. [PMID: 37833686 PMCID: PMC10576368 DOI: 10.1186/s12909-023-04760-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Limited diagnostic capabilities, resources and health worker skills have deterred the advancement of birth defects surveillance systems in most low- and middle-income countries (LMICs). Empowering health workers to identify and diagnose major external birth defects (BDs) is crucial to establishing effective hospital-based BD surveillance. Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration BD Surveillance System consists of three diagnostic levels: (1) surveillance midwives, (2) MU-JHU clinical team, and (3) U.S. Centers for Disease Control and Prevention (CDC) birth defects subject matter experts (SMEs) who provide confirmatory diagnosis. The diagnostic concordance of major external BDs by surveillance midwives or MU-JHU clinical team with CDC birth defects SMEs were estimated. METHODS Study staff went through a series of trainings, including birth defects identification and confirmation, before surveillance activities were implemented. To assess the diagnostic concordance, we analyzed surveillance data from 2015 to 2021 for major external BDs: anencephaly, iniencephaly, encephalocele, spina bifida, craniorachischisis, microcephaly, anophthalmia/microphthalmia, anotia/microtia, cleft palate alone, cleft lip alone, cleft lip with cleft palate, imperforate anus, hypospadias, talipes equinovarus, limb reduction, gastroschisis, and omphalocele. Positive predictive value (PPV) as the proportion of BDs diagnosed by surveillance midwives or MU-JHU clinical team that were confirmed by CDC birth defects SMEs was computed. PPVs between 2015 and 2018 and 2019-2021 were compared to assess the accuracy of case diagnosis over time. RESULTS Of the 204,332 infants examined during 2015-2021, 870 infants had a BD. Among the 1,245 BDs identified, 1,232 (99.0%) were confirmed by CDC birth defects SMEs. For surveillance midwives, PPV for 7 of 17 BDs was > 80%. For the MU-JHU clinical team, PPV for 13 of 17 BDs was > 80%. Among surveillance midwives, PPV improved significantly from 2015 to 2018 to 2019-2021, for microcephaly (+ 50.0%), cleft lip with cleft palate (+ 17.0%), imperforate anus (+ 30.0%), and talipes equinovarus (+ 10.8%). Improvements in PPV were also observed among MU-JHU clinical team; however, none were significant. CONCLUSION The diagnostic accuracy of the midwives and clinical team increased, highlighting that BD surveillance, by front-line health care workers (midwives) in LMICs is possible when midwives receive comprehensive training, technical support, funding and continuous professional development.
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Affiliation(s)
- Joyce Namale-Matovu
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda.
| | - Ronald Kusolo
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda
| | - Robert Serunjogi
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda
| | - Linda Barlow-Mosha
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda
| | - Daniel Mumpe-Mwanja
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda
| | | | - Dennis Kalibbala
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda
| | - Dhelia Williamson
- Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Diana Valencia
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA, USA
| | | | | | - Lisa J Nelson
- Division of Global HIV and TB, US CDC, Kampala, Uganda
| | | | - Jennifer L Williams
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA, USA
| | - Cara T Mai
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA, USA
| | - Yan Ping Qi
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA, USA
| | - Philippa Musoke
- Makerere University, Johns Hopkins University Research Collaboration (MU-JHU), P.O. Box 23491, Kampala, Uganda
- Department of Pediatrics, Makerere University College of Health Sciences, Kampala, Uganda
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21
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Ritchie HE, Polson JW, Xia A, Webster W. Effect of vinpocetine on embryonic heart rate in vitro. Curr Res Toxicol 2023; 5:100125. [PMID: 37753450 PMCID: PMC10518341 DOI: 10.1016/j.crtox.2023.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
Vinpocetine is a readily available nutritional supplement claimed to improve memory and weight loss. However, it blocks the Ikr current essential for cardiac action potential repolarisation and Ikr inhibition can cause "torsade de pointes" arrhythmias and sudden death. Moreover, Ikr blockers have exhibited teratogenic effects in reproductive toxicology studies, leading to increased birth defects and embryonic mortality. The FDA advises against vinpocetine use in pregnant and prospective mothers based on animal studies showing dose-dependent fetal mortality in rats and rabbits, and cardiovascular malformations in surviving fetuses. However, the mechanisms responsible for vinpocetine's fetal toxicity remain unclear. The present study used rat embryo culture to evaluate vinpocetine and its major metabolite, apovincaminic acid, on embryonic heart rate, a possible causative factor behind its adverse effects. Both compounds induced embryonic bradycardia in a concentration-dependent manner, with vinpocetine proving more potent. The minimum vinpocentine concentration to induce bradycardia was 100 nM, a level unlikely to be reached in humans following typical doses. Embryonic arrhythmias were also observed at the highest concentrations. These results suggest that the FDA's cautionary statement may generate undue anxiety, although re-evaluation of teratogenicity risk associated with vinpocetine should be revisited if a link to cardiac arrhythmias in adults is established.
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Affiliation(s)
- Helen Elizabeth Ritchie
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Jaimie W. Polson
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Andrea Xia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - William Webster
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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22
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Mudekereza PS, Balemba GM, Murhega RB, Murhula GB, Nteranya DS, Lekuya HM. Atypical caudal regression syndrome with lumbar agenesis, hypoplastic sacrum without sacroiliac joints in the eastern Democratic Republic of Congo: a case report. Childs Nerv Syst 2023; 39:2551-2556. [PMID: 37294350 DOI: 10.1007/s00381-023-05973-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/24/2023] [Indexed: 06/10/2023]
Abstract
The agenesis of any segment of the lower spinal column referred to as "caudal regression syndrome" (CRS) is a rare congenital defect of the spine. This malformation is characterized by the absence of some or the entire lumbosacral vertebral segment. Etiological factors remain unknown. We report an atypical caudal regression syndrome with lumbar agenesis, disconnected from the remaining hypoplastic sacrum, in the Eastern part of the Democratic Republic of Congo (DRC).An 11-month-old female infant with no particular fetal or maternal history presented limb weakness with flexed knees and flanges in the popliteal fossae, sphincter atony, and a sensation of emptiness on palpation in the lumbosacral region. A 3D CT scan of the spine showed the absence of the lumbar spine and disconnection of the upper segment of the thoracic spine from the hypoplastic sacrum. We noted also the absence of the sacroiliac joints bilaterally and an unusual trigonal shape of the iliac bones. MRI and sonographic examination are required in the investigation of the disease. The management is multidisciplinary and depends upon the degree of the defect. Spine reconstruction has proven to be a valuable management technique but has many complications. We wanted to draw the medical world's attention to the existence of this extremely rare malformation in the east of the Democratic Republic of Congo, a mining area.
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Affiliation(s)
- Paterne Safari Mudekereza
- Department of Surgery, Provincial General Reference Hospital of Bukavu, Bukavu, Democratic Republic of Congo.
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.
| | - Ghislain Maheshe Balemba
- Department of Radiology, Provincial General Reference Hospital of Bukavu, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Roméo Bujiriri Murhega
- Department of Surgery, Provincial General Reference Hospital of Bukavu, Bukavu, Democratic Republic of Congo
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroun
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Gauthier Bahizire Murhula
- Department of Surgery, Provincial General Reference Hospital of Bukavu, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Daniel Safari Nteranya
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroun
- Department of Surgery, Official University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Hervé Monka Lekuya
- Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda
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Smythe T, Rotenberg S, Lavy C. The global birth prevalence of clubfoot: a systematic review and meta-analysis. EClinicalMedicine 2023; 63:102178. [PMID: 37680947 PMCID: PMC10480528 DOI: 10.1016/j.eclinm.2023.102178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/09/2023] Open
Abstract
Background Estimates of the birth prevalence of clubfoot in low and middle income settings range from 0.5 to 2 per 1000 births. However, there is currently no estimate of global birth prevalence of clubfoot. Methods We conducted a systematic review of studies reporting the birth prevalence of clubfoot across all countries and regions worldwide in the last 10 years. Africa Wide Information, EMBASE, CINAHL, Global Health, LILACS and Medline databases were searched for relevant studies from January 1st 2012 to February 9th 2023. Pooled prevalence estimates were calculated using the inverse variance method, and a random effects model was applied to account for heterogeneity between studies. Quality appraisal was performed using a modified Newcastle-Ottawa Quality Assessment Scale for Cohort studies. This review was registered with PROSPERO, CRD42023398410. Findings The search generated 757 studies. Thirty-five studies from 36 countries and five WHO regions were included. The pooled prevalence of clubfoot was 1.18 per 1000 births (95% CI: 1.00-1.36) based on data from 44,818,965 births. The highest prevalence rates were observed in low- and middle-income countries, particularly in the South-East Asia Region (1.80, 95% CI: 1.32-2.28) and the Africa Region (1.31, 95% CI: 0.86-1.77). We estimate that 176,476 (95% CI: 126,126-227,010) children will be born with clubfoot globally each year. Interpretation This study provides a comprehensive estimate of the global prevalence of clubfoot and highlights the significant burden of this condition, particularly in low- and middle-income countries. The findings underscore the need for improving access to effective treatment and prevention strategies in resource-limited settings. Funding SR received funds from the Global Clubfoot Initiative and the Rhodes Trust.
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Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, WC1E 7HT, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Chris Lavy
- Nuffield Department of Orthopaedics, Reumatology and Musculoskeletal Sciences University of Oxford, OX2 6GG, UK
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Tanveer M, Mansha N, Nimra A, Khawar MB, Afzal A, Afzal H, Farooq M, Ehsan S, Rana R, Shahzaman S. Microplastics: unraveling the signaling pathways involved in reproductive health. Environ Sci Pollut Res Int 2023; 30:95077-95085. [PMID: 37584803 DOI: 10.1007/s11356-023-29273-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
Microplastics (MPs) are biologically active environmental pollutants having significant impact on the ecosystem and human health. MPs have been reported to increase oxidative stress, resulting in tissue damage, developmental abnormalities, metabolic disorders, epigenetic changes, abnormal reproduction, and reduced gamete quality. At present, most of the existing literature has focused on the effects of MPs on the reproduction of various aquatic organisms; however, the effects of MPs on mammalian reproduction specifically humans are least studied except a few ones fragmentally discussing the effects of MPs on gametogenesis in human. This review discusses effects of MPs on male and female reproduction with a focus on different metabolic pathways involved in compromised gamete quality, gamete toxicity, apoptosis, and DNA damage.
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Affiliation(s)
- Muhammad Tanveer
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Nimra Mansha
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Afzal Nimra
- Department of Zoology, Faculty of Science and Technology, Environmental Health and Wildlife, University of Central Punjab, Lahore, Pakistan.
| | - Muhammad Babar Khawar
- Applied Molecular Biology and Biomedicine Lab, Department of Zoology, University of Narowal, Narowal, Pakistan
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Experimental and, Translational Non-Coding RNA Research, Yangzhou, China
| | - Ali Afzal
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Hanan Afzal
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Muhammad Farooq
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Sadia Ehsan
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Rabbia Rana
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Sara Shahzaman
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
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25
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Liu Y, Qu HQ, Chang X, Mentch FD, Qiu H, Wang X, Saeidian AH, Watson D, Glessner J, Hakonarson H. Genomic variants exclusively identified in children with birth defects and concurrent malignant tumors predispose to cancer development. Mol Cancer 2023; 22:126. [PMID: 37543594 PMCID: PMC10403830 DOI: 10.1186/s12943-023-01828-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/18/2023] [Indexed: 08/07/2023] Open
Abstract
Children with birth defects (BD) express distinct clinical features that often have various medical consequences, one of which is predisposition to the development of cancers. Identification of the underlying genetic mechanisms related to the development of cancer in BD patients would allow for preventive measures. We performed a whole genome sequencing (WGS) study on blood-derived DNA samples from 1566 individuals without chromosomal anomalies, including 454 BD probands with at least one type of malignant tumors, 767 cancer-free BD probands, and 345 healthy individuals. Exclusive recurrent variants were identified in BD-cancer and BD-only patients and mapped to their corresponding genomic regions. We observed statistically significant overlaps for protein-coding/ncRNA with exclusive variants in exons, introns, ncRNAs, and 3'UTR regions. Exclusive exonic variants, especially synonymous variants, tend to occur in prior exons locus in BD-cancer children. Intronic variants close to splicing site (< 500 bp from exon) have little overlaps in BD-cancer and BD-only patients. Exonic variants in non-coding RNA (ncRNA) tend to occur in different ncRNAs exons regardless of the overlaps. Notably, genes with 5' UTR variants are almost mutually exclusive between the two phenotypes. In conclusion, we conducted the first genomic study to explore the impact of recurrent variants exclusive to the two distinguished clinical phenotypes under study, BD with or without cancer, demonstrating enrichment of selective protein-coding/ncRNAs differentially expressed between these two phenotypes, suggesting that selective genetic factors may underlie the molecular processes of pediatric cancer development in BD children.
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Affiliation(s)
- Yichuan Liu
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA.
| | - Hui-Qi Qu
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
| | - Xiao Chang
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
| | - Frank D Mentch
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
| | - Haijun Qiu
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
| | - Xiang Wang
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
| | - Amir Hossein Saeidian
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
| | - Deborah Watson
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Joseph Glessner
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Hakon Hakonarson
- Center for Applied Genomics (CAG), Children's Hospital of Philadelphia, 3615 Civic Center Blvd Abramson Building, Philadelphia, PA, 19104, USA.
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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26
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Fang Q, Jiang X, Bai S, Xu B, Zong L, Qi M, Wan Y, Jin RT, Tong XH, Wu LM. Safety of early cumulus cell removal combined with early rescue ICSI in the prevention of fertilization failure. Reprod Biomed Online 2023; 47:103214. [PMID: 37277297 DOI: 10.1016/j.rbmo.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/08/2023] [Accepted: 04/11/2023] [Indexed: 06/07/2023]
Abstract
RESEARCH QUESTION What are the clinical outcomes and safety implications of early cumulus cell removal after short-term insemination combined with early rescue intracytoplasmic sperm injection (ICSI) in preventing fertilization failure? DESIGN In this retrospective study, a total of 14,360 cycles were divided into four groups based on insemination method and fertilization ability: conventional IVF group (n = 5519); early cumulus cell removal group (n = 4107); conventional ICSI group (n = 4215); and early rescue ICSI group (where failed or low fertilization was predicted, n = 519). Fertilization outcomes, pregnancy outcomes, neonatal outcomes and birth defects were analysed by comparing the early cumulus cell removal group with the conventional IVF group, and the early rescue ICSI group with the conventional ICSI group. RESULTS There were no significant differences in the outcomes of fertilization, pregnancy, neonates or birth defects between the conventional IVF group and the early cumulus cell removal group (P > 0.05). When compared with the conventional ICSI group, the early rescue ICSI group had similar rates of two pronuclei (2PN) at fertilization, clinical pregnancy, miscarriage, ectopic pregnancy, live birth, sex, mean gestational age, very low birthweight, macrosomia and birth defects (P > 0.05) but a higher polyploidy rate, lower high-quality embryo rate (both P < 0.001), lower twin pregnancy rate (P < 0.01), lower rate of low birthweight, and a higher rate of normal birthweight (both P = 0.024). CONCLUSIONS Early cumulus cell removal combined with early rescue ICSI led to good pregnancy and neonatal outcomes without an increase in birth defects. This approach could therefore be an effective and safe method for patients with fertilization failure in conventional IVF.
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Affiliation(s)
- Qunying Fang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China; University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Xiaohua Jiang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Shun Bai
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Bo Xu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Lu Zong
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Meijie Qi
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Yangyang Wan
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Ren-Tao Jin
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Xian-Hong Tong
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
| | - Li-Min Wu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Prenatal Diagnosis, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China.
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Gaughan C, Sorrentino KM, Liew Z, Johnson NP, Clark CJ, Soriano M, Plano J, Plata DL, Saiers JE, Deziel NC. Residential proximity to unconventional oil and gas development and birth defects in Ohio. Environ Res 2023; 229:115937. [PMID: 37076028 PMCID: PMC10198955 DOI: 10.1016/j.envres.2023.115937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/30/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Chemicals used or emitted by unconventional oil and gas development (UOGD) include reproductive/developmental toxicants. Associations between UOGD and certain birth defects were reported in a few studies, with none conducted in Ohio, which experienced a thirty-fold increase in natural gas production between 2010 and 2020. METHODS We conducted a registry-based cohort study of 965,236 live births in Ohio from 2010 to 2017. Birth defects were identified in 4653 individuals using state birth records and a state surveillance system. We assigned UOGD exposure based on maternal residential proximity at birth to active UOG wells and a metric specific to the drinking-water exposure pathway that identified UOG wells hydrologically connected to a residence ("upgradient UOG wells"). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for all structural birth defects combined and specific birth defect types using binary exposure metrics (presence/absence of any UOG well and presence/absence of an upgradient UOG well within 10 km), adjusting for confounders. Additionally, we conducted analyses stratified by urbanicity, infant sex, and social vulnerability. RESULTS The odds of any structural defect were 1.13 times higher in children born to mothers living within 10 km of UOGD than those born to unexposed mothers (95%CI: 0.98-1.30). Odds were elevated for neural tube defects (OR: 1.57, 95%CI: 1.12-2.19), limb reduction defects (OR: 1.99, 95%CI: 1.18-3.35), and spina bifida (OR 1.93; 95%CI 1.25-2.98). Hypospadias (males only) was inversely related to UOGD exposure (OR: 0.62, 95%CI: 0.43-0.91). Odds of any structural defect were greater in magnitude but less precise in analyses using the hydrological-specific metric (OR: 1.30; 95%CI: 0.85-1.90), in areas with high social vulnerability (OR: 1.27, 95%CI: 0.99-1.60), and among female offspring (OR: 1.28, 95%CI: 1.06-1.53). CONCLUSIONS Our results suggest a positive association between UOGD and certain birth defects, and findings for neural tube defects corroborate results from prior studies.
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Affiliation(s)
- Casey Gaughan
- Department of Ecology and Evolutionary Biology, Yale College, New Haven, CT, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Keli M Sorrentino
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Nicholaus P Johnson
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Cassandra J Clark
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Mario Soriano
- Yale School of the Environment, Yale University, New Haven, CT, USA; High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA
| | - Julie Plano
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Desiree L Plata
- Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - James E Saiers
- Yale School of the Environment, Yale University, New Haven, CT, USA
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
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Picot C, Ajiji P, Jurek L, Nourredine M, Massardier J, Peron A, Cucherat M, Cottin J. Risk of drug use during pregnancy: master protocol for living systematic reviews and meta-analyses performed in the metaPreg project. Syst Rev 2023; 12:101. [PMID: 37344917 DOI: 10.1186/s13643-023-02256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Knowledge about the risks of drugs during pregnancy is continuously evolving due to the frequent publication of a large number of epidemiological studies. Systematic reviews and meta-analyses therefore need to be regularly updated to reflect these advances. To improve dissemination of this updated information, we developed an initiative of real-time full-scale living meta-analyses relying on an open online dissemination platform ( www.metapreg.org ). METHOD All living meta-analyses performed in this project will be conducted in accordance with this master protocol after adaptation of the search strategy. A systematic literature search of PubMed and Embase will be performed. All analytical studies (e.g., cohort, case-control, randomized studies) reporting original empirical findings on the association between in utero exposure to drugs and adverse pregnancy outcomes will be included. Study screening and data extraction will be performed in a semi-automation way supervised by a biocurator. A risk of bias will be assessed using the ROBINS-I tools. All clinically relevant pregnancy adverse outcomes (malformations, stillbirths, neuro-developmental disorders, pre-eclampsia, etc.) available in the included studies will be pooled through random-effects meta-analysis. Heterogeneity will be evaluated by I2 statistics. DISCUSSION Our living systematic reviews and subsequent updates will inform the medical, regulatory, and health policy communities as the news results evolve to guide decisions on the proper use of drugs during the pregnancy. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (OSF) registries.
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Affiliation(s)
- Cyndie Picot
- Service Hospitalo-Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, 69424 Cedex 03, Lyon, France
| | - Priscilla Ajiji
- Faculté de Santé, Université Paris-Est Créteil, EA 7379, Créteil, France
- French National Agency for Medicines and Health Products Safety (ANSM), Saint Denis, France
| | - Lucie Jurek
- Child and Adolescent Neurodevelopmental Psychiatry Department, Center for Assessment and Diagnostic of Autism, Le Vinatier Hospital, Bron, France
- RESHAPE, Université Claude Bernard Lyon 1, U1290, Lyon, France
| | - Mikail Nourredine
- Service Hospitalo-Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, 69424 Cedex 03, Lyon, France
- Service de biostatistiques, Hospices Civils de Lyon, Lyon, France
- Laboratoire d'évaluation et modélisation des effets thérapeutiques, UMR CNRS 5558, Lyon, France
| | - Jérôme Massardier
- Service de Gynécologie Obstétrique et Médecine Foetale, HFME, Hospices Civils de Lyon, Lyon, France
| | - Audrey Peron
- Service Hospitalo-Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, 69424 Cedex 03, Lyon, France
| | - Michel Cucherat
- metaEvidence.org - Service Hospitalo, Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Lyon, France
| | - Judith Cottin
- Service Hospitalo-Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, 69424 Cedex 03, Lyon, France.
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Malherbe HL, Modell B, Blencowe H, Strong KL, Aldous C. A review of key terminology and definitions used for birth defects globally. J Community Genet 2023; 14:241-262. [PMID: 37093545 PMCID: PMC10272040 DOI: 10.1007/s12687-023-00642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/08/2023] [Indexed: 04/25/2023] Open
Abstract
Birth defects, also known as congenital disorders, are a significant health issue impacting at least five million births annually worldwide. For policymakers to mount a relevant healthcare response to care for those affected, the burden of disease of these conditions must be quantified. Estimates of the contribution of birth defects to under-5 child mortality and morbidity are generated by several groups globally. These estimates often differ, causing confusion for policymakers. While some differences may be attributed to the data sources and methods used, much is due to a lack of clarity in the terminology used for the group of disorders classed as "congenital". This study aimed to gain insight into the diversity of terms and definitions for birth defects, including those used routinely by relevant international/national organisations and in the peer-reviewed literature. This two-part study included (1) scoping review of peer-reviewed literature to identify terms and definitions in use for birth defects and (2) review of key websites and grey literature to identify terms and definitions used. The results of this study indicate a wide variety of terms being used, often interchangeably and undefined, in peer-reviewed publications, on institutional websites and related literature. This suggests a lack of clarity related to terminology and sets the scene for further discussion, recommending that the community of practice working on birth defects comes to a consensus on standard terminology and definitions for global uptake and implementation. Such standardisation will facilitate a common understanding of the burden of these disorders globally, regionally and within countries so that action can be taken to support affected children and their families.
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Affiliation(s)
- H L Malherbe
- Centre for Human Metabolomics, North-West University, North-West Province, Potchefstroom, South Africa.
- Rare Diseases South Africa NPC, The Station, 63 Peter Place, Bryanston, Johannesburg, 2021, Gauteng, South Africa.
| | - B Modell
- University College London, London, UK
| | - H Blencowe
- Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - K L Strong
- Department of Maternal, Newborn, Child and Adolescent Health and Aging, Health, World Health Organization, Geneva, Switzerland
| | - C Aldous
- School of Clinical Medicine, University of Kwa-Zulu Natal, Durban, South Africa
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Brin MF, Kirby RS, Slavotinek A, Adams AM, Parker L, Ukah A, Radulian L, Elmore MRP, Yedigarova L, Yushmanova I. Pregnancy Outcomes in Patients Exposed to OnabotulinumtoxinA Treatment: A Cumulative 29-Year Safety Update. Neurology 2023:WNL.0000000000207375. [PMID: 37137724 DOI: 10.1212/wnl.0000000000207375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A previous publication of pregnancy outcomes in onabotulinumtoxinA-exposed mothers demonstrated that the prevalence of major fetal defects (0.9%, 1/110) was comparable to background rates in the general population. There is continued interest to better understand the safety of onabotulinumtoxinA during pregnancy. This analysis evaluated pregnancy outcomes following onabotulinumtoxinA exposure to provide a cumulative 29-year update. METHODS The Allergan Global Safety Database was searched from 1/1/1990 to 12/31/2018. Data from women (<65 years or unknown) during pregnancy or ≤3 months prior to conception treated with onabotulinumtoxinA were assessed to estimate birth defect prevalence rates of live births only from prospective pregnancies. RESULTS Of 913 pregnancies, 397 (43.5%) were eligible with known outcomes. Maternal age was known in 215 pregnancies: 45.6% were ≥35 years. Indication was known in 340 pregnancies: most frequent were aesthetic (35.3%) and migraine/headache (30.3%). Timing of exposure was known in 318 pregnancies: 94.6% were prior to conception or during the first trimester. OnabotulinumtoxinA dose information was known in 242 pregnancies; the majority (83.5%) were exposed to <200 U. Of 195 prospective pregnancies with 197 fetuses, there were 152 (77.2%) live births and 45 (22.8%) fetal losses (32 spontaneous, 13 elective). Of 152 live births, 148 (97.4%) had normal outcomes, 4 had abnormal outcomes. Among the 4 abnormal outcomes, there were 1 major birth defect, 2 minor fetal defects, and 1 birth complication. The prevalence rate for overall fetal defects was 2.6% (4/152, 95% CI: 1.0-6.6%) and 0.7% (1/152, 95% CI: 0.1-3.6%) for major fetal defects (3-6% in the general population). Among cases of live births and known determinable exposure times, there was 1 birth defect with preconception exposure and 2 with first-trimester exposure. DISCUSSION Although subject to reporting bias due to the nature of the post-marketing database review, this 29-year retrospective analysis of safety data in pregnant women exposed to onabotulinumtoxinA demonstrates that the prevalence rate of major fetal defects among live births is consistent with rates reported in the general population. Even though there are limited data available for second- and third-trimester exposure, this updated and expanded safety analysis provides important real-world evidence to healthcare providers and their patients. CLASSIFICATION OF EVIDENCE This analysis provides Class III data that demonstrate that the prevalence rate of major fetal defects among live births subsequent to in utero onabotulinumtoxinA exposure is comparable to reported background rates.
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Affiliation(s)
- Mitchell F Brin
- Allergan, an AbbVie Company, Irvine, CA, USA
- University of California, Irvine, Department of Neurology, Irvine, CA, USA
| | - Russell S Kirby
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - Anne Slavotinek
- University of California, San Francisco, Division of Medical Genetics, Department of Pediatrics, San Francisco, CA, USA
| | | | - Lori Parker
- Allergan, an AbbVie Company, Irvine, CA, USA
| | - Ahunna Ukah
- Allergan, an AbbVie Company, Irvine, CA, USA
| | - Lavinia Radulian
- Allergan, an AbbVie Company, Bucharest, Romania
- University of Medicine and Pharmacy, Carol Davila, Bucharest, Romania
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Huang L, Mao B, Li J, Nan N, He L, Qiu J, Yi B, Liu Q. Associations Between the Lead Level in Maternal Blood and Umbilical Cord Blood and Congenital Heart Diseases in Offspring. Biol Trace Elem Res 2023; 201:2191-2199. [PMID: 35794301 DOI: 10.1007/s12011-022-03338-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/16/2022] [Indexed: 11/02/2022]
Abstract
The incidence of congenital heart diseases (CHDs) shows an increasing trend and results in large health burdens in China. However, there have been inconsistent results of the relationship between lead (Pb) level and risk of CHDs. We performed a pair-matched case-control study and included 97 cases and 194 controls to investigate the association between pregnancy Pb exposure and the risk of CHDs in a birth cohort study conducted in Lanzhou, China. The results showed that compared to the lowest Pb tertile, both highest tertile levels of maternal blood and umbilical cord blood Pb were associated with an increased risk of CHDs. The similar significant results were found in cases with isolated CHDs. Compared to both lowest tertiles of Pb level in maternal blood and umbilical cord blood, the highest tertile was associated with an increased risk of CHDs, especially for isolated CHDs. Overall, our study suggests a significant association between pregnancy Pb exposure and risk of CHDs, especially for isolated CHDs. Future studies are needed to elucidate the underlying mechanism.
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Affiliation(s)
- Lei Huang
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Jiayue Li
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Nan Nan
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Li He
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Bin Yi
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China.
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China.
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Seyi-Olajide JO, Ma X, Guadagno E, Ademuyiwa A, Poenaru D. Screening methods for congenital anomalies in low and lower-middle income countries: A systematic review. J Pediatr Surg 2023; 58:986-993. [PMID: 36822972 DOI: 10.1016/j.jpedsurg.2023.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Surgically correctable congenital anomalies are responsible for a significant burden of morbidity and mortality in children from low-and lower-middle-income countries (LMICs). Early identification through fetal and neonatal screening is critical to reducing death and disability. This study aims to identify feasible screening methods for surgically correctable congenital anomalies in LMICs. METHODS A systematic search looking at screening for congenital anomalies in LMIC was conducted in seven databases from 2000 until May 25, 2020, with no language restriction. All articles discussing screening methods for surgically correctable congenital anomalies in LMICs were included. Articles were screened by two independent contributors using Rayyan software, with a third contributor resolving conflicts. Feasibility of the screening method and its risk of bias were assessed using the MINORS scale. RESULTS Of 3473 articles, 24 were included in the full-text review. Nine screening methods (three prenatal and six postnatal) were identified - the most frequently utilized being physician clinical examination (45.8%), pulse oximetry (33.3%) and fetal ultrasound (20.8%). The use of a birth defect picture toolkit was the most feasible screening method. The risk of bias scale yielded an average of 11.9 points, which corresponds to a moderate level of bias. CONCLUSION Despite clear benefits, prenatal and neonatal screening methods are infrequently used in LMICs to identify surgically correctable congenital anomalies in neonates, likely due to financial, material, and human resource constraints. Further research into the development of low-cost feasible methods is needed within these settings. PROSPERO REGISTRATION NUMBER CRD42020192051. TYPE OF STUDY Systematic review. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Justina O Seyi-Olajide
- Pediatric Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria.
| | - Xiya Ma
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada; Division of Plastic Surgery, Universite de Montreal, Montreal, QC, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Adesoji Ademuyiwa
- Pediatric Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria; Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Dan Poenaru
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
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Zhang Y, Jia W, Zeng F, Sun J. Independent factors associated with birth defects during the whole of pregnancy in Shenyang City, China: a case-control study. Transl Pediatr 2023; 12:719-730. [PMID: 37181012 PMCID: PMC10167386 DOI: 10.21037/tp-23-197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023] Open
Abstract
Background Birth defects, as a kind of diseases that seriously affect human life, have always attracted much attention. In the past, perinatal data have been studied for birth defects. This study analyzed the surveillance data of birth defects during the perinatal period and the whole of pregnancy, as well as the independent influencing factors, to help to minimize their risk of birth defects. Methods A total of 23,649 fetuses delivered in the hospital from January 2017 to December 2020, were enrolled in this study. There were 485 cases of birth defects, including live births and stillbirths by detailed inclusion and exclusion criteria. Maternal and neonatal clinical data were collated to analyze the influencing factors associated with birth defects. Pregnancy complications and comorbidities were diagnosed according to the criteria of the Chinese Medical Association. Univariate and multivariate logistic regression models were used to investigate the association between independent variables and birth defect events. Results The incidence of birth defects during the whole of pregnancy was 175.46/10,000, while the incidence of perinatal birth defects was 96.22/10,000. The birth defect group had significantly higher maternal age, gravidity, parity, rate of preterm birth, cesarean section (CS) rate, scarred uterus, stillborn, and male newborns compared to the control group. Multivariate logistic regression model analysis showed that preterm birth [odds ratio (OR): 1.69, 95% confidence interval (CI): 1.01 to 2.86], CS (OR: 1.46, 95% CI: 1.08 to 1.98), scarred uterus (OR: 1.70, 95% CI: 1.01 to 2.85), and low birth weight (OR >4 compared to the other two classes) were significantly associated with birth defects during the whole of pregnancy (all P<0.05). The independent influencing factors associated with perinatal birth defects included CS (OR: 1.43, 95% CI: 1.05 to 1.93), gestational hypertension (OR: 1.70, 95%: 1.04 to 2.78), and low birth weight (OR >3.70 compared to the other two classes). Conclusions The discovery and monitoring of known influencing factors associated with birth defects, such as, preterm birth, gestational hypertension, low birth weight, should be enhanced. For the controllable influencing factors, obstetrics providers should work with patients to minimize their risk of birth defects.
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Affiliation(s)
- Yu Zhang
- Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command of the Chinese People’s Liberation Army, Shenyang, China
| | - Wenyan Jia
- Medical Research Center, Yue Bei People’s Hospital, Shaoguan, China
| | - Fanyu Zeng
- Department of Preventive Medicine, Dalian Medical University, Dalian, China
| | - Jingli Sun
- Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command of the Chinese People’s Liberation Army, Shenyang, China
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Han J, Zhang B, Zhang X, Huang K, Fang V, Xu X. Associations between occurrence of birth defects and hydraulic fracturing activities in Barnett shale region, Texas. Heliyon 2023; 9:e15213. [PMID: 37089285 PMCID: PMC10114229 DOI: 10.1016/j.heliyon.2023.e15213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/20/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
The impacts of hydraulic fracturing (HF) on birth defects have been suggested by previous studies but remain largely inconclusive. In this study, we assessed whether pregnant women who lived in areas with high HF activities had increased risks of giving birth to offspring with overall or specific birth defects, including atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), microcephaly (MIC), and hydrocephaly without spina bifida (HSB). All live births between 1999 and 2014 among the residents in the four core counties of Denton, Johnson, Tarrant, and Wise in the Barnett Shale region, Texas, were analyzed. Standardized Morbidity Ratio (SMR) and Poisson regressions were applied for statistical analysis. Compared to the statewide risk, the risks of ASD, VSD, and PDA in four selected counties with high HF activities were significantly higher. The Annual Natural Gas Production from HF was significantly correlated with risks of ASD, PDA, MIC, and total birth defect after adjusting for counties and years. No significant associations of HF activities were found with VSD and HSB. This ecological study suggested that hydraulic fracturing might be associated with the increased risk of some birth defects in the Barnett Shale Region, TX, which warrants further investigations due to the limitation of an ecological study design.
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Affiliation(s)
- JeongWon Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Bangning Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Xiao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Ke Huang
- Department of Statistics, College of Science, Texas A&M University, USA
| | - Vixey Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Xiaohui Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX 77843, USA
- Corresponding author. Department of Epidemiology & Biostatistics¸ School of Public Health, Texas A&M University, 225 SPH Administration Building | MS 1266 212 Adriance Lab Road College Station, Texas 77843-1266, USA.
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Chughtai AA, He WQ, Liu B. Associations between severe and notifiable respiratory infections during the first trimester of pregnancy and congenital anomalies at birth: a register-based cohort study. BMC Pregnancy Childbirth 2023; 23:203. [PMID: 36964492 PMCID: PMC10037767 DOI: 10.1186/s12884-023-05514-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/13/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Evidence regarding the association between acute respiratory infections during pregnancy and congenital anomalies in babies, is limited and conflicting. The aim of this study was to examine the association between acute respiratory infections during the first trimester of pregnancy and congenital anomalies in babies using record linkage. METHODS We linked a perinatal register to hospitalisation and disease notifications in the Australian state of New South Wales (NSW) between 2001 to 2016. We quantified the risk of congenital anomalies, identified from the babies' linked hospital record in relation to notifiable respiratory and other infections during pregnancy using generalized Estimating Equations (GEE) adjusted for maternal sociodemographic and other characteristics. RESULTS Of 1,453,037 birth records identified from the perinatal register between 2001 and 2016, 11,710 (0.81%) mothers were hospitalised for acute respiratory infection, 2850 (0.20%) had influenza and 1011 (0.07%) had high risk infections (a record of cytomegalovirus, rubella, herpes simplex, herpes zoster, toxoplasmosis, syphilis, chickenpox (varicella) and zika) during the pregnancy. During the first trimester, acute respiratory infection, influenza and high-risk infections were reported by 1547 (0.11%), 399 (0.03%) and 129 (0.01%) mothers. There were 15,644 (1.08%) babies reported with major congenital anomalies, 2242 (0.15%) with cleft lip/ plate, 7770 (0.53%) with all major cardiovascular anomalies and 1746 (0.12%) with selected major cardiovascular anomalies. The rate of selected major cardiovascular anomalies was significantly higher if the mother had an acute respiratory infection during the first trimester of pregnancy (AOR 3.64, 95% CI 1.73 to 7.66). The rates of all major congenital anomalies and all major cardiovascular anomalies were also higher if the mother had an acute respiratory infection during the first trimester of pregnancy, however the difference was no statistically significant. Influenza during the first trimester was not associated with major congenital anomalies, selected major cardiovascular anomalies or all major cardiovascular anomalies in this study. CONCLUSION This large population-based study found severe acute respiratory infection in first trimester of pregnancy was associated with a higher risk of selected major cardiovascular anomalies in babies. These findings support measures to prevent acute respiratory infections in pregnant women including through vaccination.
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Affiliation(s)
- Abrar A Chughtai
- School of Population Health, University of New South Wales, Samuels Building, Kensington Campus, Sydney, NSW, 2052, Australia.
| | - Wen-Qiang He
- School of Population Health, University of New South Wales, Samuels Building, Kensington Campus, Sydney, NSW, 2052, Australia
| | - Bette Liu
- School of Population Health, University of New South Wales, Samuels Building, Kensington Campus, Sydney, NSW, 2052, Australia
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Matlock JG. Congenital physical anomalies associated with deceased persons in reincarnation cases with intermissions of less than nine months. Explore (NY) 2023; 19:170-175. [PMID: 36096967 DOI: 10.1016/j.explore.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/04/2022]
Abstract
A literature review of reincarnation cases with identified previous persons found 36 cases in which the "intermission" between lives was less than 9 months. In 9 cases, it was 7 days or fewer. In 32 cases, subjects had birthmarks or birth defects matching the previous person's wounds or other scars in location and appearance. Multiple anomalies appeared in 20 (62.5%) of the 32 cases with physical anomalies. There were 9 natural-death cases and 27 violent-death cases. In 15 (55.5%) of the violent-death cases, there was written documentation of wounds to the previous person. The most extreme birth defects occurred in cases with intermissions of 7 months or more. Interpretations of the data alternative to reincarnation are considered but found inadequate as explanatory models. If examples of reincarnation, these cases raise issues related to when exactly reincarnation occurs and the nature of the process that are important considerations for biology and medicine, as well as for philosophy. One purpose of this paper is to alert the research community to these findings in the hopes of encouraging additional research in this area.
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Affiliation(s)
- James G Matlock
- Parapsychology Foundation, Inc., P.O. Box 1562, New York, NY 10021, USA.
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Ishikawa T, Nishigori H, Akazawa M, Miyakoda K, Noda A, Ishikuro M, Metoki H, Iwama N, Saito M, Sugawara J, Kawame H, Yaegashi N, Kuriyama S, Mano N, Obara T. Risk of major congenital malformations associated with first-trimester antihypertensives, including amlodipine and methyldopa: A large claims database study 2010-2019. Pregnancy Hypertens 2023; 31:73-83. [PMID: 36646019 DOI: 10.1016/j.preghy.2023.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/14/2022] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To evaluate the major congenital malformation (MCM) risk of first-trimester antihypertensive exposure, specifically of amlodipine and methyldopa. STUDY DESIGN A large administrative claims database was used. MAIN OUTCOME MEASURES The prevalence of antihypertensive prescriptions during pregnancy was described in 91,390 women giving birth between 2010 and 2019. The MCM risk of first-trimester antihypertensives was evaluated in 1,185 women diagnosed with hypertensive disorders in the first trimester. The MCM risk of first-trimester amlodipine and methyldopa was evaluated in 178 women who were prescribed antihypertensives in the first trimester. RESULTS Antihypertensives were prescribed to 278 (0.30%) women during their first trimester. The prescription prevalence in the first trimester was highest for methyldopa (115, 0.13%), followed by amlodipine (55, 0.06%). Antihypertensives were prescribed to 2,955 (3.23%) women during pregnancy. Nifedipine (903, 0.99%) and nicardipine (758, 0.83%) were the most frequently prescribed oral and injectable antihypertensives during pregnancy, both with a significant increase in annual prevalence. Of the 1,185 women diagnosed with hypertensive disorders in the first trimester, antihypertensives were prescribed to 178 women. The adjusted odds ratio (aOR) of MCMs in the first-trimester prescription of any antihypertensive medication was 1.124 (95% confidence interval [CI], 0.618-2.045). Amlodipine and methyldopa were prescribed to 44 and 93 of the 178 women, respectively. The aORs of MCMs in the first-trimester prescription of amlodipine and methyldopa were 1.219 (95% CI, 0.400-3.721) and 0.921 (0.331-2.564), respectively. CONCLUSIONS The MCM risk of first-trimester exposure to antihypertensives, including amlodipine and methyldopa, was not suggested.
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Affiliation(s)
- Tomofumi Ishikawa
- Laboratory of Biomolecule and Pathophysiological Chemistry, Graduate School of Pharmaceutical Sciences, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hidekazu Nishigori
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Hikarigaoka, Fukushima 960-1295, Japan
| | - Manabu Akazawa
- Department of Public Health and Epidemiology, Meiji Pharmaceutical University, 2-522-1, Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Keiko Miyakoda
- Clinical & Translational Research Center, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Division of Public Health and Hygiene, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Noriyuki Iwama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Gynecology and Obstetrics, Graduate School of Medicine, Tohoku University, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Masatoshi Saito
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Tohoku University, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Gynecology and Obstetrics, Graduate School of Medicine, Tohoku University, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hiroshi Kawame
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Clinical Genetics, The Jikei University Hospital, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo 105-8471, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Gynecology and Obstetrics, Graduate School of Medicine, Tohoku University, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; International Research Institute for Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Nariyasu Mano
- Laboratory of Biomolecule and Pathophysiological Chemistry, Graduate School of Pharmaceutical Sciences, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.
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Anane-Fenin B, Opoku DA, Chauke L. Prevalence, Pattern, and Outcome of Congenital Anomalies Admitted to a Neonatal Unit in a Low-Income Country-a Ten-Year Retrospective Study. Matern Child Health J 2023. [PMID: 36853373 DOI: 10.1007/s10995-023-03591-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The incidence of congenital abnormalities is highest in low-and-middle-income countries. However, the prevalence, spectrum, trends of neonatal congenital anomalies and their admission outcomes have not been well explored. This study was a 10 year retrospective hospital-based research in a low-income country to address the above. METHODS All infants hospitalized in the Special Care Baby Unit at the Cape Coast Teaching Hospital in Ghana, between 1st January 2010 and 31st December 2019, had their demographic, obstetric, and clinical data recorded. RESULTS Over the decade, 236 neonates with congenital abnormalities were admitted to the unit, accounting for 2.8% of total neonatal admissions and 8.6 per 1000 births. Mortality occurred in 33.2% of neonates with congenital abnormalities, corresponding to 4.6% of all neonatal deaths. Mortality was significantly associated with place of delivery and gravidity of more than five. The commonest anomalies were in the nervous system, particularly neural tube defects, followed by suspected chromosomal abnormalities and then cardiac defects. Neonates with cardiac defects had a higher chance of dying. Health center/clinic delivery proffered a better survival than hospital delivery, but this should be interpreted with caution. CONCLUSION Neural tube defects were the most predominant anomalies; hence, intensification of preconception and antenatal folic acid supplementation is pivotal towards their reduction. Making prenatal screening for early detection of fetal anomalies an integral part of routine antenatal care is also essential. This research was conducted in a single center and did not include stillbirths and abortions so cannot give an accurate estimation of the number of congenital abnormalities in the population. A national registry of congenital anomalies is recommended.
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Knafl GJ. An analysis of birth defects and developmental disabilities for children of participants of the Air Force Health Study. Reprod Toxicol 2023; 117:108355. [PMID: 36813141 DOI: 10.1016/j.reprotox.2023.108355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
Analyses were conducted of the occurrence of eight general categories of birth defects and developmental disabilities for children fathered by participants of the Air Force Heath Study (AFHS). Participants were male Air Force veterans of the Vietnam War. Children were categorized into conceived before and after the start of the participant's Vietnam War service. Analyses accounted for correlation between outcomes for multiple children fathered by each of the participants. For each of the eight general categories of birth defects and developmental disabilities, the probability of its occurrence increased substantially for children conceived after compared to before the start of Vietnam War service. These results support the conclusion of an adverse effect on reproductive outcomes due to Vietnam War service. Data for children conceived after the start of Vietnam War service for participants with measured dioxin values were used to estimate dose-response curves for the effect of dioxin exposure on the occurrence of each of the eight general categories of birth defects and developmental disabilities. These curves were assumed to be constant up to a threshold and then monotonic after that threshold. For seven of the eight general categories of birth defects and developmental disabilities, the estimated dose-response curves increased nonlinearly after associated thresholds. These results support the conclusion that the adverse effect to conception after the start of Vietnam War service may be attributable to high enough exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War.
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Affiliation(s)
- George J Knafl
- School of Nursing, University of North Carolina at Chapel Hill, 10011 Fountain, Chapel Hill, NC 27517, USA.
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40
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Galati G, Esposito G, Somigliana E, Muzii L, Franchi M, Corrao G, Parazzini F. Trends in the incidence of major birth defects after assisted reproductive technologies in Lombardy Region, Northern Italy. J Assist Reprod Genet 2023; 40:857-863. [PMID: 36763300 DOI: 10.1007/s10815-023-02732-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
PURPOSE The incidence of birth defects is increased in children born after assisted reproductive technologies (ART). However, changes in ART over time could influence this incidence. To investigate this issue, we present the frequency and trends of birth defects in ART and natural pregnancies in Lombardy, Northern Italy, during the period 2014-2020. METHODS This is a population-based study using automated system of healthcare utilization (HCU) databases. ART pregnancies included only those obtained with conventional IVF or ICSI. After identifying the total number of deliveries, the rate of newborns with birth defects was compared between natural and ART pregnancies. A logistic regression model was used to calculate the adjusted odd ratio (OR). Analyses were repeated for every calendar year. RESULTS Overall, 508,421 deliveries were identified, of which 14,067 (2.8%) were achieved after IVF-ICSI. A decreasing trend in birth defects over time was highlighted. The adjusted OR dropped from 1.40 (95%CI: 1.03-1.91) in 2014 to 0.92 (95%CI: 0.69-1.22) in 2020. During the study period, a significant reduction in multiple pregnancy and in the ratio of ICSI to conventional IVF was also observed, explaining at least in part the positive trend observed for birth defects. CONCLUSION The increased risk of birth defects in children born after IVF-ICSI is not steady over time. A decline of this risk emerged in our region. Policy changes in ART may explain this beneficial effect.
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Affiliation(s)
- Giulia Galati
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy.
| | - Giovanna Esposito
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Franchi
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.,National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Giovanni Corrao
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.,National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Blanc N, Liao J, Gilliland F, Zhang JJ, Berhane K, Huang G, Yan W, Chen Z. A systematic review of evidence for maternal preconception exposure to outdoor air pollution on Children's health. Environ Pollut 2023; 318:120850. [PMID: 36528197 PMCID: PMC9879265 DOI: 10.1016/j.envpol.2022.120850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 05/22/2023]
Abstract
The preconception period is a critical window for gametogenesis, therefore preconception exposure to air pollutants may have long-term effects on children. We systematically reviewed epidemiological evidence concerning the effects of preconception ambient air pollution exposure on children's health outcomes and identified research gaps for future investigations. We searched PubMed and Web of Science from journal inception up to October 2022 based on an established protocol (PROSPERO: CRD42022277608). We then identified 162 articles based on searching strategy, 22 of which met the inclusion criteria. Studies covered a wide range of health outcomes including birth defects, preterm birth, birthweight, respiratory outcomes, and developmental outcomes. Findings suggested that exposure to outdoor air pollutants during maternal preconception period were associated with various health outcomes, of which birth defects has the most consistent findings. A meta-analysis revealed that during 3-month preconception period, a 10 μg/m3 increase in PM10 and PM2.5 was associated with relative risk (RR) of birth defects of 1.06 (95% confidence interval (CI): 1.00, 1.02) and 1.14 (95% CI: 0.82, 1.59), respectively. Preterm birth, low birthweight, and autism have also been associated with maternal preconception exposure to PM2.5, PM10, O3 and SO2. However, the significance of associations and effect sizes varied substantially across studies, partly due to the heterogeneity in exposure and outcome assessments. Future studies should use more accurate exposure assessment methods to obtain individual-level exposures with high temporal resolution. This will allow the exploration of which specific time window (weeks or months) during the preconception period has the strongest effect. In future epidemiologic studies, integrating pathophysiologic biomarkers relevant to clinical outcomes may help improve the causal inference of associations between preconception exposure and health outcomes suggested by the current limited literature. Additionally, potential effects of paternal preconception exposure need to be studied.
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Affiliation(s)
- Natalie Blanc
- University of Southern California, Los Angeles, CA, USA
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Frank Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Junfeng Jim Zhang
- Division of Environmental Science and Policy, Nicholas School of the Environment, Duke University, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Guoying Huang
- Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Shanghai, China
| | - Weili Yan
- Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Shanghai, China
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
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Weber KA, Yang W, Carmichael SL, Collins RT, Luben TJ, Desrosiers TA, Insaf TZ, Le MT, Evans SP, Romitti PA, Yazdy MM, Nembhard WN, Shaw GM. Assessing associations between residential proximity to greenspace and birth defects in the National Birth Defects Prevention Study. Environ Res 2023; 216:114760. [PMID: 36356662 PMCID: PMC10353702 DOI: 10.1016/j.envres.2022.114760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Residential proximity to greenspace is associated with various health outcomes. OBJECTIVES We estimated associations between maternal residential proximity to greenspace (based on an index of vegetation) and selected structural birth defects, including effect modification by neighborhood-level factors. METHODS Data were from the National Birth Defects Prevention Study (1997-2011) and included 19,065 infants with at least one eligible birth defect (cases) and 8925 without birth defects (controls) from eight Centers throughout the United States. Maternal participants reported their addresses throughout pregnancy. Each address was systematically geocoded and residences around conception were linked to greenspace, US Census, and US Department of Agriculture data. Greenspace was estimated using the normalized difference vegetation index (NDVI); average maximum NDVI was estimated within 100 m and 500 m concentric buffers surrounding geocoded addresses to estimate residential NDVI. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals comparing those in the highest and lowest quartiles of residential NDVI and stratifying by rural/urban residence and neighborhood median income. RESULTS After multivariable adjustment, for the 500 m buffer, inverse associations were observed for tetralogy of Fallot, secundum atrial septal defects, anencephaly, anotia/microtia, cleft lip ± cleft palate, transverse limb deficiency, and omphalocele, (aORs: 0.54-0.86). Results were similar for 100 m buffer analyses and similar patterns were observed for other defects, though results were not significant. Significant heterogeneity was observed after stratification by rural/urban for hypoplastic left heart, coarctation of the aorta, and cleft palate, with inverse associations only among participants residing in rural areas. Stratification by median income showed heterogeneity for atrioventricular and secundum atrial septal defects, anencephaly, and anorectal atresia, with inverse associations only among participants residing in a high-income neighborhood (aORs: 0.45-0.81). DISCUSSION Our results suggest that perinatal residential proximity to more greenspace may contribute to a reduced risk of certain birth defects, especially among those living in rural or high-income neighborhoods.
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Affiliation(s)
- Kari A Weber
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Wei Yang
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Suzan L Carmichael
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
| | - R Thomas Collins
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Thomas J Luben
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, RTP, NC, USA.
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tabassum Z Insaf
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health and Department of Epidemiology and Biostatistics, University at Albany, Albany, NY, USA.
| | - Mimi T Le
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA.
| | - Shannon Pruitt Evans
- Eagle Global Scientific LLC, San Antonio, TX, USA; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA.
| | - Mahsa M Yazdy
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA.
| | - Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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Younger DS. Neonatal and infantile hypotonia. Handb Clin Neurol 2023; 195:401-423. [PMID: 37562880 DOI: 10.1016/b978-0-323-98818-6.00011-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
The underlying etiology of neonatal and infantile hypotonia can be divided into primary peripheral and central nervous system and acquired or genetic disorders. The approach to identifying the likeliest cause of hypotonia begins with a bedside assessment followed by a careful review of the birth history and early development and family pedigree and obtaining available genetic studies and age- and disease-appropriate laboratory investigations. Until about a decade ago, the main goal was to identify the clinical signs and a battery of basic investigations including electrophysiology to confirm or exclude a given neuromuscular disorder, however the availability of whole-exome sequencing and next generation sequencing and transcriptome sequencing has simplified the identification of specific underlying genetic defect and improved the accuracy of diagnosis in many related Mendelian disorders.
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Affiliation(s)
- David S Younger
- Department of Clinical Medicine and Neuroscience, CUNY School of Medicine, New York, NY, United States; Department of Medicine, Section of Internal Medicine and Neurology, White Plains Hospital, White Plains, NY, United States.
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Lipinski RJ, Krauss RS. Gene-environment interactions in birth defect etiology: Challenges and opportunities. Curr Top Dev Biol 2023; 152:1-30. [PMID: 36707208 PMCID: PMC9942595 DOI: 10.1016/bs.ctdb.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Birth defects are relatively common congenital outcomes that significantly impact affected individuals, their families, and communities. Effective development and deployment of prevention and therapeutic strategies for these conditions requires sufficient understanding of etiology, including underlying genetic and environmental causes. Tremendous progress has been made in defining the genetic basis of familial and syndromic forms of birth defects. However, the majority of birth defect cases are considered nonsyndromic and thought to result from multifactorial gene-environment interactions. While substantial advances have been made in elucidating the genetic landscape of these etiologically complex conditions, significant biological and technical constraints have stymied progress toward a refined knowledge of environmental risk factors. Defining specific gene-environment interactions in birth defect etiology is even more challenging. However, progress has been made, including demonstration of critical proofs of concept and development of new conceptual and technical approaches for resolving complex gene-environment interactions. In this review, we discuss current views of multifactorial birth defect etiology, comparing them with other diseases that also involve gene-environment interactions, including primary immunodeficiency and cancer. We describe how various model systems have illuminated mechanisms of multifactorial etiology and these models' individual strengths and weaknesses. Finally, suggestions for areas of future emphasis are proposed.
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Affiliation(s)
- Robert J. Lipinski
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, United States,Corresponding authors: ;
| | - Robert S. Krauss
- Department of Cell, Developmental, and Regenerative Biology, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Corresponding authors: ;
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Sakai-Bizmark R, Kumamaru H, Marr EH, Bedel LEM, Mena LA, Baghaee A, Nguyen M, Estevez D, Wu F, Chang RKR. Pulse Oximetry Screening: Association of State Mandates with Emergency Hospitalizations. Pediatr Cardiol 2023; 44:67-74. [PMID: 36273322 PMCID: PMC10060123 DOI: 10.1007/s00246-022-03027-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022]
Abstract
We evaluated the association between implementation of state-mandated pulse oximetry screening (POS) and rates of emergency hospitalizations among infants with Critical Congenital Heart Disease (CCHD) and assessed differences in that association across race/ethnicity. We hypothesized that emergency hospitalizations among infants with CCHD decreased after implementation of mandated POS and that the reduction was larger among racial and ethnic minorities compared to non-Hispanic Whites. We utilized statewide inpatient databases from Arizona, California, Kentucky, New Jersey, New York, and Washington State (2010-2014). A difference-in-differences model with negative binomial regression was used. We identified patients with CCHD whose hospitalizations between three days and three months of life were coded as "emergency" or "urgent" or occurred through the emergency department. Numbers of emergency hospitalizations aggregated by month and state were used as outcomes. The intervention variable was an implementation of state-mandated POS. Difference in association across race/ethnicity was evaluated with interaction terms between the binary variable indicating the mandatory policy period and each race/ethnicity group. The model was adjusted for state-specific variables, such as percent of female infants and percent of private insurance. We identified 9,147 CCHD emergency hospitalizations. Among non-Hispanic Whites, there was a 22% (Confidence Interval [CI] 6%-36%) decline in CCHD emergency hospitalizations after implementation of mandated POS, on average. This decline was 65% less among non-Hispanic Blacks compared to non-Hispanic Whites. Our study detected an attenuated association with decreased number of emergency hospitalizations among Black compared to White infants. Further research is needed to clarify this disparity.
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Affiliation(s)
- Rie Sakai-Bizmark
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA.
- Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California, Los Angeles (UCLA), Torrance, CA, USA.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, The University of Tokyo School of Medicine, Tokyo, Japan
| | - Emily H Marr
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA
| | - Lauren E M Bedel
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA
| | - Laurie A Mena
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA
| | - Anita Baghaee
- Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California, Los Angeles (UCLA), Torrance, CA, USA
| | - Michael Nguyen
- Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California, Los Angeles (UCLA), Torrance, CA, USA
| | - Dennys Estevez
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA
| | - Frank Wu
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA
| | - Ruey-Kang R Chang
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA
- Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California, Los Angeles (UCLA), Torrance, CA, USA
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Muzzamil M, Nisa M, Raza S. The survival rate of neonates in Pakistan: Problems in health care access, quality and recommendations. Health Promot Perspect 2022; 12:355-357. [PMID: 36852197 PMCID: PMC9958232 DOI: 10.34172/hpp.2022.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/29/2022] [Indexed: 02/22/2023] Open
Abstract
There is a high prevalence of infant mortality in South Asia and other parts of Asia, but overall, the bulk of neonatal deaths occur in developing countries. Although Pakistan has made great strides in the past decade to reduce child mortality with the help of foreign donors and the government, very little progress has been made in reducing neonate and infant mortality. Several studies have demonstrated the potential for low-cost therapies to greatly reduce neonatal mortality by helping pregnant mothers and their newborns. We need to shed light on the efforts and problems surrounding this topic in order to find and implement solutions backed by research to lower newborn mortality. This brief overview was produced using international standards for conducting reviews. Researchers opted for an explanatory methodology. Our findings were based on research conducted through PubMed, Google's literature database, Journals Online, and the Internet Library. All of the works consulted primary sources, such as the World Health Organization (WHO) and the World Bank. The desired findings were obtained by using the term "neonatal mortality." The study's authors were interested in tracking variations in neonatal mortality over time. The increasing prevalence of neonatal death in Pakistan emphasizes the need for policies and programs that prioritized the health of children. Neonatal survival can be improved with the help of basic obstetric and newborn care in Pakistan.
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Affiliation(s)
- Muhammad Muzzamil
- Health Services Academy, Islamabad, Pakistan,Corresponding Author: Muhammad Muzzamil,
| | - Maryam Nisa
- Health Services Academy, Islamabad, Pakistan
| | - Shaeroz Raza
- Jinnah Medical and Dental College, Karachi, Pakistan
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Everson JL, Eberhart JK. Gene-alcohol interactions in birth defects. Curr Top Dev Biol 2022; 152:77-113. [PMID: 36707215 PMCID: PMC9897481 DOI: 10.1016/bs.ctdb.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Most human birth defects are thought to result from complex interactions between combinations of genetic and environmental factors. This is true even for conditions that, at face value, may appear simple and straightforward, like fetal alcohol spectrum disorders (FASD). FASD describe the full range of structural and neurological disruptions that result from prenatal alcohol exposure. While FASD require alcohol exposure, evidence from human and animal model studies demonstrate that additional genetic and/or environmental factors can influence the embryo's susceptibility to alcohol. Only a limited number of alcohol interactions in birth defects have been identified, with many sensitizing genetic and environmental factors likely yet to be identified. Because of this, while unsatisfying, there is no definitively "safe" dose of alcohol for all pregnancies. Determining these other factors, as well as mechanistically characterizing known interactions, is critical for better understanding and preventing FASD and requires combined scrutiny of human and model organism studies.
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Affiliation(s)
- Joshua L Everson
- Department of Molecular Biosciences, School of Natural Sciences, University of Texas at Austin, Austin, TX, United States; Waggoner Center for Alcohol and Addiction Research, School of Pharmacy, University of Texas at Austin, Austin, TX, United States.
| | - Johann K Eberhart
- Department of Molecular Biosciences, School of Natural Sciences, University of Texas at Austin, Austin, TX, United States; Waggoner Center for Alcohol and Addiction Research, School of Pharmacy, University of Texas at Austin, Austin, TX, United States.
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48
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Nemec B, Dron H. The environments of reproductive and birth defects research in the U.S. and West Germany (c. 1955-1975). Stud Hist Philos Sci 2022; 95:50-63. [PMID: 35981444 DOI: 10.1016/j.shpsa.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/15/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Most historiographies of the crossroads of environmental and reproductive health in 20th century start and end with the case of thalidomide. Despite its global scope, thalidomide today stands for sharp contrasts: in the numbers of victims, in institutional responses to the disaster, and also-more generally-in regulatory approaches to potential risks and national cultures of reproductive justice and disability rights. This paper takes a closer look at two countries that have been seen as emblematic of this divide in regulatory frameworks, despite similarities and interconnections in other areas, such as (pharma)industrial production, science, and robust feminist environmental health movements: the U.S. and West Germany. It argues that thalidomide needs to be historically contextualized within a broad framework of concepts and models of environment from research on exogenous reproductive effects. To do so, it reconstructs what counted as environment in research on reproductive health and birth defects in these two national settings in the postwar decades. It looks at transformations made across multifaceted initiatives, studying collective landscapes and workplaces as potentially dangerous "outer worlds," as well as smaller scale and more individualized environments, i.e., the maternal metabolism, uterus, lifestyle, or social interactions. The article thereby aims to explicate concepts and debates about the environment that influenced later national divisions in politics of science and technology, hinting of the democratic challenges these posed.
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Affiliation(s)
- Birgit Nemec
- Universitätsmedizin Berlin, Institute for History of Medicine and Ethics of Medicine, Thielallee 71, 14195 Berlin, Germany.
| | - Heather Dron
- University of Michigan, 3700 Haven Hall, 505 S. State St., Ann Arbor, MI 48109-1045, USA.
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Requia WJ, Kill E, Papatheodorou S, Koutrakis P, Schwartz JD. Prenatal exposure to wildfire-related air pollution and birth defects in Brazil. J Expo Sci Environ Epidemiol 2022; 32:596-603. [PMID: 34504295 DOI: 10.1038/s41370-021-00380-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Birth defects are a major cause of poor health outcomes during both childhood and adulthood. A growing body of evidence demonstrated associations between air pollution exposure during pregnancy and birth defects. To date, there is no study looking at birth defects and exposure to wildfire-related air pollution, which is suggested as a type of air pollution source with high toxicity for reproductive health. OBJECTIVE Our study addresses this gap by examining the association between birth defects and wildfire smoke exposure in Brazil between 2001 and 2018. Based on known differences of impacts of wildfires across different regions of Brazil, we hypothesized differences in risks of birth defects for different regions. METHODS We used a logistic regression model to estimate the odds ratios (ORs) for individual birth defects (12 categories) associated with wildfire exposure during each trimester of pregnancy. RESULTS Among the 16,825,497 birth records in our study population, there were a total of 7595 infants born in Brazil between 2001 and 2018 with birth defects in any of the selected categories. After adjusting for several confounders in the primary analysis, we found statistically significant OR for three birth defects, including cleft lip/cleft palate [OR: 1.007 (95% CI: 1.001; 1.013)] during the second trimester of exposure, congenital anomalies of the respiratory system [OR: 1.013 (95% CI: 1.002; 1.023)] in the second trimester of exposure, and congenital anomalies of the nervous system [OR: 1.002 (95% CI: 1.001; 1.003)] during the first trimester of exposure for the regions South, North, and Midwest, respectively. SIGNIFICANCE Our results suggest that maternal exposure to wildfire smoke during pregnancy may increase the risk of an infant being born with some congenital anomaly. Considering that birth defects are associated with long-term disability, impacting families and the healthcare system (e.g., healthcare costs), our findings should be of great concern to the public health community. IMPACT STATEMENT Our study focused on the association between maternal exposure to wildfire smoke in Brazil during pregnancy and the risk of an infant being born with congenital anomalies, which presents serious public health and environmental challenges.
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Affiliation(s)
- Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil.
| | - Erick Kill
- Faculty of Medicine, Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Petros Koutrakis
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
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50
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Suhl J, Conway KM, Rhoads A, Langlois PH, Feldkamp ML, Michalski AM, Oleson JJ, Sidhu A, Kancherla V, Obrycki J, Mazumdar M, Romitti PA. Pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects. Public Health Nutr 2022; 26:1-13. [PMID: 35620934 PMCID: PMC9989706 DOI: 10.1017/s1368980022001318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/11/2022] [Accepted: 05/04/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To explore associations between maternal pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects. DESIGN This is a population-based, case-control study using maternal responses to a dietary assessment and published arsenic concentration estimates in food items to calculate average daily total and inorganic arsenic exposure during the year before pregnancy. Assigning tertiles of total and inorganic arsenic exposure, logistic regression analysis was used to estimate OR for middle and high tertiles, compared to the low tertile. SETTING US National Birth Defects Prevention Study, 1997-2011. PARTICIPANTS Mothers of 10 446 children without birth defects and 14 408 children diagnosed with a non-cardiac birth defect. RESULTS Maternal exposure to total dietary arsenic in the middle and high tertiles was associated with a threefold increase in cloacal exstrophy, with weak positive associations (1·2-1·5) observed either in both tertiles (intercalary limb deficiency) or the high tertile only (encephalocele, glaucoma/anterior chamber defects and bladder exstrophy). Maternal exposure to inorganic arsenic showed mostly weak, positive associations in both tertiles (colonic atresia/stenosis, oesophageal atresia, bilateral renal agenesis/hypoplasia, hypospadias, cloacal exstrophy and gastroschisis), or the high (glaucoma/anterior chamber defects, choanal atresia and intestinal atresia stenosis) or middle (encephalocele, intercalary limb deficiency and transverse limb deficiency) tertiles only. The remaining associations estimated were near the null or inverse. CONCLUSIONS This exploration of arsenic in diet and non-cardiac birth defects produced several positive, but mostly weak associations. Limitations in exposure assessment may have resulted in exposure misclassification. Continued research with improved exposure assessment is recommended to identify if these associations are true signals or chance findings.
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Affiliation(s)
- Jonathan Suhl
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
| | - Kristin M Conway
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
| | - Anthony Rhoads
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
| | - Peter H Langlois
- Department of Epidemiology, Human Genetics, and Environmental Science, University of Texas, School of Public Health in Austin, Austin, TX, USA
| | - Marcia L Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Adrian M Michalski
- New York State Department of Health, Bureau of Environmental and Occupational Epidemiology, Albany, NY, USA
| | - Jacob J Oleson
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Alpa Sidhu
- Division of Medical Genetics and Genomics, The Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | - John Obrycki
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
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