Population monitoring of birth defects provides a means for detecting relative changes in their frequency. Many varied systems have been developed throughout the world since the thalidomide tragedy of the early 1960s. Although it is difficult to pinpoint specific teratogenic agents based on rises in rates of a particular defect or a constellation of defects, monitoring systems can provide clues for hypothesis testing in epidemiological investigations. International coordination of efforts in this area resulted in the founding of the International Clearinghouse for Birth Defects Monitoring Systems (ICBDMS) in 1974. In this paper we will describe the functions and basic requirements of monitoring systems in general, and look at the development and activities of the ICBDMS. A review of known and suspected environmental teratogenic agents (eg, chemical, habitual, biological, physical, and nutritional) is also presented.
A review of the field of human teratoepidemiology-the epidemiology of congenital malformations-is presented here along with a discussion of the importance of international collaboration in monitoring congenital malformations. Studies implicating various environmental teratogens such as drugs, industrial and agricultural chemicals, intrauterine infections, radiation and nutritional factors are discussed at some length as well as problems encountered in detecting human teratogenic agents.
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