Complete ascertainment of birth defects is important in developing and evaluating preventive programs, and in investigating clusters of birth defects.

One in eight cases of birth defects were ascertained beyond 1 year of age. We consider that the additional work required to include these cases in Western Australia is outweighed by the benefit of more complete ascertainment.

Objective: To repor t on trends in neural tube defects in Wester n Australia, in relation to folate promotion, periconceptional use of folic acid supplements and food fortification with folate.

Background When evaluating preventive programs such as folate promotion and rubella vaccination, it is critically important to include terminations of pregnancy for neural tube defects and congenital rubella syndrome. Data from birth defects registries are often used for this purpose. The Western Australian Birth Defects Registry ascertains cases of birth defects in livebirths, stillbirths, and terminations of pregnancy for fetal abnormality, using multiple sources of ascertainment. Methods Data on terminations of pregnancy for fetal abnormality from the Western Australian Hospital Morbidity Data System 1980–1997 (not previously available to the Registry) were used to estimate the completeness of ascertainment of such cases by the Registry. Ascertainment‐adjusted prevalences were calculated using capture‐recapture methods. Results A total of 702 terminations with birth defects were identified among hospital discharges, most of which were already known to the Registry (87.9%). Of the 85 new cases, seven had a neural tube defect, 23 had a chromosomal defect, and 12 had confirmed maternal rubella infection during pregnancy. The ascertainment‐adjusted prevalence was not significantly different for birth defects overall or for these individual conditions, although the 95% confidence intervals for all birth defects, and for all chromosomal defects, did not include the prevalence based on registered cases only. Conclusions The Western Australian Birth Defects Registry ascertains a high proportion of pregnancies terminated for fetal abnormality, and should therefore be a reliable source of data with which to assist in monitoring the effectiveness of preventive programs. Teratology 63:23–25, 2001. © 2001 Wiley‐Liss, Inc.

Asthma is a prevalent chronic disorder that might substantially complicate pregnancy. Some recent reports suggest that the presence of a female fetus might be associated with worse maternal asthma symptoms during pregnancy. We tested this hypothesis using the sample of 719 pregnant women with asthma prospectively enrolled in the OTIS study. The presence of a female fetus was associated with a higher incidence of hospitalizations for asthma during pregnancy (OR = 1.84; 95% CI: 1.05; 3.21) independent of maternal age, BMI, ethnicity, smoking, and socioeconomic status. The current study suggests that pregnant asthmatic women carrying a girl might be more susceptible to asthma exacerbations.

SummaryBackgroundSnacking among US preschoolers has increased in recent decades, raising questions about whether snacking contributes to dietary excess.ObjectivesThis research aimed to characterize snacking contributions to dietary excess and to evaluate associations with appetite and weight among preschool‐aged children.MethodsThis study is a cross‐sectional, observational study of 187 Hispanic low‐income preschoolers. Three 24‐h dietary recalls were used to assess snacking frequency and parameters of dietary excess including energy, saturated fat, trans fats and added sugars. Parental reports of child satiety responsiveness, food responsiveness, and enjoyment of food were obtained. Child height and weight were measured.ResultsChildren consumed 28% (395 kcal) of daily energy from snacks eaten at 2.3 ± 1.0 occasions per day. Greater snacking frequency was associated with greater daily intakes of energy (p < 0.05) and added sugars (p < 0.001). Among overweight/obese children, higher enjoyment of food was associated with more frequent snacking and greater energy intake from snacks (p = 0.01). Inverse associations of enjoyment of food with snacking frequency and energy intake were seen among normal weight children (p < 0.05).ConclusionsMore frequent snacking among low‐income Hispanic preschoolers may contribute to excessive intakes of energy and added sugars, particularly among overweight/obese children with greater motivation to eat.

A series of studies was undertaken in 1989 to validate the data held by the Western Australian Congenital Malformations Registry. Comparison with hospital discharge data identified 1585 children six years of age or younger with malformations discharged from hospitals in Westem Australia in 1986.226 of whom were not already recorded on the Congenital Malformations Register. When the records of a special register for cleft lip and palate were examined, all cases of facial cleft known to the special register were also recorded on the Malformations Register.