Birth defects surveillance: experiences in Argentina and Colombia

Abstract

Birth defects (BDs) are structural or functional anomalies, sporadic or hereditary, of prenatal origin. Public health surveillance is defined as the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice. BD surveillance systems may have different characteristics according to design, coverage, type of surveillance, case ascertainment, case definition, BD description, maximum age of diagnosis, pregnancy outcomes, coding systems, and the location of the coding process (central or local). The aim of this article is to describe and compare methodology, applications, and results of birth defect surveillance systems in two South-American countries: Colombia and Argentina. In both countries, the surveillance systems developed activities in relation to the Zika virus emergency. For most BDs, a statistically significant higher prevalence is observed in Argentina-RENAC than in Colombian registries. This may be due to methodological reasons or real differences in prevalence. The strengths, weaknesses, and the future perspectives of the Argentine and Colombian systems are presented. When developing a surveillance system, the objectives, the available resources, and previous experiences in similar contexts must be taken into account. In that sense, the experience of Argentina and Colombia can be useful for others when developing a birth defect surveillance system.

A Retrospective Analysis of the Spectrum of Congenital Malformations Diagnosed Prenatally Based on the Lviv Medical Genetics Center during 2018-2020 yy

“…Вивчення частоти ПВР дає змогу припустити вплив тератогенів і мутагенів [24], що допоможе уникнути наслідків цього впливу у плануванні подальшої вагітности, проведенні медико-генетичних консультацій у осіб із високим ризиком виникнення ПВР [13,14]. Проте вичерпні дані про поширеність ПВР в європейських країнах, включаючи Україну, є нечисленними й недостовірними через епідемію коронавірусу, що позначилося на кількості вагітних у цей період [15,17].…”

Why are Birth Defects Surveillance Programs Important?

“…In addition to population coverage and case-finding, the design and data gathering on birth defects can be different among several surveillance programs mainly regarding the case definition, age of inclusion, inclusion or absence of data from prenatal diagnosis and elective termination of pregnancy for fetal anomaly (ETOPFA), congenital anomalies description, and coding systems ( 7 ). Although the definition of birth defects includes both structural and functional anomalies, birth defects surveillance programs often monitor major structural birth defects and sometimes minor structural birth defects, too ( 11 ). The detection of functional anomalies as inborn errors of metabolism and blood disorders is frequently performed by neonatal screening programs ( 8 ).…”

Lethality of Birth Defects in Live Born Infants Categorized by Gestational Age and Birth Weight

“…4 In Colombia, neonatal death reached 10.8 per 1000 livebirths, 19.3% of which (20.8 per 10,000) were due to BDs. 5 In Argentina, Groisman et al (2019) reported a 9.7 per 1000 infant mortality rate, from which $60% were neonatal deaths and 27% were due to BDs. 6 Birth defects are present in $2-3% of all newborns and mortality due to the defect depends on its severity as well as on other mainly clinical conditions, such as prematurity and small for gestational age (SGA) or intrauterine growth restriction, whose association with BDs has repeatedly been demonstrated.…”

“…5 In Argentina, Groisman et al (2019) reported a 9.7 per 1000 infant mortality rate, from which ~60% were neonatal deaths and 27% were due to BDs. 6 Birth defects are present in ~2-3% of all newborns and mortality due to the defect depends on its severity as well as on other mainly clinical conditions, such as prematurity and small for gestational age (SGA) or intrauterine growth restriction, whose association with BDs has repeatedly been demonstrated. [7][8][9] Although these conditions have been mentioned as risk factors for neonatal death of malformed infants and even some authors have adjusted their mortality rates by gestational age (GA) and birth weight (BW), [10][11][12] their actual contribution to BDs' lethality has not been evaluated.…”