Paper 4: EUROCAT statistical monitoring: Identification and investigation of ten year trends of congenital anomalies in Europe

Abstract

BACKGROUND: As part of EUROCAT's surveillance of congenital anomalies in Europe, a statistical monitoring system has been developed to detect recent clusters or long-term (10 year) time trends. The purpose of this article is to describe the system for the identification and investigation of 10-year time trends, conceived as a ''screening'' tool ultimately leading to the identification of trends which may be due to changing teratogenic factors. METHODS: The EUROCAT database consists of all cases of congenital anomalies including livebirths, fetal deaths from 20 weeks gestational age, and terminations of pregnancy for fetal anomaly. Monitoring of 10-year trends is performed for each registry for each of 96 non-independent EUROCAT congenital anomaly subgroups, while Pan-Europe analysis combines data from all registries. The monitoring results are reviewed, prioritized according to a prioritization strategy, and communicated to registries for investigation. Twenty-one registries covering over 4 million births, from 1999 to 2008, were included in monitoring in 2010. CONCLUSIONS: Significant increasing trends were detected for abdominal wall anomalies, gastroschisis, hypospadias, Trisomy 18 and renal dysplasia in the Pan-Europe analysis while 68 increasing trends were identified in individual registries. A decreasing trend was detected in over one-third of anomaly subgroups in the Pan-Europe analysis, and 16.9% of individual registry tests. Registry preliminary investigations indicated that many trends are due to changes in data quality, ascertainment, screening, or diagnostic methods. Some trends are inevitably chance phenomena related to multiple testing, while others seem to represent real and continuing change needing further investigation and response by regional/national public health authorities. Birth Defects Research (Part A) 91:S31-S43,

Mutations in GREB1L Cause Bilateral Kidney Agenesis in Humans and Mice

“…Altogether, CAKUT occur in about 1 in 500 live births and account for 15%-20% of congenital anomalies detected in utero. 1 They represent a major cause of chronic kidney disease in children, 2 and the most severe cases are associated with perinatal lethality and may lead to termination of pregnancy. CAKUT are due to defects arising during kidney development.…”

Registries of cleft lip/palate cases between 2004 and 2010 in Denizli, Turkey

“…Of particular interest was a decrease in spina bifida in Wales. The inconsistent trend in this anomaly across Europe Age (years) N % requires investigation (EUROCAT Statistical Monitoring Report, 2009;Loane et al, 2011). Therefore, we concluded that the prevalence of various types of clefts might differ between populations.…”

“…Countries with the highest and lowest rates are Japan (19.05) and South Africa (3.13), respectively. In the United States, the national rate averages 7.75, with highest and lowest rates in Maryland (21.46) and West Virginia (2.59), respectively (Loane et al, 2011;Tanaka et al, 2012). Other reported incidences are 1.94 and 1.46 cleft cases per 1000 live birth in the Philippines and Brazil (Martelli-Junior et al, 1998;Murray, 2002).…”

Medfødte misdannelser med basis i Medisinsk fødselsregister; tidstrender og mulige sammenhenger

“…Den sentrale databasen kan dermed brukes til årsaksforskning om medfødte misdannelser med et helt annet antall tilfeller enn om hvert enkelt land skulle gjøre disse analysene alene. I tillegg gjøres det epidemiologiske overvåkningsanalyser sentralt, både for alle registrene totalt og for hvert enkelt register, med utgangspunkt i denne databasen (22).…”