Secular Changes in the Incidence of Malformations of the Central Nervous System

MacMahon, Brian; Record, R. G.; McKeown, Thomas

doi:10.1136/jech.5.4.254

Cited by 12 publications

(5 citation statements)

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“…The great majority of these lethal malformations would have been to the central nervous system, and so unrelated to quality of postnatal medical care. A specific study in Birmingham of the two commonest of such malformations (anencephalus and spina bifida) by MacMahon, Record and McKeown (1951), showed the same peak extending over the years 1940-3, which could not be attributed to changes in mean age of the mothers or in birth rank, or to any epidemic. It may not be wholly out of place to remark that the mental and emotional stresses upon a population during wartime could be responsible for these congenital malformations.…”

Section: Prenatal Impairment In Manmentioning

confidence: 94%

Abnormal Mothering as a Cause of Mental Subnormality—i. A Critique of Some Classic Studies of Maternal Deprivation in the Light of Possible Congenital Factors

Stott

1962

Child Psychology Psychiatry

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Section: Prenatal Impairment In Manmentioning

confidence: 94%

Abnormal Mothering as a Cause of Mental Subnormality—i. A Critique of Some Classic Studies of Maternal Deprivation in the Light of Possible Congenital Factors

Stott

1962

Child Psychology Psychiatry

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“…Between 1936 and the early 1960s, the birth prevalence rates of both anencephaly and spina bifida in Great Britain peaked twice (Fig. 1) (2,16–19). The first peak occurred around 1940 and the second peak in the mid to late 1950s.…”

Section: Prevalence Of Ntdsmentioning

confidence: 99%

Epidemiology of Neural Tube Defects

2003

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Summary: Neural tube defects (NTDs)-malformations secondary to abnormal neural tube closure between the third and fourth weeks of gestational age-have a complex and imperfectly understood etiology in which both genetic and environmental factors appear to be involved. A number of specific chromosomal or single-gene disorders, presumably not affected by environmental influences, are associated with the development of NTDs, but such syndromal cases account for a small proportion of NTDs in live-born infants. Analysis of recurrence patterns within families and of twin-concordance data provides evidence of a genetic influence in nonsyndromal cases, but factors such as socioeconomic status and geographic area (independent of race or ethnicity) are also associated with variations in the incidence of NTDs. The prevalence at birth of both anencephaly and spina bifida has decreased, but the advent of antenatal diagnosis and elective termination of affected pregnancies has undermined the reliability of birth prevalence rate as an estimate of incidence. Some occupational and other exposures, including maternal use of antiepileptic drugs (AEDs), are associated with increased risk for NTDs. Among women who have had an NTD-affected pregnancy, recurrence risk is markedly higher than the risk for a first NTD-affected pregnancy in the general population. There is strong evidence, overall, for a protective effect of adequate folate consumption. In some high-risk groups, however, such as women taking AEDs, folate supplementation has not been proven to reduce NTD risk.

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“…Valid testing of any genetic or other hypothesis proposed in explanation for the occurrence of these defects requires complete ascertainment within a welldefined population at risk, hence surveys of spina bifida cystica and hydrocephalus are more difficult to conduct because of the varying proportions of births so affected who are still surviving and because of problems relating to diagnosis. Several investigators (Record and McKeown 1949, MacMahon et al 1951, Edwards 1958) have considered only fatal cases of spina bifida and hydrocephalus (observed as stillbirths and infant deaths), but as the proportion of such infants surviving beyond one year of age may be increasing, both fatal and non-fatal cases need to be considered.…”

Section: Introductionmentioning

confidence: 99%

Major Central Nervous System Malformations Notified in Northern Ireland 1964–1968

Elwood¹

1972

Develop Med Child Neuro

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SUMMARY Of 171,076 live and stillbirths in Northern Ireland during the years 1964 to 1968, there were 607 cases of anencephalus, 613 of spina bifida and 409 of hydrocephalus. The data were obtained from official statistics and from the voluntary notification system for congenital malformations which has been in operation in Northern Ireland, England and Wales since 1964. The malformation rates per 1,000 live and stillbirths were 3.5 for anencephalus, 3.6 for spina bifida and 2.4 for hydrocephalus. All areas of Northern Ireland were found to have high frequencies of the three defects and there was a significant excess in females and in urban compared with rural areas. None of the malformation rates varied markedly between one year and another, nor was there any significant variation according to season of the year. RÉSUMÉ Malformations graves du systPme nerveux central en Irlande du Nord 1964–1968 Sur on total de 171.076 enfants nés vivants ou morts‐nés en Irlande du Nord durant les années 1964–1968, il a été observé 607 cas d'anencéphalie, 613 de spina bifida et 409 d'hydro‐céphalie. Ces données ont été obtenues à partir des statistiques officielles et du système de notification volontaire des malformations congénitales en action en Trlande du Nord, Angleterre et Pays de Galles depuis 1964. Le taux de malformations pour 1000 enfants nés vivants ou morts‐nés a été de 3,5 pour l'anencéphalie, 3,6 pour le spina bifida et 2,4 pour l'hydrocéphalie. Une grande fréquence de ces trois malformations a été observée dans toutes les régions d'Irlande du Nord; il a été observé un écart significatif du nombre de cas féminins, plus élevé dans les régions urbaines que dans les régions rurales. Il n'a été observé aucune variation marquée d'une année à l'autre, ni d'une saison à l'autre au cours d'une même année. ZUSAMMENFASSUNG Die am häufgsten aujiretenden Mißbildungen des ZNS in Nord Irrland, 1964–1968 Von 171.076 Lebend‐und Totgeburten in Nord Irrland in den Jahren von 1964–1968 waren 607 Fälle mit Anencephalus, 613 mit Spina bifida und 409 mit Hydrocephalus. Die Daten wurden offiziellen Statistiken und dem freiwilligen Meldewesen für angeborene Mißbildungen, das in Nord Irrland, England und Wales seit 1964 besteht, entnommen. Die Mißbildungsrate pro 1000 Lebend‐und Totgeburten war 3.5 für Anencephalus, 3.6 für Spina bifida und 2.4 für Hydrocephalus. Für ganz Nord Irrland fand man eine hohe Frequenz der drei Defekte, sowie eine signifikant größere Anzahl weiblicher Patienten in Stadtbezirken als in Landbezirken. Keine der Mißbildungsraten zeigte eine auffallende Jahresdifferenz und auch keine signifikante jahreszeitliche Häufung. RESUMEN Malformaciones mayores del sistema nervioso central en el Norte de Irlanda (1964–1968) De un total de 171.076 recién nacidos vivos o muertos en Irlanda del Norte durante los años 1964 a 1968 hubo 607 casos de anencefalia, 613 de espina bífida y 409 de hidrocefalia. Los datos fueron obteni dos de estadísticas oficiales y del sistema de notificación volunta ria de malformaciones congénitas qu...

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Secular Changes in the Incidence of Malformations of the Central Nervous System

Cited by 12 publications

References 0 publications

Abnormal Mothering as a Cause of Mental Subnormality—i. A Critique of Some Classic Studies of Maternal Deprivation in the Light of Possible Congenital Factors

Abnormal Mothering as a Cause of Mental Subnormality—i. A Critique of Some Classic Studies of Maternal Deprivation in the Light of Possible Congenital Factors

Epidemiology of Neural Tube Defects

Major Central Nervous System Malformations Notified in Northern Ireland 1964–1968

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