Serial examination of 20,248 newborn fetuses and infants: Correlations between drug exposure and major malformations

Maternal medication during the first trimester of pregnancy has been discussed as a risk factor for development of birth defects. The correlation between maternal drug use and major malformations was investigated in a population-based case-control study in Mainz. Over a period of 5 years (1990–1994), 20,248 livebirths, stillbirths, and abortions underwent physical and sonographic examination, and anamnestic data were collected. A total of 1,472 births with congenital anomalies (cases) and 9,682 births without major and minor malformations (controls) were analyzed. We distinguished between 30 different drug categories, which were divided into medication taken continuously (before and during …

Serial examination of 20,248 newborns: Correlations between drug exposure and major malformations

Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990-1998).

Prevalence rates of birth defects in the Federal Republic of Germany are informative to assess the general background risk of having a child with a birth defect. They provide basic figures to determine temporal and regional prevalence trends, to evaluate and initiate preventive measures and to initiate research projects. To avoid observer, definition and collection bias, active monitoring systems are required. Data collected in the active monitoring system of the Mainz Birth Defects Registry are presented. From 1990-1998, 30,940 live-births, stillbirths and abortions underwent standardized physical and sonographic examinations. Anamnestic data were collected from prenatal care records, mate…

Prä- und postnatales Nierenscreening im Vergleich: eine Analyse von 34.450 Neugeborenen des Geburtenregisters Mainzer Modell

Zielsetzung. Fehlbildungen des internen Urogenitalsystems sind haufig und stellen die zweithaufigste Organkategorie dar. Anhand des Mainzer Geburtenregisters werden populationsbezogene Pravalenzen von Nierenfehlbildungen, die Sensitivitat des pranatalen Ultraschalls und die Haufigkeit operationsbedurftiger Befunde ermittelt. Material und Methode. Im Zeitraum von 1990–2001 erhielten alle in Mainz geborenen Kinder neben einer klinischen Untersuchung eine Ultraschalluntersuchung der ableitenden Harnwege. Bei Totgeborenen, Spontanaborten (≥15. SSW) und induzierten Aborten wurden die Befunde der Pathologie in die Erfassung einbezogen. Seit 1996 (nach Einfuhrung des Fehlbildungsschalles in die Mu…

Erhöht mütterliche Adipositas das Risiko für kindliche Fehlbildungen?

Aim To investigate the risk of congenital malformations for newborn of obese women (BMI > or = 30) compared with women of average prepregnancy weight. Methods We performed a prospective, population-based case-control study of 20,248 newborn born in the city of Mainz. A total of 1,451 infants (cases) with and 8,088 without congenital malformations (controls) were analysed. The relative risks of associations between obesity and malformations were calculated as odds ratios (OR) with 95% confidence intervals (CI). Results The prevalence of malformations in children of obese mothers is 11.1% and thus approximately 4% higher than those of the total study population. There is a significant odds ra…

Klinisches Neugeborenenscreening zur Erfassung angeborener Fehlbildungen

Epidemiologische Daten eines klinischen Neugeborenenscreenings sind die Grundlage, zeitliche und regionale Trends von Fehlbildungspravalenzen zu erfassen, Risikofaktoren und damit Ansatzpunkte fur Praventionsmasnahmen zu ermitteln, Praventionsmasnahmen zu veranlassen bzw. zu uberprufen sowie Forschungsprojekte zu initiieren. Zur Erfassung valider Daten und zur Vermeidung von Beobachter-, Definitions- und Selektionsverzerrungen sollten aktive Erfassungssysteme verwendet werden. 34.211 Lebendgeborene, Totgeborene und Aborte der populationsbezogenen Geburtenkohorte des aktiven Mainzer Geburtenregisters wurden nach einem standardisierten Schema klinisch und sonographisch untersucht und anamnest…

Evidence for a teratogenic risk in the offspring of health personnel exposed to ionizing radiation?!

Background The evidence concerning safety of occupational exposure to ionizing radiation on teratogenic effects mainly relies on animal models, disaster epidemiology and experience in cancer etiology. Following an explorative result on maternal exposure in medical occupations we conducted a feasibility study, addressing congenital anomalies (CA) in the offspring of health workers potentially exposed to radiation. Methods In a prospective follow-up study, we enrolled women, identified by mandatory registration at the office of radiation protection as wearing a dosimeter. The participating women answered a questionnaire and if pregnant agreed to an examination of their infant. CA were diagnos…

Congenital Pediatric Diseases

Major congenital malformations are diagnosed in 4%–6% of all infants and fetuses (Lynberg and Edmonds 1992). About one third of them are the leading cause for infant mortality or morbidity (Grandjean et al. 1999). Malformations of the internal urogenital system are diagnosed in about 1% of all infants and account for approximately 20% of all congenital malformations, thus being one of the three most frequent birth defects (Table 11.1.1). Therefore a pre- and/or postnatally performed ultrasound screening for malformations of the internal urogenital system should be part of the routine to reduce perinatal mortality and morbidity. The reliability and value of ultrasonographic screening for con…