X hits on this document

PDF document

Adolfo Correa-Villase ˜nor,* Janet Cragan, James Kucik, Leslie O’Leary, Csaba Siffel, ... - page 6 / 8

48 views

0 shares

0 downloads

0 comments

6 / 8

622

˜ CORREA–VILLASENOR ET AL.

ment of uniform methods and approaches to birth defect surveillance and a prototype for active case ascertainment surveillance across the United States and around the world. The program has served as a training ground for a large number of professionals active in birth defects epi- demiology, including CDC Epidemic Intelligence Service Officers, visiting scientists, fellows, preventive medicine residents, and medical and public health students. Such training has been important for building professional ca- pacity in birth defects epidemiology in state health depart- ments, federal agencies, universities, and private industry.

In its 35 years of continuous operation, MACDP has provided data from which numerous valuable scientific findings have been made in the field of birth defects epi- demiology. Ongoing analyses of data from current studies and contributions to collaborative studies are certain to further extend our knowledge of the etiology of birth de- fects.

Figure 3. Reported prevalence of congenital heart defects, Metro- politan Atlanta Congenital Defects Program, 1968-1998.

DISCUSSION

Since its inception, MACDP has served as a model for many state-based programs, a resource for the develop-

As birth defects continue to be an important cause of morbidity and mortality in children and as the causes of many birth defects remain unknown, there is a need to evaluate our current birth defects monitoring and research activities and to consider ways of enhancing such efforts. Current projects that represent an expansion of our sur- veillance capabilities and tools are: (1) development of an electronic database that will allow for more efficient inte-

Case-control Ecologic

Possible association No association

Case-control Case-control

No association Findings support an association

Case-control Case-control

No association Reduction in risk among offspring of users of multivitamins

Secular trends Case-control Case-control Case-control

Decline in congenital rubella Association with several defects No association An association

Case review and secular trends Case-control

Decrease in at birth prevalence of anencephaly Reduction in risk of conotruncal defects

Case-control

Possible association

Case-control

Possible gene-environment interaction

Secular trends

Increasing and decreasing trends with racial variations Possible reduction in risk

Case-control

Cohort

Improved survival over time; prognostic factors include presence of other defects, low birth weight, race

Table 2 Examples of Uses of Data from the Metropolitan Atlanta Congenital Defects Program, 1971–2001

Year 1972

1973

1975 1976

1979 1980

1984 1988

1989 1990 1994 1995

1995

1996

1996

2000

2001

2001

2003

Type of study Case review

Secular trends

Findings

None of the mothers of cases with reduction deformity used the drugs No change in rates of birth defects

Author Rachelefalsy

CDC

Saffra Erickson

Edmonds Layde

Erickson Mulinare

Cochi Becerra Sylvester Olney

Roberts

Botto

Watkins

Honein

Botto

Itikala

Siffel

Concern

Increased rate of phocomelia with

use of tricyclic antidepressants Increased rates of birth defects

with increased sales of spray adhesives Diazepam and cleft lip Water fluoridation and birth

defects Airport noise and birth defects Maternal fever and neural tube

defects Vietnam veterans and birth defects Periconceptional use of

multivitamins and neural tube defects Maternal rubella and birth defects Maternal diabetes and birth defects

Anesthesia and birth defects Chorionic villus sampling and

transverse digital deficiency Impact of prenatal diagnosis on at

birth prevalence of birth defects Periconceptional multivitamin use

and heart defects Maternal obesity and neural tube

defects Maternal smoking, family history

and clubfoot Temporal trends and racial

variations in heart defects Periconceptional multivitamin use

and orofacial clefts Survival of and prognostic factors

for infants with encephalocele

Birth Defects Research (Part A) 67:617–624 (2003)

Document info
Document views48
Page views48
Page last viewedTue Jan 24 12:08:43 UTC 2017
Pages8
Paragraphs212
Words6035

Comments