Major congenital anomalies in a Danish region

Dan Med J. 2014 Jun;61(6):A4825.

Abstract

Introduction: This study describes the prevalence of congenital anomalies and changes over time in birth outcome, mortality and chronic maternal diseases.

Material and methods: This study was based on population data from the EUROCAT registry covering the Funen County, Denmark, 1995-2008. The registry covers live births, foetal deaths with a gestational age (GA) of 20 weeks or more, and terminations of pregnancy due to congenital anomalies (TOPFA).

Results: The overall prevalence of congenital anomalies was 2.70% (95% confidence interval: 2.58-2.80). The majority of cases had an isolated congenital anomaly, 13.9% had a chromosomal anomaly and 7.7% were multiple congenital anomalies. The combined foetal and infant mortality in the study area was 11.6 per 1,000 births. 19% (2.2 per 1,000) of these deaths were foetuses and infants with major congenital anomalies. Combined foetal and infant mortality decreased significantly over time for cases with major congenital anomalies (p < 0.001), whereas the number and proportion of TOPFA increased. Median GA at TOPFA decreased from 18 to 15 weeks. Among the congenital anomaly cases, 8% had a registration of one of these chronic maternal diseases: diabetes, epilepsy, mental disorder, thyroid disease, asthma, or inflammatory bowel disease. Medication for these conditions accounted for 46% of maternal drug use.

Conclusion: Maternal morbidity and use of potentially teratogenic medication have increased among congenital anomaly cases. Foetal and infant mortality for congenital anomaly cases have decreased significantly, probably owing to an increase in early prenatal diagnosis and TOPFA.

Funding: The study was funded by Region of South Denmark.

Trial registration: not relevant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / epidemiology*
  • Abnormalities, Multiple / mortality
  • Abortion, Eugenic / trends*
  • Asthma / drug therapy
  • Asthma / epidemiology
  • Chromosome Disorders / epidemiology*
  • Chromosome Disorders / mortality
  • Denmark / epidemiology
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology
  • Epilepsy / drug therapy
  • Epilepsy / epidemiology
  • Female
  • Fetal Mortality / trends*
  • Gestational Age
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology
  • Mental Disorders / drug therapy
  • Mental Disorders / epidemiology
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / epidemiology*
  • Prevalence
  • Registries
  • Thyroid Diseases / drug therapy
  • Thyroid Diseases / epidemiology