Background: Estimates of the proportion of birth defects diagnosed before birth exist for only a few types of birth defects and for a few geographic regions in the United States. This population-based study examines rates of prenatal diagnosis for previously unstudied birth defects in a new geographic region. Methods: Active surveillance of 23 categories of birth defects among 111,902 infants born in 77 birthing hospitals in Texas in 1995 identified 852 infants or fetuses with major birth defects. Surveillance was conducted by the Texas Birth Defects Monitoring Program of the Texas Department of Health. Two regions were covered, the Houston/Galveston metropolitan area as well as the Lower Rio Grande Valley of Texas. Rates of prenatal diagnosis were evaluated for 23 different types of birth defects, using proportions and 95% confidence intervals. Results: One third of the 852 infants or fetuses with birth defects were prenatally diagnosed. Diagnosis rates varied greatly depending on the type of birth defects and were lower among infants born to Black and Hispanic women. More than 60% of anencephaly, encephalocele, gastroschisis and trisomies 13 and 18 were diagnosed antenatally. Many of the fetuses that were electively terminated had birth defects or combinations of birth defects that were potentially lethal. Prevalence rates for birth defects generally do not include fetuses that die or are electively terminated before 20 weeks of gestation. Thus, 36% of anencephaly, 21% of omphalocele, 15% of encephalocele and between 7 and 10% of spina bifida, hydrocephaly, renal agenesis, and trisomies 13, 18, and 21 were not included in our published rates. Conclusions: Published rates for specific types of birth defects are spuriously low. This should be considered when investigating alleged clusters and comparing rates of birth defects across geographic areas. Since many elective abortions are for lethal or potentially lethal birth defects, a major effect of prenatal diagnosis is the resultant decrease in infant mortality attributable to birth defects.
D. Kim Waller, PhD, Assistant Professor of Epidemiology
University of Texas Houston Health Science Center
School of Public Health, 1200 Hermann Pressler Drive, W-210
Houston, TX 77225 (USA)
Tel. +1 713 500 9155, Fax +1 713 500 9149, E-Mail email@example.com
Received: Received: October 15, 1999
Accepted: March 16, 2000
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 2, Number of References : 20
Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)
Formerly ‘Fetal Therapy’
Official Organ of the ‘International Fetal Medicine, Surgery Society’ and the International Society ‘Fetus as a Patient’
Vol. 15, No. 6, Year 2000 (Cover Date: November-December 2000)
Journal Editor: W. Holzgreve, Basel
ISSN: 1015–3837 (print), 1421–9964 (Online)
For additional information: http://www.karger.com/journals/fdt
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