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Prevalence of esophageal atresia among 18 international birth defects surveillance programs
Authors:Natasha Nassar  Emanuele Leoncini  Emmanuelle Amar  Jazmín Arteaga‐Vázquez  Marian K Bakker  Carol Bower  Mark A Canfield  Eduardo E Castilla  Guido Cocchi  Adolfo Correa  Melinda Csáky‐Szunyogh  Marcia L Feldkamp  Babak Khoshnood  Danielle Landau  Nathalie Lelong  Jorge S López‐Camelo  R Brian Lowry  Robert McDonnell  Paul Merlob  Julia Métneki  Margery Morgan  Osvaldo M Mutchinick  Miland N Palmer  Anke Rissmann  Csaba Siffel  Antonin Sìpek  Elena Szabova  David Tucker  Pierpaolo Mastroiacovo
Institution:1. Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Australia;2. Center of the International Clearinghouse for Birth Defects Surveillance and Research, Rome, Italy;3. Rhone‐Alps Registry of Birth Defects REMERA, Lyon, France;4. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Departamento de Genética, Registro y Vigilancia Epidemiológica de Malformaciones Congénitas, Mexico City, Mexico;5. EUROCAT Northern Netherlands, Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;6. Western Australian Register of Developmental Anomalies, Perth, Australia;7. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas;8. Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil;9. Estudio Colaborativo Latino Americano de Malformaciones Congenitas at Centro de Educación Médica e Investigación Clínica, Buenos Aires, Argentina;10. Estudio Colaborativo Latino Americano de Malformaciones Congenitas at Laboratório de Epidemiologia de Malforma??es Congênitas, Instituto Oswaldo Cruz, Funda??o Oswaldo Cruz, Rio de Janeiro, Brazil;11. Indagine Malformazioni congenite Emilia Romagna Registry, Department of Pediatrics, Bologna University, Bologna, Italy;12. Metropolitan Atlanta Congenital Defects Program, Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;13. Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi;14. Department of Hungarian Congenital Abnormality Registry and Surveillance, National Center for Healthcare Audit and Inspection, Budapest, Hungary;15. Division of Medical Genetics, University of Utah Health Sciences Center, Salt Lake City, Utah;16. Utah Birth Defect Network, Utah Department of Health, Salt Lake City, Utah;17. Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S953, Epidemiological Research on Perinatal Health and Women's and Children's Health, H?pital Cochin and UPMC University, Paris, France;18. Department of Neonatology, Soroka University Medical Center, Beer‐Sheba, Israel;19. Alberta Congenital Anomalies Surveillance System, Alberta Health and Wellness, Calgary, Canada;20. Dublin EUROCAT Registry, Health Service Executive, Dublin, Ireland;21. Department of Neonatology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel;22. Congenital Anomaly Register for Wales, Singleton Hospital, Swansea, Wales, United Kingdom;23. Malformation Monitoring Centre Saxony‐Anhalt, Otto‐von‐Guericke University Magdeburg, Germany;24. National Registry of Congenital Anomalies of the Czech Republic, Department of Medical Genetics, Thomayer University Hospital, Prague, Czech Republic;25. Slovak Teratologic Information Centre, Slovak Medical University, Bratislava, Slovak Republic
Abstract:BACKGROUND: The prevalence of esophageal atresia (EA) has been shown to vary across different geographical settings. Investigation of geographical differences may provide an insight into the underlying etiology of EA. METHODS: The study population comprised infants diagnosed with EA during 1998 to 2007 from 18 of the 46 birth defects surveillance programs, members of the International Clearinghouse for Birth Defects Surveillance and Research. Total prevalence per 10,000 births for EA was defined as the total number of cases in live births, stillbirths, and elective termination of pregnancy for fetal anomaly (ETOPFA) divided by the total number of all births in the population. RESULTS: Among the participating programs, a total of 2943 cases of EA were diagnosed with an average prevalence of 2.44 (95% confidence interval CI], 2.35–2.53) per 10,000 births, ranging between 1.77 and 3.68 per 10,000 births. Of all infants diagnosed with EA, 2761 (93.8%) were live births, 82 (2.8%) stillbirths, 89 (3.0%) ETOPFA, and 11 (0.4%) had unknown outcomes. The majority of cases (2020, 68.6%), had a reported EA with fistula, 749 (25.5%) were without fistula, and 174 (5.9%) were registered with an unspecified code. CONCLUSIONS: On average, EA affected 1 in 4099 births (95% CI, 1 in 3954–4251 births) with prevalence varying across different geographical settings, but relatively consistent over time and comparable between surveillance programs. Findings suggest that differences in the prevalence observed among programs are likely to be attributable to variability in population ethnic compositions or issues in reporting or registration procedures of EA, rather than a real risk occurrence difference. Birth Defects Research (Part A), 2012. © 2012 Wiley Periodicals, Inc.
Keywords:esophageal atresia  congenital anomalies  prevalence  epidemiology
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