Impact of prenatal diagnosis and selective abortions on the frequency of congenital malformations
Objective. To evaluate the impact of prenatal diagnosis of congenital malformations (CMF) and induced abortions on the level of congenital anomalies among newborns.Demikova N.S., Podolnaya M.A., Lapina A.S. Asanov, A.Yu.
Material and methods. The study material was CMF cases among live-born and stillborn infants and fetuses during the period 2010 to 2014. The analysis included gross malformations (anencephaly, encephalocele, myelocele, hydrocephalus, omphalocele, gastroschisis, renal agenesis, transposition of the great vessels, hypoplastic left heart syndrome, diaphragmatic hernia, and bladder exstrophy, cleft lip/palate, cleft palate, reduction defects of the limbs, esophageal atresia, anorectal atresia, hypospadias, epispadia) and Down syndrome.
Results. The frequencies of each defect were determined with and without considering fetuses. The defects with a high level of abortion include anencephaly, encephalocele, and bilateral renal agenesis. The abortion rates in cases of Down syndrome are 34% after prenatal diagnosis according to the monitoring data. As a result of inclusion of data on induced abortions, the frequency of defects varies considerably: anencephaly (by 7.48 times), and encephalocele (by 3.18 times), renal agenesis (by 2.53%), and omphalocele (by 2.39 times). The incidence of Down syndrome among newborns without regard to fetuses reduces by 1.5 times.
Conclusion. Taking into account CMF not only in newborns, but also in fetuses with this condition can determine the true frequency of congenital anomalies and evaluate the impact of prenatal diagnosis on the level of CMF among newborns.
Keywords
congenital malformations
prenatal diagnosis
frequency
induced abortions
Supplementary Materials
- Table 1. The number, rates of congenital malformations (CM) and proportion of induced abortions
- Table 2. Impact of including of induced abortions on CM rates
- Table 3. The proportion of induced abortions with CM in the monitoring of the Russian Federation and EUROCAT
References
1. Garne E., Stoll C., Clementi M.; Euroscan Study Group. Evaluation of prenatal diagnosis of congenital heart diseases by ultrasound: experience from 20 European registries. Ultrasound Obstet. Gynecol. 2001; 17(5): 386-91. doi: 10.1046/j.1469-0705.2001.00385.x.
2. Garne E., Haeusler M., Barisic I., Gjergja R., Stoll C., Clementi M.; Euroscan Study Group. Congenital diaphragmatic hernia: evaluation of prenatal diagnosis in 20 European regions. Ultrasound Obstet. Gynecol. 2002; 19(4): 329-33. doi: 10.1046/j.1469-0705.2002.00635.x.
3. Haeusler M.C., Berghold A., Stoll C., Barisic I., Clementi M.; Euroscan Study Group. Prenatal ultrasonographic detection of gastrointestinal obstruction: results from 18 European congenital anomaly registries. Prenat. Diagn. 2002; 22(7): 616-23. doi: 10.1002/pd.341.
4. Ethen M.K., Canfield M.A. Impact of including elective pregnancy terminations before 20 weeks gestation on birth defect rates. Teratology. 2002; 66(Suppl. 1): 32-5. doi: 10.1002/tera.90008.
5. Forrester M.B., Merz R.D., Yoon R.W. Impact of prenatal diagnosis and elective termination on the prevalence of selected birth defects in Hawai. Am. J. Epidemiol. 1998; 148(12): 1206-11.
6. Barisic I., Clementi M., Hausler M., Gjergja R., Kern J., Stoll C.; Euroscan Study Group. Evaluation of prenatal ultrasound diagnosis of fetal abdominal wall defect by 19 European registries. Ultrasound Obstet. Gynecol. 2001; 18(4): 309-16. doi: 10.1046/j.0960-7692.2001.00534.x.
7. Garne E., Loane M., Dolk H., De Vigan C., Scarano G., Tucker D. et al. Prenatal diagnosis of severe structural congenital malformations in Europe. Ultrasound Obstet. Gynecol. 2005; 25(1): 6-11. doi: 10.1002/uog.1784.
8. Available at: http://www.eurocat-network.eu/
Received 16.12.2016
Accepted 23.12.2016
About the Authors
Demikova Nataliya S., Chief Researcher, MD, Pirogov Russian National Research Medical University, Research Clinical Institute of Pediatric.125412, Russia, Moscow, Taldomskaya str. 2. E-mail: ndemikova@pedklin.ru
Podolnaya Marina A., Senior Researcher, Pirogov Russian National Research Medical University, Research Clinical Institute of Pediatric.
125412, Russia, Moscow, Taldomskaya str. 2. E-mail:mpodolnaya@pedklin.ru
Lapina Aleksandra S., Senior Researcher, PhD, Pirogov Russian National Research Medical University, Research Clinical Institute of Pediatric.
125412, Russia, Moscow, Taldomskaya str. 2. E-mail:alapina@pedklin.ru
Asanov Aliy Yu., Head of the Department of Medical Genetics, professor, MD, PhD., I.M. Sechenov First Moscow State Medical University.
119991, Russia, Moscow, Trubetskaya str. 8, bld. 2. E-mail:aliy@rambler.ru
For citations: Demikova N.S., Podolnaya M.A., Lapina A.S. Asanov, A.Yu. Impact of prenatal diagnosis and selective abortions on the frequency of congenital malformations. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (7): 130-5. (in Russian)
http://dx.doi.org/10.18565/aig.2017.7.130-5
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