Expanding the Massachusetts Birth Defects Monitoring Program to include additional pregnancy outcomes: Programmatic efforts and impacts on case ascertainment, 2012–2020

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2024-03-13 DOI:10.1002/bdr2.2323

Amy Fothergill, Rebecca F. Liberman, Eirini Nestoridi, Cara T. Mai, Lorraine F. Yeung, Cathleen Higgins, Mahsa M. Yazdy

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引用次数: 0

Abstract

Background

Birth defects affect 1 in 33 infants in the United States and are a leading cause of infant mortality. Birth defects surveillance is crucial for informing public health action. The Massachusetts Birth Defects Monitoring Program (MBDMP) began collecting other pregnancy losses (OPLs) in 2011, including miscarriages (<20 weeks gestation) or elective terminations (any gestational age), in addition to live births and stillbirths (≥20 weeks gestation). We describe programmatic changes for adding OPLs and their impact on prevalence estimates.

Methods

Using population-based, statewide, data from the MBDMP (2012–2020), we assessed prevalence per 10,000 live births and 95% confidence intervals (CIs) with and without OPLs overall and for specific birth defects by time period, maternal age, and race/ethnicity.

Results

Including OPLs required amending a state statute and promulgating regulations, new data sources, and additional data processing, cleaning, and verification. Overall prevalence with OPLs increased from 257.4 (95% CI: 253.5–261.4) to 333.9 (95% CI: 329.4–338.4) per 10,000; increases were observed in all time periods, age, and race/ethnicity groups. After including OPLs, the prevalence increased for neural tube defects [3.2 (2.7–3.6) to 8.3 (7.6–9.0)], and trisomies 13 [0.5 (0.3–0.7) to 4.1 (3.6–4.6)], 18 [1.5 (1.2–1.9) to 8.2 (7.5–8.9)], and 21 [12.3 (11.4–13.2) to 28.9 (27.6–30.2)]. Cardiovascular defects increased slightly, while prevalence of eye/ear, respiratory, and gastrointestinal defects remained similar.

Conclusions

Adding OPLs required substantial programmatic efforts and resulted in more complete case ascertainment, particularly for certain birth defects. More complete case ascertainment will allow for improved research, screening, and resource allocation.

查看原文本刊更多论文

扩大马萨诸塞州出生缺陷监测计划，纳入更多妊娠结果：2012-2020 年计划工作及对病例确定的影响。

背景：在美国，每 33 个婴儿中就有 1 个患有出生缺陷，这是婴儿死亡的主要原因之一。出生缺陷监测对于为公共卫生行动提供信息至关重要。马萨诸塞州出生缺陷监测计划（MBDMP）于 2011 年开始收集其他妊娠损失（OPL），包括流产（方法：通过马萨诸塞州出生缺陷监测计划（MBDMP）中的数据，对流产进行监测：利用马萨诸塞州出生缺陷监测计划（MBDMP）（2012-2020 年）中基于人口的全州数据，我们评估了每 10,000 例活产的患病率和 95% 的置信区间（CIs），包括有无 OPLs 的总体患病率，以及按时间段、孕产妇年龄和种族/民族划分的特定出生缺陷的患病率：将 OPL 纳入其中需要修改州法规和颁布条例、新的数据来源以及额外的数据处理、清理和验证。有 OPLs 的总体患病率从每 10,000 人中 257.4 例（95% CI：253.5-261.4 例）上升到 333.9 例（95% CI：329.4-338.4 例）；在所有时间段、年龄和种族/民族组中都观察到了患病率的上升。在包括 OPL 后，神经管畸形[3.2（2.7-3.6）升至 8.3（7.6-9.0）]、13[0.5（0.3-0.7）升至 4.1（3.6-4.6）]、18[1.5（1.2-1.9）升至 8.2（7.5-8.9）]和 21[12.3（11.4-13.2）升至 28.9（27.6-30.2）]的患病率均有所上升。心血管缺陷略有增加，而眼/耳、呼吸道和胃肠道缺陷的发病率保持相似：增加 OPLs 需要大量的计划工作，但却能更全面地确定病例，尤其是某些出生缺陷。更全面的病例确定将有助于改进研究、筛查和资源分配。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.