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[Abdominal wall defects from 1961 to 2000--incidence, prenatal diagnosis and prevalence by maternal age]
Insights
Abdominal wall defects like omphalocele and gastroschisis decreased in the Czech Republic due to prenatal diagnosis. Maternal age impacts risk: older women face higher omphalocele risk, while younger and older women have higher gastroschisis risk.
Area of Science:
- Medical Genetics
- Epidemiology
- Public Health
Context:
- Congenital abdominal wall defects, specifically omphalocele and gastroschisis, represent significant public health concerns.
- Understanding their incidence and risk factors is crucial for effective prenatal care and management.
Purpose:
- To analyze the prevalence and trends of omphalocele and gastroschisis in the Czech Republic from 1961 to 2000.
- To investigate the association between maternal age and the risk of these congenital defects.
Summary:
- A retrospective epidemiological study analyzed 2293 cases of abdominal wall defects registered between 1961 and 2000 in the Czech Republic.
- Omphalocele (1450 cases) and gastroschisis (843 cases) showed varying prenatal diagnosis rates, with 378 pregnancies terminated following prenatal diagnosis.
- A significant decline in neonatal incidence was observed, attributed to advancements in prenatal diagnostic capabilities.
Impact:
- The study highlights a significant decrease in neonatal abdominal wall defects, likely due to improved prenatal diagnosis.
- Identified specific maternal age groups at higher risk for omphalocele (over 39 years) and gastroschisis (under 18 and over 39 years).
- Findings can inform targeted screening programs and genetic counseling for at-risk populations.
Objective:
Presentation of defects of the abdominal wall--omphalocele and gastroschisis--in the Czech Republic during 1961 to 2000. Analysis of the prevalence of these defects in different groups by maternal age.
Design:
Retrospective demographic epidemiological study.
Setting:
Institute for the Care of Mother and Child, Prague.
Method:
Data from the nationwide registration of congenital defects were used which are kept in the Institute for Health Information and Statistics of the CR and data on the prenatal diagnosis from different departments of medical genetics. Epidemiological analysis of the incidence of defects of the abdominal wall--omphalocele and gastroschisis, diagnosed pre- and postnatally in the Czech Republic in 1961-2000. For the mathematical and statistical analysis of the prevalence of these defects by maternal age the method of calculation of the 95% confidence interval of probability was used.
Results:
In the Czech Republic during the period of 1961-2000 a total of 2293 cases of abdominal wall defects were registered. From this total number of notified defects 1915 cases were diagnosed after delivery, prenatal diagnosis was made in 378 cases and pregnancy was therefore terminated prematurely. From the total number of abdominal wall defects there were 1450 cases of omphalocele (incl. 136 prenatally diagnosed cases) and 843 cases of gastroschisis (incl. 242 cases diagnosed prenatally).
Conclusion:
The authors found a significant decrease in the incidence in the neonatal population of the Czech Republic due to the advances of prenatal diagnosis in the recent decade. As regards omphalocele there is a significantly higher risk in women older than 39 years, in the case of gastroschisis there is a higher risk for women under 18 years and women above 39 years.