[Nation-wide registration of limb deficiencies in Germany]

A detailed registration of the frequency and the aetiology of limb deficiencies has been established for the first time in Germany.

According to the ESPED model (Documentation of rare paediatric diseases in Germany) we send out at an interval of three months a questionnaire for registration of live births, still births and their limb deficiencies to 1 073 gynaecological hospitals. In case of a positive response for a limb deficiency a second questionnaire is sent for details about pregnancy, birth and family. The limb defects are registered according to the ICD-10 classification and statistically analysed.

Current acquisition period: 48 months (April 2000-April 2004). Total number of registered births: 1 070 541. Number of live births with limb deficiencies: 1 534 (0.14 %). Number of still births with limb deficiencies: 55 (1.7 %). Minor limb deficiencies such as polydactyly (22.4 %) are more frequent than major deficiencies of the tibia (1.0 %) or of the fibula (1.6 %). A familiar disposition is found in 9.7 %. A correlation to the profession of parents or their age (mother: 29, father: 33), or nicotine abuse could not be detected. The numbers of special features during pregnancy (amniocentesis in 3.3 %, oligohydramnion in 0.5 %, polyhydramnion in 0.3 %, etc.) and during delivery (relation between normal delivery and caesarean section = 59.5 %/29 %, etc.) were similar to the frequencies in the normal population.

Our register represents the largest study world-wide in respect to the birth rate and the most accurate record of limb deficiencies. In the current acquisition period no correlation of the registered limb deficiencies to environmental effects, individual misbehaviour, exposed professional group and peculiarities during pregnancy and parturition could be found. The continuation of our register is essential for further detection of the incidence and aetiology of limb defects.