Congenital abnormalities in a Vermont County. Detection and medical care

A retrospective cohort study of congenital abnormalities was undertaken on all the 1813 children born in 1952 to the residents of Chittenden County, Vermont. Multiple screening procedures were utilized and included questionnaires to parents, review of hospital charts, hospital pediatric-consultant records, death certificates, hospital pathological files and agencies for crippled and retarded children. Information was obtained for 1775 of the 1813 children (89 per cent). Two hundred and thirty-eight children with 270 malformations were discovered, and the incidence of malformations was 152.1 per 1000 live births; 42.6 per cent of the defects were discovered in the perinatal period. An additional 16.3 per cent were detected between the ages of one month and one year, and 36.3 per cent were discovered initially after one year of age. An assessment of the level of professional care required for the abnormalities discovered indicated that 33.6 per cent required no care, 42.9 per cent required short-term care, and 23.5 per cent required long-term continuing care. The early discovery of congenital defects in this study was accomplished less frequently than in many prospective studies in which screening was likely to be more comprehensive and less representative of reality. The only method of improving early medical care for children handicapped by congenital defects is by serial observation of families over long periods by trained personnel.