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2030-01-01
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AMELIA: A MULTI-CENTER DESCRIPTIVE EPIDEMIOLOGIC STUDY IN A LARGE DATASET FROM THE INTERNATIONAL CLEARINGHOUSE FOR BIRTH DEFECTS SURVEILLANCE AND RESEARCH, AND OVERVIEW OF THE LITERATURE
Author
Bermejo-Sánchez, Eva
Cuevas, Lourdes
Amar, Emmanuelle
Bakker, Marian K.
Bianca, Sebastiano
Bianchi, Fabrizio
Canfield, Mark A.
Castilla, Eduardo E.
Clementi, Maurizio
Cocchi, Guido
Feldkamp, Marcia L.
Landau, Danielle
Leoncini, Emanuele
Li, Zhu
Lowry, R. Brian
Mastroiacovo, Pierpaolo
Mutchinick, Osvaldo M.
Rissmann, Anke
Ritvanen, Annukka
Scarano, Gioacchino
Siffel, Csaba
Szabova, Elena
Martínez-Frías, María-Luisa
Cuevas, Lourdes
Amar, Emmanuelle
Bakker, Marian K.
Bianca, Sebastiano
Bianchi, Fabrizio
Canfield, Mark A.
Castilla, Eduardo E.
Clementi, Maurizio
Cocchi, Guido
Feldkamp, Marcia L.
Landau, Danielle
Leoncini, Emanuele
Li, Zhu
Lowry, R. Brian
Mastroiacovo, Pierpaolo
Mutchinick, Osvaldo M.
Rissmann, Anke
Ritvanen, Annukka
Scarano, Gioacchino
Siffel, Csaba
Szabova, Elena
Martínez-Frías, María-Luisa
Affilliation
Instituto de Salud Carlos III (ISCIII). Instituto de Investigación de Enfermedades Raras (IIER). Madrid, Spain. / ECEMC (Spanish Collaborative Study of Congenital Malformations), Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III (ISCIII). Madrid, Spain / CIBER de Enfermedades Raras (CIBERER) (Centre for Biomedical Research on Rare Diseases). Madrid, Spain.
ECEMC (Spanish Collaborative Study of Congenital Malformations), Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III (ISCIII). Madrid, Spain / CIBER de Enfermedades Raras (CIBERER) (Centre for Biomedical Research on Rare Diseases). Madrid, Spain.
Rhone-Alps Registry of Birth Defects REMERA Lyon, France.
University Medical Center Groningen. Department of Genetics. Eurocat Northern Netherlands. Groningen, The Netherlands.
Centro di Consulenza Genetica e di Teratologia della Riproduzione. Laboratorio di Citogenetica. Dipartimento Materno Infantile. Catania, Italy.
CNR Institute of Clinical Physiology and CNR-Tuscany Region “Gabriele Monasterio” Foundation. Pisa, Italy.
Texas Department of State Health Services. Birth Defects Epidemiology and Surveillance Branch. Texas, USA.
INAGEMP (Instituto Nacional de Genética Médica Populacional), Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz.. CLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas). Rio de Janeiro, RJ, Brasil.
University of Padua, Department of Pediatrics, Clinical Genetics Unit. Padua, Italy.
Bologna University. Department of Pediatrics. IMER Registry. Bologna, Italy.
University of Utah Health School of Medicine. Division of Medical Genetics, Department of Pediatrics. Salt Lake City, Utah / Utah Department of Healt. Utah Birth Defect Network. Salt Lake City, Utah, USA.
Soroka University Medical Center. Department of Neonatology. Beer-Shaba, Israel.
Centre of the International Clearinghouse for Birth Defects Surveillance and Research. Rome, Italy.
Peking University Health Science Center. National Center for Maternal and Infant Health. Beijing, People’s Republic of China.
Alberta Health & Wellness. Alberta Congenital Anomalies Surveillance System. Alberta, Canada.
Centre of the International Clearinghouse for Birth Defects Surveillance and Research. Rome, Italy.
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. Departamento de Genética. RYVEMCE (Registro y Vigilancia Epidemiológica de Malformaciones Congénitas),. Mexico, México.
University Magdeburg. Medical Faculty Otto-von-Guericke. Malformation Monitoring Centre Saxony-Anhalt. Germany.
20Malformation Monitoring Centre Saxony-Anhalt. The Finnish Register of Congenital Malformations. THL, Helsinki, Finland.
General Hospital “G. Rummo” Benevento. Medical Genetics Dept. Birth Defects Campania Registry. Italy.
Centers for Disease Control and Prevention. Metropolitan Atlanta Congenital Defects Program, National Center on Birth Defects and Developmental Disabilities. Atlanta, Georgia, USA.
Slovak Medical University. Slovak Teratologic Information Centre. Bratislava, Slovak Republic.
ECEMC (Spanish Collaborative Study of Congenital Malformations), Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III (ISCIII). Madrid, Spain / CIBER de Enfermedades Raras (CIBERER) (Centre for Biomedical Research on Rare Diseases). Madrid, Spain / Universidad Complutense de Madrid. Faculty of Medicine. Department of Pharmacology. Madrid, Spain.
ECEMC (Spanish Collaborative Study of Congenital Malformations), Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III (ISCIII). Madrid, Spain / CIBER de Enfermedades Raras (CIBERER) (Centre for Biomedical Research on Rare Diseases). Madrid, Spain.
Rhone-Alps Registry of Birth Defects REMERA Lyon, France.
University Medical Center Groningen. Department of Genetics. Eurocat Northern Netherlands. Groningen, The Netherlands.
Centro di Consulenza Genetica e di Teratologia della Riproduzione. Laboratorio di Citogenetica. Dipartimento Materno Infantile. Catania, Italy.
CNR Institute of Clinical Physiology and CNR-Tuscany Region “Gabriele Monasterio” Foundation. Pisa, Italy.
Texas Department of State Health Services. Birth Defects Epidemiology and Surveillance Branch. Texas, USA.
INAGEMP (Instituto Nacional de Genética Médica Populacional), Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz.. CLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas). Rio de Janeiro, RJ, Brasil.
University of Padua, Department of Pediatrics, Clinical Genetics Unit. Padua, Italy.
Bologna University. Department of Pediatrics. IMER Registry. Bologna, Italy.
University of Utah Health School of Medicine. Division of Medical Genetics, Department of Pediatrics. Salt Lake City, Utah / Utah Department of Healt. Utah Birth Defect Network. Salt Lake City, Utah, USA.
Soroka University Medical Center. Department of Neonatology. Beer-Shaba, Israel.
Centre of the International Clearinghouse for Birth Defects Surveillance and Research. Rome, Italy.
Peking University Health Science Center. National Center for Maternal and Infant Health. Beijing, People’s Republic of China.
Alberta Health & Wellness. Alberta Congenital Anomalies Surveillance System. Alberta, Canada.
Centre of the International Clearinghouse for Birth Defects Surveillance and Research. Rome, Italy.
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. Departamento de Genética. RYVEMCE (Registro y Vigilancia Epidemiológica de Malformaciones Congénitas),. Mexico, México.
University Magdeburg. Medical Faculty Otto-von-Guericke. Malformation Monitoring Centre Saxony-Anhalt. Germany.
20Malformation Monitoring Centre Saxony-Anhalt. The Finnish Register of Congenital Malformations. THL, Helsinki, Finland.
General Hospital “G. Rummo” Benevento. Medical Genetics Dept. Birth Defects Campania Registry. Italy.
Centers for Disease Control and Prevention. Metropolitan Atlanta Congenital Defects Program, National Center on Birth Defects and Developmental Disabilities. Atlanta, Georgia, USA.
Slovak Medical University. Slovak Teratologic Information Centre. Bratislava, Slovak Republic.
ECEMC (Spanish Collaborative Study of Congenital Malformations), Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III (ISCIII). Madrid, Spain / CIBER de Enfermedades Raras (CIBERER) (Centre for Biomedical Research on Rare Diseases). Madrid, Spain / Universidad Complutense de Madrid. Faculty of Medicine. Department of Pharmacology. Madrid, Spain.
Abstract
This study describes the epidemiology of congenital amelia (absence of limb/s), using the largest series of cases known to date. Data were gathered by 20 surveillance programs on congenital anomalies, all International Clearinghouse for Birth Defects Surveillance and Research members, from all continents but Africa, from 1968 to 2006, depending on the program. Reported clinical information on cases was thoroughly reviewed to identify those strictly meeting the definition of amelia. Those with amniotic bands or limb-body wall complex were excluded. The primary epidemiological analyses focused on isolated cases and those with multiple congenital anomalies (MCA). A total of 326 amelia cases were ascertained among 23,110,591 live births, stillbirths and (for some programs) elective terminations of pregnancy for fetal anomalies. The overall total prevalence was 1.41 per 100,000 (95% confidence interval: 1.26-1.57). Only China Beijing and Mexico RYVEMCE had total prevalences, which were significantly higher than this overall total prevalence. Some under-registration could influence the total prevalence in some programs. Liveborn cases represented 54.6% of total. Among monomelic cases (representing 65.2% of nonsyndromic amelia cases), both sides were equally involved, and the upper limbs (53.9%) were slightly more frequently affected. One of the most interesting findings was a higher prevalence of amelia among offspring of mothers younger than 20 years. Sixty-nine percent of the cases had MCA or syndromes. The most frequent defects associated with amelia were other types of musculoskeletal defects, intestinal, some renal and genital defects, oral clefts, defects of cardiac septa, and anencephaly.
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