Environmental epidemiology at the Medical Birth Registry of Norway; strengths and limitations.
A national registry of all pregnancy-outcomes was started in Norway. in 1967 to facilitate epidemiological surveillance. One aim was to detect increases in birth detect prevalences that was caused by new harmful exposures. Over the years several studies of unexpected time-trends and regional differences have been performed, but specific harmful exposures have so far not been detected. In a study of possible effects of the Chernobyl fallout, the registry enabled a detailed investigation of a possible increase in prevalence of birth detects that occurred specifically in the most exposed areas of Norway. The strength of this approach was the population coverage of the registry, while important limitations were incomplete reporting (outcome misclassification) and crude exposure information (exposure misclassification). While still taking advantage of the population coverage of the medical birth registry, a new generation of studies with more complete case ascertainment and individual exposure information are being prepared. One particularly interesting new option is to use molecular genetic tools to identity susceptible mothers or children. Collection and storage of biological specimens on a large scale is challenging, but in the search for gene-environment interactions, population-based studies are particularly attractive.
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Section for Medical Informatics and Statistics, University of Bergen, Norway.
D000013:Congenital Abnormalities / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D012042:Registries