title: Limb defects associated with major congenital anomalies: clinical and epidemiological study from the International Clearinghouse for Birth Defects Monitoring Systems.
abstract: Although limb defects associated with other congenital anomalies are rarely studied, they may provide insights into limb development that may be useful for etiologic studies and public health monitoring. We pooled data from 11 birth defect registries that are part of the International Clearinghouse for Birth Defects Monitoring Systems. We identified 666 infants, born from 1983 through 1993, who had a non-syndromal limb defect plus at least one other major malformation (rate 12.9/100,000 population). We used observed/expected ratios and log-linear models to detect association patterns. We found that specific limb defects occurred with relatively distinct sets of malformations. Preaxial limb defects occurred more frequently with microtia, esophageal atresia, anorectal atresia, heart defects, unilateral kidney dysgenesis, and some axial skeleton defects; postaxial defects with hypospadias; transverse defects with craniofacial defects, micrognathia, ring constrictions, and muscular defects; intercalary defects with omphalocele; split hand/foot with encephalocele; and amelia with anorectal atresia, omphalocele, severe genitalia defects, unilateral kidney dysgenesis, gastroschisis, and ring constriction. Log-linear modeling identified higher order associations among some of these same malformations.
authors.affiliation: International Centre for Birth Defects, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rosano
authors.forename: L D
authors.initials: LD
authors.lastname: Botto
authors.forename: R S
authors.initials: RS
authors.lastname: Olney
authors.forename: M J
authors.initials: MJ
authors.lastname: Khoury
authors.forename: A
authors.initials: A
authors.lastname: Ritvanen
authors.forename: J
authors.initials: J
authors.lastname: Goujard
authors.forename: C
authors.initials: C
authors.lastname: Stoll
authors.forename: G
authors.initials: G
authors.lastname: Cocchi
authors.forename: P
authors.initials: P
authors.lastname: Merlob
authors.forename: O
authors.initials: O
authors.lastname: Mutchinick
authors.forename: M C
authors.initials: MC
authors.lastname: Cornel
authors.forename: E E
authors.initials: EE
authors.lastname: Castilla
authors.forename: M L
authors.initials: ML
authors.lastname: Martínez-Frías
authors.forename: G
authors.initials: G
authors.lastname: Zampino
authors.forename: J D
authors.initials: JD
authors.lastname: Erickson
authors.forename: P
authors.initials: P
authors.lastname: Mastroiacovo
mesh_terms: D002972:Cleft Palate; D000013:Congenital Abnormalities; D019465:Craniofacial Abnormalities; D016021:Epidemiologic Studies; D005260:Female; D005835:Genitalia / Q000002:abnormalities; D006330:Heart Defects, Congenital; D006801:Humans; D007021:Hypospadias; D007231:Infant, Newborn; D017880:Limb Deformities, Congenital; D016014:Linear Models; D008297:Male; D008831:Microcephaly; D008844:Micrognathism; D012042:Registries / Q000706:statistics & numerical data*; D012737:Sex Factors; D013576:Syndactyly