title: Multiple congenital anomalies: issues for birth defects surveillance.
abstract: Approximately 1 in 200 individuals and 20 percent to 30 percent of those in whom any major structural malformation is found will have 2 or more serious and potentially unrelated birth defects. In addition to the challenges that multiple malformations create for affected persons, their families, and the health care system, appropriate surveillance of such complex patterns can be a concern for birth defects registries. This paper provides examples of how monitoring of multiple anomalies can be beneficial from clinical and public health perspectives; presents a staged approach to documentation of such defects, including suggestions for their coding; describes the types of patterns in which they occur; and discusses some of the unique issues that arise with respect to statistical analysis of multiple versus isolated birth defects.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Evans
mesh_terms: D000015:Abnormalities, Multiple / Q000453:epidemiology*; D059019:Clinical Coding / Q000379:methods*; D004282:Documentation / Q000379:methods*; D006801:Humans; D011159:Population Surveillance / Q000379:methods*; D012042:Registries