title: Major congenital anomalies in a Danish region.
abstract: BACKGROUND
  This study describes the prevalence of congenital anomalies and changes over time in birth outcome, mortality and chronic maternal diseases.
  
  
  METHODS
  This study was based on population data from the EUROCAT registry covering the Funen County, Denmark, 1995-2008. The registry covers live births, foetal deaths with a gestational age (GA) of 20 weeks or more, and terminations of pregnancy due to congenital anomalies (TOPFA).
  
  
  RESULTS
  The overall prevalence of congenital anomalies was 2.70% (95% confidence interval: 2.58-2.80). The majority of cases had an isolated congenital anomaly, 13.9% had a chromosomal anomaly and 7.7% were multiple congenital anomalies. The combined foetal and infant mortality in the study area was 11.6 per 1,000 births. 19% (2.2 per 1,000) of these deaths were foetuses and infants with major congenital anomalies. Combined foetal and infant mortality decreased significantly over time for cases with major congenital anomalies (p < 0.001), whereas the number and proportion of TOPFA increased. Median GA at TOPFA decreased from 18 to 15 weeks. Among the congenital anomaly cases, 8% had a registration of one of these chronic maternal diseases: diabetes, epilepsy, mental disorder, thyroid disease, asthma, or inflammatory bowel disease. Medication for these conditions accounted for 46% of maternal drug use.
  
  
  CONCLUSIONS
  Maternal morbidity and use of potentially teratogenic medication have increased among congenital anomaly cases. Foetal and infant mortality for congenital anomaly cases have decreased significantly, probably owing to an increase in early prenatal diagnosis and TOPFA.
  
  
  BACKGROUND
  The study was funded by Region of South Denmark.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Pædiatrisk Afdeling, Sygehus Lillebælt Kolding, Skovvangen 2-8, 6000 Kolding, Denmark. ester.garne@rsyd.dk.
authors.forename: Ester
authors.initials: E
authors.lastname: Garne
authors.forename: Anne Vinkel
authors.initials: AV
authors.lastname: Hansen
authors.forename: Anne Sofie
authors.initials: AS
authors.lastname: Birkelund
authors.forename: Anne Marie Nybo
authors.initials: AM
authors.lastname: Andersen
mesh_terms: D000015:Abnormalities, Multiple / Q000453:epidemiology* / Q000401:mortality; D000025:Abortion, Eugenic / Q000639:trends*; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology; D025063:Chromosome Disorders / Q000453:epidemiology* / Q000401:mortality; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D046689:Fetal Mortality / Q000639:trends*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000453:epidemiology; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D012042:Registries; D013959:Thyroid Diseases / Q000188:drug therapy / Q000453:epidemiology