title: Prevalence and prenatal ultrasound detection of clubfoot in a non-selected population: an analysis of 549, 931 births in Tuscany.
abstract: OBJECTIVE
  To evaluate the prevalence and prenatal ultrasound detection of clubfoot in Tuscany during a period of 20 years.
  
  
  METHODS
  This is a descriptive analysis on data from the Tuscan register of congenital defects, covering a 20-year period from 1992 to 2011. The Tuscan registry of congenital defects is a population-based register for the epidemiologic surveillance of congenital anomalies. The study included all cases of pre- or postnatally diagnosed clubfoot (isolated clubfoot and cases associated with other congenital defects). Overall prevalence and pre-natal detection rates were calculated.
  
  
  RESULTS
  Among the 549,931 deliveries recorded in Tuscany between 1992 and 2011, 858 cases of clubfoot were registered, with a prevalence of 1.56/1000. Seventy-eight percent of cases were isolated. The detection rate was higher when the defect was associated with other anomalies compared to isolated forms. Over the study period, there was a substantial improvement in the prenatal detection of clubfoot (from 11 to 31% overall). For isolated forms, detection rate improved from 4 to 16%, and for cases associated with other congenital defects, it increased from 43 to 73%.
  
  
  CONCLUSIONS
  Prevalence of clubfoot in Tuscany is 1.56 per 1000 births, in agreement with the incidence reported in epidemiological studies in Europe. Prenatal detection of clubfoot improved over time. The detection rate was higher in cases associated with other anomalies.
authors.affiliation: a Medical Surgical Fetal-Neonatal Department , "A. Meyer" University Children's Hospital , Florence , Italy .
authors.forename: Viola
authors.initials: V
authors.lastname: Seravalli
authors.affiliation: b CNR Institute of Clinical Physiology, Unit of Environmental Epidemiology , Pisa , Italy .|c CNR-Tuscany Region "Gabriele Monasterio" Foundation, Unit of Epidemiology , Pisa , Italy .
authors.forename: Anna
authors.initials: A
authors.lastname: Pierini
authors.affiliation: b CNR Institute of Clinical Physiology, Unit of Environmental Epidemiology , Pisa , Italy .|c CNR-Tuscany Region "Gabriele Monasterio" Foundation, Unit of Epidemiology , Pisa , Italy .
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bianchi
authors.affiliation: d Department of Clinical and Experimental Biomedical Sciences , University of Florence , Florence , Italy .|e Medical Genetics Unit , Meyer Children's University Hospital , Florence , Italy , and.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Giglio
authors.affiliation: f Department of Molecular and Developmental Medicine , Obstetrics and Gynecology, University of Siena , Siena , Italy.
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Vellucci
authors.affiliation: a Medical Surgical Fetal-Neonatal Department , "A. Meyer" University Children's Hospital , Florence , Italy .
authors.forename: Ettore
authors.initials: E
authors.lastname: Cariati
mesh_terms: D002869:Chromosome Aberrations; D003025:Clubfoot / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D000013:Congenital Abnormalities / Q000175:diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012042:Registries; D016216:Ultrasonography, Prenatal
keywords: Clubfoot; congenital abnormalities; prenatal diagnosis; ultrasound