title: Descriptive analysis of high birth prevalence rate geographical clusters of congenital anomalies in South America.
abstract: BACKGROUND
  The birth prevalence rate (BPR) of congenital anomalies (CAs) is heterogeneous and exhibits geographical and sociocultural variations throughout the world. In South America (SA), high birth prevalence regions of congenital anomalies have been observed. The aim of this study was to identify, describe, and characterize geographical clusters of congenital anomalies in SA.
  
  
  METHODS
  This observational descriptive study is based on clinical epidemiological data registered by the Latin-American Collaborative Study of Congenital Malformations network. Between 1995 and 2012, a total of 25,082 malformed newborns were ascertained from 2,557,424 births at 129 hospitals in SA. The spatial scan statistic was used to determine geographical regions with high BPR of CAs. The BPR was obtained with a Poisson regression model. Odds ratios were estimated for several risk factors inside the geographical clusters.
  
  
  RESULTS
  We confirmed the existence of high BPR regions of CAs in SA. Indicators of low socioeconomic conditions, such as a low maternal education, extreme age childbearing, infectious diseases, and medicine use during pregnancy were detected as risk factors inside these regions. Native and African ancestries with high frequency of consanguineous marriages could explain partially these high BPR clusters.
  
  
  CONCLUSIONS
  The recognition of clusters could be a starting point in the identification of susceptibility genes associated with the occurrence of CA in high BPR regions.
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Gili
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.|Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil.
authors.forename: Fernando Adrián
authors.initials: FA
authors.lastname: Poletta
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.
authors.forename: Lucas Gabriel
authors.initials: LG
authors.lastname: Giménez
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.
authors.forename: Mariela Soledad
authors.initials: MS
authors.lastname: Pawluk
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.
authors.forename: Hebe
authors.initials: H
authors.lastname: Campaña
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.|Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil.
authors.forename: Eduardo Enrique
authors.initials: EE
authors.lastname: Castilla
authors.affiliation: Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Laboratorio de Epidemiologia Genética, Dirección de Investigación, CEMIC-CONICET, Buenos Aires, Argentina.|Estudio Colaborativo Latinoamericano de Malformaciones Congénitas-ECLAMC, Instituto Nacional de Genética Médica Populacional, Rio de Janeiro, Brazil.
authors.forename: Jorge Santiago
authors.initials: JS
authors.lastname: López-Camelo
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013020:South America / Q000453:epidemiology
keywords: ECLAMC; South America; birth prevalence rate; congenital anomalies