AUTHOR=Toxværd Marlene E. , Garne Ester 

TITLE=Epidemiology of Multiple Congenital Anomalies Before and After Implementation of a Nationwide Prenatal Screening Program in Denmark

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.614864

DOI=10.3389/fped.2021.614864

ISSN=2296-2360

ABSTRACT=Surveillance of congenital anomalies is important in order to detect negative influences from environment, medication or lifestyle as early as possible. Since most teratogens are associated with a spectrum of birth defects rather than a single defect, analysis of the epidemiology of multiple congenital anomalies is important to detect an increase due to environmental or medicine exposure.
The aim of the study was to describe changes in prevalence, types of anomalies and outcome of pregnancies for cases fetuses and infants with multiple congenital anomalies before and after introduction of the new screening programme in the County of Funen, Denmark. The study was based on data from the EUROCAT registry of the County of Funen for the period 1990 to 2014 covering 135,.057 births. The registry includes information about the mother and the fetus including livebirths, fetal deaths after 20 weeks of gestation and terminations of pregnancy after prenatal diagnosis of fetal anomalies.  All Ccases with two or more major congenital anomalies in different organ systems, where the pattern of anomalies were has not been recognized as part of a chromosomal or genetic syndrome or a sequence were included in the study.
Overall prevalence of multiple congenital anomalies was 19.7 per 10,000 pregnancies. There was no significant change in prevalence over time. The prenatal detection rate increased from 26% to 57% after introduction of the screening programme (p < 0.001). Proportion of terminations of pregnancy increased from 11% to 30% of all cases and one-week survival for livebirths increased from 64% to 94%. There was no  study did not observe any change in combinations of involved organ systems.
The implementation of the new screening programme in 2004 has led to an increased prenatal detection rate of multiple congenital anomalies followed by an increased rate of termination of pregnancy for the most severe cases and an increased one-week survival for liveborn infants with multiple congenital anomalies.