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The 15-year experience of the Registry of Congenital Defects of Asturias reveals the utility of this type of database to evaluate prenatal screening programs, plan the resources needed in affected pregnant women and infants, and perform epidemiological surveillance of congenital defects in relation to environmental risks, drug exposure and assisted reproduction techniques.

Systematic and independent educational interventions aimed at women in the general population and prescribers are both effective and necessary. The HRT epidemic and its health costs, as well as the shift to tibolone prescription and the adverse effects of this drug, should be investigated nationwide.

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