Changes in detection of birth defects and perinatal mortality after introduction of prenatal ultrasound screening in the Kola Peninsula (North-West Russia): combination of two birth registries

Abstract

BackgroundPrenatal diagnostics ultrasound was established in Russia in 2000 as a routine method of screening for birth defects. The aims of the current study were twofold: to assess changes in birth defects prevalence at birth and perinatal mortality after ultrasound screening was implemented and to estimate prenatal detection rates for congenital malformations in the city of Monchegorsk (Murmansk County, North-West Russia).MethodsThe Murmansk County Birth Registry and the Kola Birth Registry were the primary sources of information, and include 30 448 pregnancy outcomes in Monchegorsk for the period 1973–2011. Data from these registries were supplemented with information derived from hospital records about pregnancy terminations for 2000–2007.ResultsThe total number of newborns with any kind of birth defects in Monchegorsk during 1973–2011 was 1099, of whom 816 were born in the 1973–2000 period. The prevalence of defects at birth increased from 34.2/1000 (95 % CI = 31.9-36.5) to 42.8/1000 newborns (95 % CI = 38.0-47.7) after prenatal ultrasound screening was formally implemented. We observed significant decreases (p < 0.05) in the birth prevalence of congenital malformations of the circulatory system, the musculoskeletal system (including deformations), and other (excluding multiple); those of the urinary system increased from 0.9/1000 to 17.1/1000 (p < 0.0001). The perinatal mortality among newborns with any kind of malformation decreased from 106.6 per 1000 newborns with birth defects (95 % CI = 84.3-129.1) to 21.2 (95 % CI = 4.3-38.1). Mothers who had undergone at least one ultrasound examination during pregnancy (n = 9883) had a decreased risk of having a newborn die during the perinatal period [adjusted OR = 0.49 (95 % CI = 0.27-0.89)]. The overall prenatal detection rate was 34.9 % with the highest for malformations of the nervous system.ConclusionImproved detection of severe malformations with subsequent pregnancy termination was likely the main contributor to the observed decrease in perinatal mortality in Murmansk County, Russia.

Prenatal detection of congenital anomalies and related factors in Argentina

“…The overall PDR was 50.3%. This rate is within the range previously reported in other settings: 34.9-62.0% (Rydberg and Tunón 2017;Postoev et al 2015;Rossi and Prefumo 2013;CAROBB 2012;Campaña et al 2010). Birth in an institution belonging to the nonpublic sector was shown to be a predictor for a higher chance of prenatal detection.…”

“…European surveillance programs showed the influence on PDR of different legislations regarding mandatory fetal screening of CA. Countries without mandatory prenatal screening had the lowest rates (Postoev et al 2015;Stoll et al 2001;Garne et al 2005). Likewise, in the Swedish experience, the routine use of a checklist to investigate CA prenatally increased prenatal detection (Rydberg and Tunón 2017).…”

Congenital anomalies of the kidney and the urinary tract: A murmansk county birth registry study

“…In our previous study (Postoev et al, 2015b), the prenatal detection rate for CAKUTs in Monchegorsk was 42.1% for the 2000-2007 period. The possibility for underestimating the prevalence when using data at birth is illustrated by Caiulo et al, 2012, who showed that the prevalence of CAKUTs among children at the age of two months was close to 1 % based on mass ultrasound screening.…”

The Impact of Scientific and Technical Training on Improving Routine Collection of Antenatal Care Data for Maternal and Foetal Risk Assessment: A Case Study in the Province of South Kalimantan, Indonesia

“…Serial ultrasonic scanning has been recommended in the national and international ANC standards as a means to detect foetal growth abnormalities [ 4 , 24 , 25 , 38 , 41 , 49 ]. However, the fields to record such measurements do not exist in the manual pregnancy register ( Table 12 ).…”