Biomedical subjects

Adolfo Correa-Villaseñor

Publications and source records attributed to Adolfo Correa-Villaseñor.

4 recordsLinked to original sources

PubMed2006

Feasibility of using the national hospital discharge survey to estimate the prevalence of selected birth defects.

BACKGROUND: Nationally representative data on the prevalence of certain birth defects are largely unavailable. We evaluated the feasibility of using data from the National Hospital Discharge Survey (NHDS) to describe the prevalence of selected birth defects. METHODS: All live births recorded in the NHDS during 1999-2001 were included. The prevalence for selected birth defects was calculated using weighted ratio estimators. Prevalence ratios comparing the NHDS estimates to published national estimates from the National Birth Defects Prevention Network (NBDPN) were calculated. RESULTS: With the exception of common truncus, the NHDS prevalence for the selected defects was consistently lower than the NBDPN estimates. The prevalence ratios ranged from 0.38 for trisomy 18 and anopthalmia/micropthalmia to 1.16 for common truncus. The NHDS prevalence estimates for spina bifida without anencephaly (PR 0.89, 95% CI: 0.57-1.22) and gastroschisis/omphalocele (PR 0.94, 95% CF: 0.48-1.40) most closely approximated the NBDPN estimates. CONCLUSIONS: NHDS data underestimate the prevalence of most birth defects. Additional research is needed to determine whether NHDS estimates may be useful for evaluating trends in certain conditions. Surveillance systems employing active case-finding continue to provide more accurate estimates of birth defects prevalence.

Congenital Abnormalities↗

PubMed2004

Parental lead exposure and total anomalous pulmonary venous return.

BACKGROUND: Investigators from the Baltimore-Washington Infant Study (BWIS) reported an association between self-reported maternal lead exposure and total anomalous pulmonary venous return (TAPVR) in their offspring. This association was further evaluated in the BWIS population using a more sensitive exposure estimate. METHODS: Cases included 54 live-born infants with TAPVR; controls were a stratified random sample of 522 live-born infants from the BWIS control group. Parental lead exposure was based on three assessment methods, including: an industrial hygiene assessment, an a priori job exposure matrix, and self-reported exposures. A parent was classified as exposed to lead if he/she was classified as exposed by any one of the assessment methods. RESULTS: Approximately 17% of case mothers and 11% of control mothers were classified as exposed to lead during the three months prior to conception through the first trimester (odds ratio [OR], 1.57; 95% confidence interval [CI], 0.64-3.47). Among fathers, 61% of case fathers and 46% of control fathers were classified as exposed to lead during the six months prior to conception (paternal critical period) (OR, 1.83; 95% CI, 1.00-3.42). During the paternal critical period, when only the father was exposed compared to neither parent exposed, the OR for any lead exposure and TAPVR was 1.65 (95% CI, 0.84-3.25). CONCLUSIONS: This study supports a possible association between paternal lead exposure and TAPVR. Further studies are warranted using validated assessment methods for occupational and nonoccupational lead exposures to corroborate this association and to elucidate the possible biological mechanism. Birth Defects Research (Part A), 2004.

Adult↗

PubMed2003

Random error and undercounting in birth defects surveillance data: implications for inference.

BACKGROUND: There has been an ongoing debate among birth defects investigators about whether or not to publish estimates of rates of birth defects with confidence intervals to allow for comparisons of rates across regions and time. A major impediment in resolving this debate has been the lack of a framework for quantifying uncertainties in the data that can be applied uniformly to birth defects surveillance programs. This report presents an overview of random error and ascertainment bias in birth defects surveillance data, and of the implications of these errors for estimation and comparisons of birth defects rates. METHODS: We consider when confidence intervals can be used as part of a strategy to make inference on rates, as well as ratios of or differences between two rates. Worth noting is that confidence intervals only address random error in the data. In the presence of undercounting of cases, estimation of rates and confidence intervals requires knowledge or an estimate of the extent of underascertainment. Rate estimates and confidence intervals that ignore such bias can be misleading. However, if it is reasonable to assume that the ascertainment bias is constant over time (or across regions), then it is possible to make valid comparisons of rates over time (or across regions) using ratio or difference estimators, even when lack of knowledge of the extent of undercounting makes estimating the absolute rate and its confidence interval problematic. Finally, sensitivity analyses can use confidence limits to determine the difference in ascertainment bias necessary to explain an apparent difference in rates. CONCLUSION: Because birth defects surveillance systems have evolved in the absence of agreed upon standards to guide the process, it is difficult to determine the extent to which the variability in rates of birth defects across programs or over time is real or due to differences in surveillance methods. Efforts to develop standards for birth defects surveillance may help to minimize the variability in prevalence of birth defects due to differences in case ascertainment methods and allow for evaluations of real temporal and spatial variations in environmental effects. In the meantime, if comparisons of rates need to be made to address public health concerns, it would be prudent to conduct only such comparisons between regions or across time when the degree of case ascertainment can be assumed to be relatively constant across regions and time.

Birth Certificates↗

PubMed2003

The Metropolitan Atlanta Congenital Defects Program: 35 years of birth defects surveillance at the Centers for Disease Control and Prevention.

BACKGROUND: The Metropolitan Atlanta Congenital Defects Program (MACDP) is a population-based birth defects surveillance program administered by the Centers for Disease Control and Prevention (CDC) that has been collecting, analyzing, and interpreting birth defects surveillance data since 1967. This paper presents an overview of MACDP current methods and accomplishments over the past 35 years. METHODS: MACDP actively monitors major birth defects among infants born to residents of five counties of metropolitan Atlanta, an area with approximately 50,000 annual births. Cases are ascertained from multiple sources, coded using a modified British Pediatric Association six-digit code, and reviewed and classified by clinical geneticists. RESULTS: MACDP has monitored trends in birth defects rates and has served as a case registry for descriptive, risk factor, and prognostic studies of birth defects, including studies of Agent Orange exposure among Vietnam War veterans, maternal use of multivitamins, diabetes, febrile illnesses, and survival of children with neural tube defects. MACDP has served as a data source for one of the centers participating in the National Birth Defects Prevention Study, and for developing and evaluating neural tube defects prevention strategies related to the periconceptional use of folic acid supplements. CONCLUSIONS: Since its inception, MACDP has served as a resource for the development of uniform methods and approaches to birth defect surveillance across the United States and in many other countries, monitoring birth defects rates, and as a case registry for various descriptive, etiologic, and survival studies of birth defects. MACDP has also served as a training ground for a large number of professionals active in birth defects epidemiology.

2,4,5-Trichlorophenoxyacetic Acid↗