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Biomedical subjects

L D Edmonds

Publications and source records attributed to L D Edmonds.

At least 37 records · Page 2Linked to original sources
PubMed1990

A profile of mothers giving birth to infants with congenital rubella syndrome. An assessment of risk factors.

To formulate strategies for elimination of congenital rubella syndrome, it is important to identify risk factors for delivering an infant affected by it. We analyzed cases of congenital rubella syndrome in infants born from 1970 to 1985 and reported to either one of two independent Centers for Disease Control surveillance systems. Mothers of infants with congenital rubella syndrome identified in both surveillance systems were disproportionately younger than mothers giving birth in the United States. The risk for delivering an infant with congenital rubella syndrome was approximately 2.5 times higher for blacks compared with whites for both reporting systems. A total of 18% of infants with congenital rubella syndrome born since 1979 were Hispanic (national population average, 7%). Both surveillance systems showed that, although primiparous mothers were at highest risk, 39% of women delivering infants affected by congenital rubella syndrome had had at least one previous live birth, suggesting that postpartum immunization could have prevented these congenital rubella syndrome cases. Young, black, and Hispanic primiparous women represent populations at elevated risk for delivering a congenital rubella syndrome-affected infant and should be specifically targeted for immunization.

Adolescent↗
PubMed1990

Temporal trends in the prevalence of congenital malformations at birth based on the birth defects monitoring program, United States, 1979-1987.

The Birth Defects Monitoring Program (BDMP) is a national program that monitors congenital malformations by using hospital discharge data concerning newborns. BDMP data for 38 selected malformations were examined for temporal trends. The prevalence at birth of these malformations for the two periods 1979-1980 and 1986-1987 was compared and then grouped into three time-trend categories: increasing greater than or equal to 2% annually, decreasing greater than or equal to 2% annually, and remaining stable. Results showed that 29 malformations had increasing trends, two had decreasing trends and seven remained stable. Follow-up studies are needed to evaluate whether these trends are real or due to improved ascertainment of the respective malformations.

Anencephaly↗
PubMed1988

Reproductive outcomes of mothers with potential exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

Animal laboratory studies have demonstrated that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has fetotoxic and teratogenic effects at low doses. TCDD contamination of soil in nine residential areas of eastern Missouri began in 1971 when several horse arenas and dirt roads were sprayed for dust control with a mixture that contained waste oil and dioxin. The authors conducted an epidemiologic investigation to determine if adverse human reproductive outcomes are associated with exposure to soil contaminated with dioxin. The authors attempted to identify all births during the period of January 1, 1972 through December 31, 1982 that had potential exposure to dioxin, based on proximity of the maternal address to a location of known TCDD contamination. This group totaled 410 births. A matched set of 820 unexposed births was selected as a comparison group after being matched for maternal age and race, year of birth, hospital of birth, and plurality. The exposed group had increased risk ratios for infant, fetal, and perinatal death; low birth weight; and several subcategories of birth defects. None of these increased risk ratios for the exposed group were statistically significant. These results do not provide evidence that TCDD exposure has a substantial impact on the reproductive outcomes investigated. If TCDD does produce effects on reproductive health, a larger study and/or better measures of exposure may be needed to discover them.

Abnormalities, Drug-Induced↗
PubMed1987

Trends in pyloric stenosis incidence, Atlanta, 1968 to 1982.

Four studies reported an increasing incidence of pyloric stenosis during the late 1970s from geographically diverse areas of the United Kingdom. It was suggested that the increased incidence might be related to changes in infant feeding practices. We used data from the Metropolitan Atlanta Congenital Defects Program, a population based birth defects registry, to examine the secular trends and descriptive epidemiology of pyloric stenosis in a North American city. For the period 1968 to 1982, the incidence of pyloric stenosis was 1.33 per 1000 live births; there was no evidence of an increasing trend for either race or sex specific rates of pyloric stenosis. The descriptive epidemiology of the pyloric stenosis cases showed higher rates for males, whites, and infants of higher birth weight. We found no increasing trend in pyloric stenosis incidence in Atlanta, despite well documented changes in US infant feeding practices (an increased prevalence of breast feeding) during the 1970s.

Breast Feeding↗
PubMed1982

Conjoined twins in the united states, 1970-1977.

The descriptive epidemiology of conjoined twinning in the United States was investigated using data from the Birth Defects Monitoring Program (BDMP), a nationwide congenital malformations surveillance system that monitors discharge diagnoses associated with a third of the births in the United States. This is the largest recorded series concerning conjoined twins; data were analyzed on 7,903,000 births monitored by the BDMP in the period 1970-1977. The analysis identified 81 sets of conjoined twins, for a crude incidence of 10.25 per million births. The most common types of conjoined twins were thoracoomphalopagus (28%), thoracopagus (18%), omphalopagus (10%), parasitic twins (10%), and craniopagus (6%). Conjoined twins are more common among females than males, and in nonwhites than whites. No maternal age effect was found. There was no evidence of seasonal or temporal clustering of the cases. The large number of conjoined twins who had birth defects that are not obviously linked to the conjoining (particularly neural tube defects and orofacial clefts) may provide insights into the pathogenesis of birth defects resulting from disordered embryonic migration and fusion.

Congenital Abnormalities↗
PubMed1982

Current trends in the incidence of neural tube defects.

To verify and investigate the reported decline of neural tube defects (NTDs) in the last decade, data from three different sources were examined: the Birth Defects Monitoring Program (BDMP), composed of newborn discharge diagnoses; the population-base Metropolitan Atlanta Congenital Defects Program (MACDP); and the National Center for Health Statistics (NCHS), whose data include only live births. Although the three systems use different methods of ascertaining cases, all data bases showed a decreasing trend in NTD rates, with annual percent decreases of 3.1% for NCHS, 5.7% for BDMP, and 7.7% for MACDP. The decrease was noted in all variables examined: race, sex, and birth status for each defect. NTD rates appear to be declining more rapidly in females than in males. Further, the rate among stillborn infants decreased more than the rate among live-born infants. The exclusion of stillbirths in the NCHS data may contribute to its low rate of decline for female anencephalics. Data from England showed a larger average annual decrease (10.6%) than did data from the United States. Although reasons for the overall decline are not verifiable, a variety of explanations are suggested for this decline and for the difference in NTD rate decline noted between live births and stillbirths. The overall decline in NTD rates should be investigated with respect to etiology; recognition of the decline is useful for planning and evaluating health care programs.

Anencephaly↗
PubMed1981

Congenital malformations surveillance: two American systems.

As part of its epidemiologic studies of congenital malformations, the Centers for Disease Control (CDC) conducts two birth defects surveillance systems in the United States. The Metropolitan Atlanta Congenital Defects Programme (MACDP) is an intensive surveillance system using several methods to identify infants born with birth defects in the Atlanta area. The Birth Defects Monitoring Programme (BDMP) is a nationwide surveillance system that monitors 1 million births per year, about a third of all births in the U.S. It relies on diagnoses from newborn discharge summaries to ascertain affected infants. The systems were originally designed to detect potential 'epidemics' of birth defects that could occur following the widespread dissemination of new teratogens similar to thalidomide. In addition to monitoring, they have also proved to be useful resources for a variety of studies of the epidemiology of birth defects.

Abnormalities, Drug-Induced↗
PubMed1980

Is there an epidemic of ventricular septal defects in the U.S.A.?

In the past 10 yr the reported incidence of ventricular septal defect (VSD) has increased more than two-fold in two American birth-defects surveillance systems--the Metropolitan Atlanta Congenital Defects Program and the nationwide Birth Defects Monitoring Program. To test the hypothesis that this increase was caused by improved clinical diagnosis, resulting in the diagnosis of minor VSDs, we conducted a follow-up investigation of infants with VSD in the Atlanta area. We compared the rate of spontaneous closure by 1 yr of age of VSDs diagnosed during 1970--72 with the closure rate during 1975--76. If the recently increased incidence was caused entirely by better diagnosis of minor defects that are likely to close spontaneously, we would have expected a much higher rate of spontaneous closure in the later period. In fact, the rate of spontaneous closure by 1 yr was almost identical for both periods (23.8% and 23.9%). The considerable recent increase in the reported incidence of VSD cannot be simply due to better diagnosis.

Disease Outbreaks↗
PubMed1980

Maternal fever and neural tube defects.

It has been proposed that hyperthermia in the pregnant woman is associated with neural tube defects in her offspring. We analyzed retrospective interview data for a maternal history of probable febrile illness during the first trimester of pregnancy among mothers of infants with anencephaly or spina bifida. There were two control groups--mothers of infants with Down syndrome and mothers of infants with cleft lip or palate. With the Down syndrome group serving as controls, the incidence of febrile illness among mothers of all infants with neural tube defects was significantly elevated. With the cleft group as controls, the fever incidence was not significantly increased in the neural tube defect groups. When the combined cleft and Down syndrome controls were used, only mothers of the spina bifida group had an elevated fever incidence. Epidemiology data suggest an association of maternal fever during pregnancy with neural tube defects in the offspring.

Anencephaly↗
PubMed1979

Reducing birth defect risk in advanced maternal age.

The incidence of birth defects increases with maternal age. Recent advances in fetal diagnosis, coupled with elective abortion, offer the older pregnant woman an opportunity to reduce this risk. To determine the magnitude of potential risk reduction, we reviewed the maternal age-specific incidence of infants born with one or more severe birth defects in metropolitan Atlanta from 1968 to 1975, removing from analysis certain anomalies that were preventable by currently available methods. For women aged 35 to 44 years, the risk of bearing an infant with a severe birth defect was reduced to a level comparable with that for younger women. Despite prenatal diagnosis and elective abortion, the risk for women aged 45 years or older, although reduced considerably, was two times greater than that for women aged 34 years or younger.

Adult↗
PubMed1978

Congenital central nervous system malformations and vinyl chloride monomer exposure: a community study.

Incidence rates for central nervous system (CNS) malformations in infants born to residents of Kanawha County, West Virginia, 1970-1974, were significantly higher than comparable United States rates during those years. Since Kanawha County contains a polyvinyl chloride (PVC) polymerization plant, a case-control study was conducted on the possible relationship between the occurrence of CNS defects and parental occupational or residential exposure to vinyl chloride monomer emissions from this plant. No relationship with parental occupation was found. While a tendency was noted for residences of case families to be located in an area northeast of the plant, this observation did not entirely correlate with existing data on local patterns of wind direction and air pollution.

Abnormalities, Drug-Induced↗
PubMed1978

Patent ductus arteriosus and ventricular septal defect: trends in reported frequency.

Nationwide secular increases in the reported frequency of patent ductus arteriosus (PDA) and ventricular septal defect (VSD) are presented. Detailed examination of data from one locality, Metropolitan Atlanta, indicates that the increases were primarily the result of a rise in the reported frequency of these heart defects in isolated form (i.e., without other malformations). During the latter years of the study more Atlanta babies with isolated PDA were of low birth weight and short gestational age, and more cases were diagnosed in the infants' first week of life. The increase in VSD was not as consistent nor as dramatic as that of PDA. Neither were there any changes over time in the demographic characteristics of Atlanta infants affected by isolated VSD. At least part and perhaps all of the increase in PDA may be explained by an increased awareness on the part of physicians who take care of premature infants. While the increase in reported VSD may be explainable on the basis of awareness or secular shifts in diagnostic standards, the problem seems qualitatively different from that of PDA.

Black or African American↗
PubMed1976

Epidemiological field studies of animal populations.

Numerous survey designs have been developed for epidemiological field studies of human populations, most of which are also applicable to field studies of animal poulations. Each design has its own advantages and disadvantages. The final design selected for a particular study depends upon such factors as the overall purpose of the study, the geographic dimensions of the study area, the diseases incidence or prevalence and species to be studied as well as the planned use for the data. Population dynamics including the distribution and density of the species to be studied are factors that should also be considered in the initial design of a study. A surveillance system, using mailed questionnaire data and a subsequent survey using direct interviews of validate the data in a statewide study of swine birth defects are used to illustrate some of the techniques that can be applied to domestic animal populations in a fairly large geographic area. The type of data collected, its use and its limitations are also considered.

Animal Diseases↗