BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

Chapter X
Congenital Anomalies
Knowledge of the geographic distribution
and of the frequency of congenital anonalies
is an important. first step in the search
for causes of these serious and often fatal
abnormialities found at birth. Causes of a
few of theim have been discovered-such as
rubella in the mother (Gregg, 1941 which
leads to congenital heart disease, cataract,
microcephaly, and (leafness in the child, and
the drug thalidomide taken in early pregnancy
which has caused severe inalfornations
of the extremities (Taussig, 1962, and
Leek and Miller, 1962). Genetic factors,
chromosomal abnormalities, and a number
of environmental intrauterline fictors such
as infection are amlong the groups of causes
to be suspected on discovery of a congenital
anomaly (Warkany and Kalter, 1961).
Npi-pplla¢,:e the lclatioiiqhili lrtwoon tin
anomaly and a specific cause is nearly always
impossil)le to establish, a fact that
makes llrevention rarely f,iIiLC,
Although it I,.,, Ibeen recommended that
the term "anomaly" embrace congenital abnormal
molecular structure, that is, inborn
errors of metabolism (Warkany and Kalter,
as used in this
1961), congenital anomaly
Investigation refers to macroscopic structural
abnormality, as manifested by a devi-
ation from normal development at birth.
This definition used in the Investigation enbraces
all the conditions appearing in the
section on congenital anomalies in tile InternationalClassificationof
Diseases and perinits
the inclusion of a few other abnormalities
appearing in other sections.
One of the important considerations that
led to the undertaking of this Investigation
was the need for clarification of the situation
in the Americas in regard to frequency
of congenital anomalies. The Pan American
Health Organization (1963) held a planning
conference in 1963 designed to stimulate interest
in research in this important field of
health. Fortunately this Investigation has
provided the geographic distributions of
serious anomalies resulting in deaths of
children under 5 years of age as well as of
minor anomalies diagnosed in deceased children.
Ill 1959, the World Health O,,ganim,lion
Iei! 1),. D.r, Alctn C. tevenson to organize
and conduct a prospective study of congenital
mnalformnations* in accordance with
recommendations made by a meeting of
186
specialists held in April 1959. Facilities
and staff of the Population Genetics Research
Unit of tile Medical Research Coun­
-eat i Britain were availble for the
cil of G
collection and analysis of the data that were
to be assembled. In that research program
uniform information was recorded for con-
* In the 111065 Revision of the International Classification
of Diseases the term anomaly was introduced, replacing
malformation.