engleski

Epidemiology of congenital anomalies in northwestern Croatia: ten years experience

Birth defects are becoming the most important cause of perinatal mortality and morbidity in developed countries. As they include many different and rare disorders in order to arrive to a critical mass of information it is necessary to establish multicentric international network and registries of patients. The EUROCAT (European Registration of Congenital Anomalies and Twins) program is a Concerted Action of the Commission of the European Communities for the epidemiological surveillance of congenital anomalies. Zagreb Registry is included in the network of registries from 1983. Here we want to present the total birth prevalence for major congenital anomalies during the ten-year registration of congenital anomalies in four regional centers (Varaždin, Koprivnica, Pula and Rijeka) of Croatia. To compare the official routine health care statistics data of the Republic of Croatia and the data from the Zagreb EUROCAT Registry with respect to efficiency and uniformity of ascertainment, and diagnostic accuracy. The ascertainment of data, calculation of prevalence rates and statistical methods used are based on EUROCAT methodology. During the monitored period (1990-1999) 1274 children with congenital anomalies per 64, 364 births were registered, with the mean prevalence rate of 19.7/ 1000 births. Stability in the overall prevalence of malformations was observed, but statistically significant differences (p<0.01) in prevalence rates among four regions of Croatia were established. The most common malformations expressed as rates per 10, 000 births were ventricular septal defect (14.4), cleft lip palate (9.0), polydactyly (8.7), atrial septal defect (8.2), and limb reduction defects (4.2). Down syndrome was the most frequent chromosomal aberration with a prevalence rate of 10.7/10 000 births. The prevalence rates of marker anomalies are tenfold higher compared to the routine statistical data of the Republic of Croatia. It is important that national surveillance of congenital malformations should continue. However modifications to the present monitoring system are necessary, including an efficient system for collecting information, greater standardization of data collection, multiple source of information, appropriate population denominator, and the inclusion of data on post-mortem examinations of still-births and therapeutic abortions performed for fetal abnormality.

congenital anomalies; epidemiology

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