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Sex differences in the prevalence of congenital anomalies: a population-based study
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Dr Sandhya Samarasekera
Professor Tanja Pless-Mulloli
Professor Judith Rankin
Tennant PWG, Samarasekera SD, Pless-Mulloli T, Rankin J
Birth Defects Research Part A: Clinical and Molecular Teratology
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Limited data is available concerning the sex distribution of various congenital anomaly subtypes. This study investigated sex differences in the prevalence of congenital anomalies, overall and by subtype, using high quality population-based data from the North of England.
: Information on congenital anomalies occurring among singleton pregnancies during 1985 and 2003 were extracted from the Northern Congenital Abnormality Survey (NorCAS). Anomalies were categorised by groups, subtypes, and syndromes according to the European Surveillance of Congenital Anomalies guidelines. Relative risks (RR) comparing the prevalences in males to that in females were calculated for a range of congenital anomaly subtypes.
12,795 eligible cases of congenital anomaly were identified during the study period, including 7,019 (54.9%) males and 5,776 (45.1%) females. Overall, male fetuses were significantly more prevalent in pregnancies affected by a congenital anomaly than female fetuses [RR, male versus female=1.15 (95% CI: 1.11-1.19)], but there was significant heterogeneity between subtypes (p<0.001). 44 of 110 (40%) unique subtypes were at least 40% more prevalent in males than females, with affected subtypes occurring across all major anomaly groups. 13 of 110 (12%) unique subtypes were at least 40% more prevalent in females than males, but the female-biased relative risk of a neural tube defect was less pronounced than previously reported [RR=0.84 (95% CI: 0.73-0.95)].
This study adds to the growing evidence of sex-specific differences in the prevalence of a wide range of congenital anomaly subtypes
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