Birth defects, registries

Continue to develop and enhance population-based surveillance systems for the real-time capture of sentinel health end-points. This includes current surveillance systems such as vital registration for birth size and gestation and birth defects registries for capture of major malformations. Consideration of emerging sentinel end-points such as fecundability, as measured by time to pregnancy and sex ratios, should receive added research consideration. 

Cases reported by physicians to the FDA cases reported to the State Birth Defects Registry... 

Fox, D. J. Druschel, C. M. (2003). Estimating prevalence of fetal alcohol syndrome (FAS) effectiveness of a passive birth defects registry system. Birth Defects Res. A Clin. Mol. Teratol. 67 604—608. 

Monitor infants for birth defects and/or unusual reactions that may be due to maternal drug use. Report suspected drug-related reactions to the FDA and other appropriate registries. 

DOl 10.1002/0471238961.0605182008150606.a01.pub2 Arbuckle TE, Sherman GJ, Corey PN, Walters D, Lo B (1988) Water nitrates and CNS birth defects a population-based case-control study. Arch Environ Health 43 162-167 ATSDR (1994) Agency for Toxic Substances and Disease Registry. Toxicological profile for carbon tetrachloride (update). Public Health Service, U.S. Department of Health and Human Services, Atlanta, GA... 

Improve the surveillance, collection and harmonization of data on the frequency and geographical distribution of birth defects and developmental disorders, with special attention to establishment of complete registries. 

In 1982 we drew attention to this problem in the article "What every chemist should know about teratogens—-chemicals that cause birth defects" (ref. 1). One year later we addressed the teratogen problem from the point of view of research chemists (ref. 2). Earlier, we have accumulated a list of over 500 teratogenic chemicals, proven or suspected, from the Registry of Toxic Effects of Chemical Substances (ref. 3, 4),... 

Registries could offer some preliminary information about the distribution and determinants of a few reproductive and developmental outcomes (fetal death, live births, birth defects), but often additional information on exposures and the precise nature of the adverse outcomes will need to be collected. Registry data are simply not available for most fecundity-related outcomes indicative of male and female reproductive health (conception delay, early pregnancy loss). 

No reports of adverse developmental effects on humans after exposure to coal tar were found in the literature. No adverse developmental outcomes were detected in a survey of inhabitants of a housing development built on an abandoned creosote factory site, which was known to be contaminated with creosote (Agency for Toxic Substances and Disease Registry 1994). A retrospective study of dermal exposure to coal tar found no increased risk of birth defects associated with exposure to coal tar during pregnancy, but this was a small study and was unlikely to have sufficient resolution to detect a modest increase in risk (Franssen et al. 1999). 

Toxicological studies have linked some phthalate esters to liver and kidney damage, and to possible testicular or reproductive birth defect problems, characterizing them as endocrine disruptors. In this way, up to 12 phthalate esters, such as DBF, BBP, DEHP, DIDP, and DINP are within the list of the proposed substances suspected to produce endocrine alterations published by the EU. The endocrine disruption potential of pthalate esters was recently reviewed by Harris and Sumpter. The U.S. Agency for Toxic Substances and Disease Registry (ASTDR), the World... 

Registries of birth defects can also be used to identify potentially hazardous exposures. Massachusetts Institute of Technology and Tufts University have established the Birth Defects Information Center (BDIC), which will retain data supplied by hospitals and regional medical centers concerning observed birth defects. The BDIC will be available at selected locations as an automated interactive system. This effort is being supported by the March of Dimes, which also published A Compendium of Birth Defects (45). Other states and hospitals also keep registries of the spontaneous abortions that may be indicative of exposures to environmental chemicals (64). 

Roberts SS, Miller RK, Jones JK, Lindsay KL, Greene MF, Maddrey WC, Williams IT, Liu J, Spiegel RJ. The Ribavirin Pregnancy Registry findings after 5 years of enrollment, 2003-2009. Birth Defects Res A Clin Mol Teratol 2010 88 (7) 551-9. 

Pregnancy Among 955 live births prena-tally exposed to lopinavir + ritonavir reported to the Antiretroviral Pregnancy Registry, 23 had birth defects (2.4%) among 267 live births with first-trimester exposure, five had birth defects (1.9%) [185 ]. These rates are similar to the population rate of 2.7% and the rate in infants with second- or third-trimester exposure (2.6%). There was no common pattern of birth defects. 

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