The Alberta Congenital Anomalies Surveillance System: a 40-year review with prevalence and trends for selected congenital anomalies, 1997–2019

Author:

Lowry R. Brian123,Bedard Tanya1,Grevers Xin1,Crawford Susan4,Greenway Steven C.3567,Brindle Mary E.58,Sarnat Harvey B.39,Harrop A. Robertson51011,Kiefer Gerhard N.1112,Thomas Mary123

Affiliation:

1. Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada

2. Departments of Pediatrics and Medical Genetics, University of Calgary and Alberta Children’s Hospital, Calgary, Alberta, Canada

3. Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

4. Alberta Perinatal Health Program, Alberta Health Services, Calgary, Alberta, Canada

5. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

6. Department of Cardiac Sciences and Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

7. Department of Biochemistry & Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

8. Division of Pediatric General and Thoracic Surgery, Department of Surgery, Alberta Children’s Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

9. Departments of Pediatrics (Neurology), Pathology (Neuropathology) and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

10. Section of Plastic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

11. Section of Pediatric Surgery, Alberta Children’s Hospital, Calgary, Alberta, Canada

12. Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Abstract

Introduction

Current published long-term provincial or territorial congenital anomaly data are lacking for Canada. We report on prevalence (per 1000 total births) and trends in 1997–2019, in Alberta, Canada, for selected congenital anomalies. Associated risk factors are also discussed.

Methods

We used data from the Alberta Congenital Anomalies Surveillance System (ACASS) to calculate the prevalence and perform chi-square linear trend analyses.

Results

From 1997 to 2019, the overall prevalence of neural tube defects was stable, at 0.74 per 1000 total births. The same was true for spina bifida (0.38), orofacial clefts (1.99), more severe CHDs (transposition of the great arteries, 0.38; tetralogy of Fallot, 0.33; and hypoplastic left heart syndrome, 0.32); and gastroschisis (0.38). Anencephaly, cleft palate and anorectal malformation significantly decreased with a prevalence of 0.23, 0.75 and 0.54 per 1000 total births, respectively. Significantly increasing trends were reported for anotia/microtia (0.24), limb reduction anomalies (0.73), omphalocele (0.36) and Down syndrome (2.21) and for hypospadias and undescended testes (4.68 and 5.29, respectively, per 1000 male births).

Conclusion

Congenital anomalies are an important public health concern with significant social and societal costs. Surveillance data gathered by ACASS for over 40 years can be used for planning and policy decisions and the evaluation of prevention strategies. Contributing genetic and environmental factors are discussed as is the need for continued surveillance and research.

Publisher

Health Promotion and Chronic Disease Prevention Branch (HPCDP) Public Health Agency of Canada

Subject

Public Health, Environmental and Occupational Health,Health Policy,Epidemiology

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