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PMID- 28446117
DA  - 20170427
DCOM- 20170502
LR  - 20170502
IS  - 1326-5377 (Electronic)
IS  - 0025-729X (Linking)
VI  - 206
IP  - 8
DP  - 2017 May 01
TI  - Prevalence of microcephaly in an Australian population-based birth defects
      register, 1980-2015.
PG  - 351-356
AB  - OBJECTIVES: To describe the prevalence and characteristics of microcephaly in a
      geographically defined Australian population. DESIGN, SETTING AND PARTICIPANTS:
      Descriptive epidemiological study of microcephaly cases ascertained by the
      Western Australian Register of Developmental Anomalies, 1980-2015, defining
      microcephaly as an occipito-frontal head circumference below the third percentile
      or more than two standard deviations below the mean sex- and age-appropriate
      distribution curve. MAIN OUTCOME MEASURES: Microcephaly prevalence (per 10 000
      births) was calculated for cases with known and unknown causes, and by
      demographic characteristics. Temporal trends were analysed, and prevalence ratios
      (PRs) and 95% CIs calculated for Aboriginal and non-Aboriginal births. RESULTS:
      For births during 1980-2009 (ie, with at least 6 years' follow-up and therefore
      complete case ascertainment), 416 cases were identified, a prevalence of 5.5 per 
      10 000 births (95% CI, 4.95-6.02), or 1 in 1830 births. There was no significant 
      temporal trend in prevalence (P = 0.23). Most cases were in live-born children
      (389, 93.5%), and other major birth defects were diagnosed in 335 of the affected
      children (80%). Prevalence was higher in Aboriginal births (PR, 4.5; 95% CI,
      3.55-5.73). A cause of microcephaly was identified in 186 cases (45% of cases),
      and more often for Aboriginal (64 cases, 70%) than non-Aboriginal births (122
      cases, 38%). The most frequent known cause of microcephaly in Aboriginal births
      was fetal alcohol spectrum disorder (FASD; 11 per 10 000 births); monogenic (0.68
      per 10 000) and chromosomal conditions (0.59 per 10 000 births) were the most
      common causes in non-Aboriginal births. CONCLUSIONS: These data provide a
      baseline for prospective surveillance of microcephaly. We identified a high
      proportion of cases without known cause, highlighting the need for clinicians to 
      carefully investigate all possibilities, including emerging infections. FASD is
      an important cause of microcephaly in the Aboriginal population.
FAU - Hansen, Michele
AU  - Hansen M
AD  - Telethon Kids Institute, Perth, WA [email protected]
FAU - Armstrong, Paul K
AU  - Armstrong PK
AD  - Communicable Disease Control Directorate, WA Department of Health, Perth, WA.
FAU - Bower, Carol
AU  - Bower C
AD  - Telethon Kids Institute, Perth, WA.
FAU - Baynam, Gareth S
AU  - Baynam GS
AD  - Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, WA.
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Med J Aust
JT  - The Medical journal of Australia
JID - 0400714
SB  - IM
MH  - Australia/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fetal Alcohol Spectrum Disorders/*epidemiology
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Live Birth/*epidemiology
MH  - Male
MH  - Microcephaly/*epidemiology/etiology
MH  - Oceanic Ancestry Group/*statistics & numerical data
MH  - Population Surveillance
MH  - Pregnancy
MH  - Prospective Studies
MH  - Registries
MH  - Regression Analysis
EDAT- 2017/04/28 06:00
MHDA- 2017/05/04 06:00
CRDT- 2017/04/28 06:00
PHST- 2016/08/11 [received]
PHST- 2017/01/16 [accepted]
AID - 10.5694/mja16.00966 [pii]
PST - ppublish
SO  - Med J Aust. 2017 May 1;206(8):351-356.

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