Prevalence of Microcephaly in Europe: A Population based study

Joan Morris, Judith Rankin, Ester Garne, Maria Loane, Ruth Greenlees, Marie-Claude Addor, Larraitz Arriola, Ingeborg Barisic, Jorieke Bergman, Melinda Csaky-Szunyogh, Carlos Dias, Elizabeth Draper, Miriam Gatt, Babak Khoshnood, Kari Klunysoyr, Jennifer Kurinczuk, Catherine Lynch, Robert McDonnell, Vera Nelen, Amanda Neville & 10 others Mary O'Mahony, Anna Pierini, Hanitra Randrianaivo, Anke Rissmann, David Tucker, Christine Verellun-Dumoulin, Hermien de Walle, Diana Wellesley, Awi Wiesel, Helen Dolk

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

AbstractObjectivesMicrocephaly is a congenital anomaly where the baby’s head is smaller than expected when compared with babies of the same sex, age and ethnicity. Many of these babies will have underdeveloped brains. This study aimed to provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe and to evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies).DesignA questionnaire and a population-based, observational study Setting 24 EUROCAT registries covering 570,000 births annually in 15 countries. Participants2443 cases of microcephaly not associated with a genetic condition, among live births, fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly at any gestation. Main Outcome MeasuresPrevalence of microcephaly (1st Jan 2003- 31st Dec 2012) analysed using random effects Poisson regression models to account for heterogeneity across registries.ResultsSixteen registries responded to the questionnaire of whom 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 standard deviations (SD) below the mean for sex, age and ethnic origin), 19% (3/16) used a 2 SD cut-off, 31% (5/16) were reliant on the criteria used by individual clinicians and one registry changed criteria between 2003 and 2012.Prevalence of microcephaly in Europe was 1.53 (95% CI : 1.16-1.96) per 10,000 births with registries varying from 0.4 (95% CI : 0.2-0.7) to 4.3 (95% CI : 3.8-4.8) per 10,000 (Chi-squared =338 with 23 degrees of freedom, I2 = 93%). Registries with the 3 SD cut-off reported a prevalence of 1.74 per 10,000 (95% CI: 0.86-2.93) compared with those with the less stringent 2 SD cut-off of 1.21 per 10,000 (95% CI: 0.21-2.93).The prevalence of microcephaly would need to increase in 1 year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (p
LanguageEnglish
Pages1-6
JournalBMJ.com
Volume354
Early online date13 Sep 2016
DOIs
Publication statusE-pub ahead of print - 13 Sep 2016

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Microcephaly
Registries
Population
Parturition
Pregnancy
Fetal Death
Brain
Live Birth
Skull
Gestational Age
Observational Studies
Head

Keywords

  • Microcephaly
  • EUROCAT
  • Prevalence

Cite this

Morris, Joan ; Rankin, Judith ; Garne, Ester ; Loane, Maria ; Greenlees, Ruth ; Addor, Marie-Claude ; Arriola, Larraitz ; Barisic, Ingeborg ; Bergman, Jorieke ; Csaky-Szunyogh, Melinda ; Dias, Carlos ; Draper, Elizabeth ; Gatt, Miriam ; Khoshnood, Babak ; Klunysoyr, Kari ; Kurinczuk, Jennifer ; Lynch, Catherine ; McDonnell, Robert ; Nelen, Vera ; Neville, Amanda ; O'Mahony, Mary ; Pierini, Anna ; Randrianaivo, Hanitra ; Rissmann, Anke ; Tucker, David ; Verellun-Dumoulin, Christine ; de Walle, Hermien ; Wellesley, Diana ; Wiesel, Awi ; Dolk, Helen. / Prevalence of Microcephaly in Europe: A Population based study. In: BMJ.com. 2016 ; Vol. 354. pp. 1-6.
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abstract = "AbstractObjectivesMicrocephaly is a congenital anomaly where the baby’s head is smaller than expected when compared with babies of the same sex, age and ethnicity. Many of these babies will have underdeveloped brains. This study aimed to provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe and to evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies).DesignA questionnaire and a population-based, observational study Setting 24 EUROCAT registries covering 570,000 births annually in 15 countries. Participants2443 cases of microcephaly not associated with a genetic condition, among live births, fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly at any gestation. Main Outcome MeasuresPrevalence of microcephaly (1st Jan 2003- 31st Dec 2012) analysed using random effects Poisson regression models to account for heterogeneity across registries.ResultsSixteen registries responded to the questionnaire of whom 44{\%} (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 standard deviations (SD) below the mean for sex, age and ethnic origin), 19{\%} (3/16) used a 2 SD cut-off, 31{\%} (5/16) were reliant on the criteria used by individual clinicians and one registry changed criteria between 2003 and 2012.Prevalence of microcephaly in Europe was 1.53 (95{\%} CI : 1.16-1.96) per 10,000 births with registries varying from 0.4 (95{\%} CI : 0.2-0.7) to 4.3 (95{\%} CI : 3.8-4.8) per 10,000 (Chi-squared =338 with 23 degrees of freedom, I2 = 93{\%}). Registries with the 3 SD cut-off reported a prevalence of 1.74 per 10,000 (95{\%} CI: 0.86-2.93) compared with those with the less stringent 2 SD cut-off of 1.21 per 10,000 (95{\%} CI: 0.21-2.93).The prevalence of microcephaly would need to increase in 1 year by over 35{\%} in Europe or by over 300{\%} in a single registry to reach statistical significance (p",
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author = "Joan Morris and Judith Rankin and Ester Garne and Maria Loane and Ruth Greenlees and Marie-Claude Addor and Larraitz Arriola and Ingeborg Barisic and Jorieke Bergman and Melinda Csaky-Szunyogh and Carlos Dias and Elizabeth Draper and Miriam Gatt and Babak Khoshnood and Kari Klunysoyr and Jennifer Kurinczuk and Catherine Lynch and Robert McDonnell and Vera Nelen and Amanda Neville and Mary O'Mahony and Anna Pierini and Hanitra Randrianaivo and Anke Rissmann and David Tucker and Christine Verellun-Dumoulin and {de Walle}, Hermien and Diana Wellesley and Awi Wiesel and Helen Dolk",
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Morris, J, Rankin, J, Garne, E, Loane, M, Greenlees, R, Addor, M-C, Arriola, L, Barisic, I, Bergman, J, Csaky-Szunyogh, M, Dias, C, Draper, E, Gatt, M, Khoshnood, B, Klunysoyr, K, Kurinczuk, J, Lynch, C, McDonnell, R, Nelen, V, Neville, A, O'Mahony, M, Pierini, A, Randrianaivo, H, Rissmann, A, Tucker, D, Verellun-Dumoulin, C, de Walle, H, Wellesley, D, Wiesel, A & Dolk, H 2016, 'Prevalence of Microcephaly in Europe: A Population based study', BMJ.com, vol. 354, pp. 1-6. https://doi.org/10.1136/bmj.i4721

Prevalence of Microcephaly in Europe: A Population based study. / Morris, Joan; Rankin, Judith; Garne, Ester; Loane, Maria; Greenlees, Ruth; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Bergman, Jorieke; Csaky-Szunyogh, Melinda; Dias, Carlos; Draper, Elizabeth; Gatt, Miriam; Khoshnood, Babak; Klunysoyr, Kari; Kurinczuk, Jennifer; Lynch, Catherine; McDonnell, Robert; Nelen, Vera; Neville, Amanda; O'Mahony, Mary; Pierini, Anna; Randrianaivo, Hanitra; Rissmann, Anke; Tucker, David; Verellun-Dumoulin, Christine; de Walle, Hermien; Wellesley, Diana; Wiesel, Awi; Dolk, Helen.

In: BMJ.com, Vol. 354, 13.09.2016, p. 1-6.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence of Microcephaly in Europe: A Population based study

AU - Morris, Joan

AU - Rankin, Judith

AU - Garne, Ester

AU - Loane, Maria

AU - Greenlees, Ruth

AU - Addor, Marie-Claude

AU - Arriola, Larraitz

AU - Barisic, Ingeborg

AU - Bergman, Jorieke

AU - Csaky-Szunyogh, Melinda

AU - Dias, Carlos

AU - Draper, Elizabeth

AU - Gatt, Miriam

AU - Khoshnood, Babak

AU - Klunysoyr, Kari

AU - Kurinczuk, Jennifer

AU - Lynch, Catherine

AU - McDonnell, Robert

AU - Nelen, Vera

AU - Neville, Amanda

AU - O'Mahony, Mary

AU - Pierini, Anna

AU - Randrianaivo, Hanitra

AU - Rissmann, Anke

AU - Tucker, David

AU - Verellun-Dumoulin, Christine

AU - de Walle, Hermien

AU - Wellesley, Diana

AU - Wiesel, Awi

AU - Dolk, Helen

PY - 2016/9/13

Y1 - 2016/9/13

N2 - AbstractObjectivesMicrocephaly is a congenital anomaly where the baby’s head is smaller than expected when compared with babies of the same sex, age and ethnicity. Many of these babies will have underdeveloped brains. This study aimed to provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe and to evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies).DesignA questionnaire and a population-based, observational study Setting 24 EUROCAT registries covering 570,000 births annually in 15 countries. Participants2443 cases of microcephaly not associated with a genetic condition, among live births, fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly at any gestation. Main Outcome MeasuresPrevalence of microcephaly (1st Jan 2003- 31st Dec 2012) analysed using random effects Poisson regression models to account for heterogeneity across registries.ResultsSixteen registries responded to the questionnaire of whom 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 standard deviations (SD) below the mean for sex, age and ethnic origin), 19% (3/16) used a 2 SD cut-off, 31% (5/16) were reliant on the criteria used by individual clinicians and one registry changed criteria between 2003 and 2012.Prevalence of microcephaly in Europe was 1.53 (95% CI : 1.16-1.96) per 10,000 births with registries varying from 0.4 (95% CI : 0.2-0.7) to 4.3 (95% CI : 3.8-4.8) per 10,000 (Chi-squared =338 with 23 degrees of freedom, I2 = 93%). Registries with the 3 SD cut-off reported a prevalence of 1.74 per 10,000 (95% CI: 0.86-2.93) compared with those with the less stringent 2 SD cut-off of 1.21 per 10,000 (95% CI: 0.21-2.93).The prevalence of microcephaly would need to increase in 1 year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (p

AB - AbstractObjectivesMicrocephaly is a congenital anomaly where the baby’s head is smaller than expected when compared with babies of the same sex, age and ethnicity. Many of these babies will have underdeveloped brains. This study aimed to provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe and to evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies).DesignA questionnaire and a population-based, observational study Setting 24 EUROCAT registries covering 570,000 births annually in 15 countries. Participants2443 cases of microcephaly not associated with a genetic condition, among live births, fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly at any gestation. Main Outcome MeasuresPrevalence of microcephaly (1st Jan 2003- 31st Dec 2012) analysed using random effects Poisson regression models to account for heterogeneity across registries.ResultsSixteen registries responded to the questionnaire of whom 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 standard deviations (SD) below the mean for sex, age and ethnic origin), 19% (3/16) used a 2 SD cut-off, 31% (5/16) were reliant on the criteria used by individual clinicians and one registry changed criteria between 2003 and 2012.Prevalence of microcephaly in Europe was 1.53 (95% CI : 1.16-1.96) per 10,000 births with registries varying from 0.4 (95% CI : 0.2-0.7) to 4.3 (95% CI : 3.8-4.8) per 10,000 (Chi-squared =338 with 23 degrees of freedom, I2 = 93%). Registries with the 3 SD cut-off reported a prevalence of 1.74 per 10,000 (95% CI: 0.86-2.93) compared with those with the less stringent 2 SD cut-off of 1.21 per 10,000 (95% CI: 0.21-2.93).The prevalence of microcephaly would need to increase in 1 year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (p

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KW - EUROCAT

KW - Prevalence

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JO - BMJ

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JF - BMJ

SN - 0959-8138

ER -

Morris J, Rankin J, Garne E, Loane M, Greenlees R, Addor M-C et al. Prevalence of Microcephaly in Europe: A Population based study. BMJ.com. 2016 Sep 13;354:1-6. https://doi.org/10.1136/bmj.i4721