The return of thalidomide : Are birth Defects surveillance systems ready ?
In the 1960s, thalidomide caused limb deficiencies in thousands of infants worldwide.
The limb deficiencies were frequently of the intercalary type.
As a result, numerous countries started birth defect surveillance programs.
In 1967, the Centers for Disease Control (CDC) started the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based surveillance system, to provide early warning against new teratogens.
Recent studies have shown that thalidomide may be beneficial for a range of conditions, including cancer and AIDS, and it may once again become widely available.
Here, we examine the ability of MACDP to detect an increase in the birth prevalence of limb deficiency as an early warning of fetal exposure to thalidomide.
We calculated base rates for all limb deficiencies, for bilateral nonsyndromic intercalary or preaxial deficiencies, and for all nonsyndromic intercalary limb deficiencies among Atlanta infants born from 1968 through 1993.
We used relative risk estimates from previous studies and a range of pregnancy exposure rates for thalidomide.
We tested the statistical power of MACDP to detect subtle changes in the birth prevalence of these defects using Poisson and cumulative sum (CUSUM) techniques.
The base rates for all limb deficiencies, for bilateral intercalary or preaxial deficiencies, and for all intercalary limb deficiencies, were 0.53,0.035, and 0.022/1,000, and the estimated relative risks were 175,4,570, and 8,180, respectively. (...)
Mots-clés Pascal : Thalidomide, Toxicité, Tératogène, Antiémétique, Malformation, Membre, Surveillance, Population, Etude statistique, Prévalence, Epidémiologie, Homme, Système ostéoarticulaire pathologie
Mots-clés Pascal anglais : Thalidomide, Toxicity, Teratogen, Antiemetic, Malformation, Limb, Surveillance, Population, Statistical study, Prevalence, Epidemiology, Human, Diseases of the osteoarticular system
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0031362
Code Inist : 002B02U10. Création : 17/04/1998.