Anomalías Congénitas en España: Vigilancia epidemiológica en el último cuarto de siglo (1980-2004)

Abstract

The main results of the annual surveillance of congenital anomalies performed in the ECEMC (Spanish Collaborative Study of Congenital Anomalies) are presented here. The analysed data correspond to the last 25 years (1980-2004). A total of 2,045,751 newborn infants were surveyed, for an overall coverage of 23.39% of births in Spain. Among those infants, 32,883 were registered because of the presence of congenital defects detected during the first three days of life, for a prevalence of 1.61%. A statistically significant decrease of the global prevalence has been observed after the passing of the law permitting terminations of pregnancy (TOP) following prenatal detection of malformations. According to the ECEMC's data, that decrease can be attributable to the impact of TOP on the neonatal frequency, as there is an increasing number of defects that can be prenatally detected. The global decrease is also observed in most of the 17 Spanish Autonomic Regions, and is statistically significant in 11 of them. After studying the secular trend for some selected anomalies, either globally or by Autonomic Regions, the decrease is the rule. However, given the difficulties to routinely gather data on TOP, the epidemiological and etiological analyses including them are still almost unfeasible. Another circumstance that has to be taken into consideration in any investigation on congenital defects in our country, is the increasing number of immigrant people having infants in Spain, as it has been observed in the ECEMC's data. Finally, the versatility of the ECEMC registry to adapt itself to changes in the surveyed population and in knowledge, is highlighted, as well as the accomplishment, in the ECEMC, of the objectives summarized by the NBDPN (National Birth Defects Prevention Network), from the USA, in their guidelines for conducting birth defects surveillance, edited in 2004.