背景:先天性马蹄内翻足(马蹄内翻足)是一种常见的肌肉骨骼异常,怀疑是多因素病因。在这里,我们使用公开可用的数据来确定1994-2021年期间在丹麦分娩的马蹄内翻足的活出生婴儿,并对同时发生的先天性异常进行分类。估计年度患病率,并将马蹄内翻足的发生率与产妇吸烟率进行比较,一个常见的风险因素。在全国范围内,liveborn队列为病因调查和生命过程监测提供了基于人群的资源。
方法:本病例队列研究使用了来自丹麦国家患者登记和丹麦民事登记系统的数据,通过公开的丹麦生物银行登记册访问,确定1994年至2021年期间在丹麦交付给丹麦父母的1,315,282名活体婴儿。其中,2,358名婴儿(65.1%为男性)被确定为马蹄内翻足,并被归类为综合征(同时发生的染色体,遗传,或致畸综合征)和非综合征(孤立或共同发生的多种先天性异常[MCA])。非综合征性马蹄内翻足儿童的年患病率估计值和相应的95%置信区间(CIs)使用泊松回归进行估计,并与基于人群的,从公开资源中获得的产妇年吸烟率。
结果:婴儿最常表现为非综合征性马蹄内翻足(孤立=88.6%;MCA=11.4%);肢体和心脏异常是最常见的MCA。患病率(每1,000名活体出生婴儿)为分离的1.52(CI1.45-1.58),MCA马蹄畸形为0.19(CI0.17-0.22)。在研究期间,孤立和MCA马蹄足的患病率估计保持相对稳定,尽管以人口为基础的产妇吸烟率显著下降。
结论:从1994年到2021年,丹麦非综合征性马蹄内翻足的患病率相对稳定。人口水平的产妇吸烟率的降低似乎并没有影响患病率估计,为这种异常的可疑多因素病因提供了一些支持。这个全国范围内,活生生的队列,使用丹麦生物库注册的公开数据确定和临床特征,为未来的病因调查和生命过程监测提供基于人群的临床和生物资源。
BACKGROUND: Congenital talipes equinovarus (clubfoot) is a common musculoskeletal anomaly, with a suspected multifactorial etiopathogenesis. Herein, we used publicly available data to ascertain liveborn infants with clubfoot delivered in Denmark during 1994-2021, and to classify co-occurring congenital anomalies, estimate annual prevalence, and compare clubfoot occurrence with maternal smoking rates, a commonly reported risk factor. Characterizing this nationwide, liveborn cohort provides a population-based resource for etiopathogenic investigations and life course surveillance.
METHODS: This case-cohort study used data from the Danish National Patient Register and Danish Civil Registration System, accessed through the publicly available Danish Biobank Register, to identify 1,315,282 liveborn infants delivered during 1994-2021 in Denmark to Danish parents. Among these, 2,358 infants (65.1% male) were ascertained with clubfoot and classified as syndromic (co-occurring chromosomal, genetic, or teratogenic syndromes) and nonsyndromic (isolated or co-occurring multiple congenital anomalies [MCA]). Annual prevalence estimates and corresponding 95% confidence intervals (CIs) for children with nonsyndromic clubfoot were estimated using Poisson regression and compared with population-based, maternal annual smoking rates obtained from publicly available resources.
RESULTS: Infants most often presented with nonsyndromic clubfoot (isolated = 88.6%; MCA = 11.4%); limb and heart anomalies were the most frequently identified MCAs. Prevalence (per 1,000 liveborn infants) was 1.52 (CI 1.45-1.58) for isolated and 0.19 (CI 0.17-0.22) for MCA clubfoot. Prevalence estimates for both isolated and MCA clubfoot remained relatively stable during the study period, despite marked decreases in population-based maternal smoking rates.
CONCLUSIONS: From 1994 to 2021, prevalence of nonsyndromic clubfoot in Denmark was relatively stable. Reduction in population-level maternal smoking rates did not seem to impact prevalence estimates, providing some support for the suspected multifactorial etiopathogenesis of this anomaly. This nationwide, liveborn cohort, ascertained and clinically characterized using publicly available data from the Danish Biobank Register, provides a population-based clinical and biological resource for future etiopathogenic investigations and life course surveillance.