Congenital Malformations

Abstract

Gregg (1941) noticed a change in the proportion of children referred to his clinic in Australia with certain eye defects. This stimulated him to initiate studies into the association between maternal rubella and congenital abnormality in the subsequently born child, which led to a clear demonstration of one of the factors that could cause congenital malformations. About the same time, the proportion of the overall fetal loss due to congenital malformation rose, as the other causes of stillbirth and neonatal death declined. In England and Wales 11 per cent of all neonatal deaths were certified as due to congenital malformations; by 1945 this proportion had risen to 14 per cent, and by 1985 to 32 per cent. This rise gradually brought the topic into greater prominence and attention was sharply focused by the thalidomide disaster in the 1960s. More recent trends in the proportion of fetal loss due to congenital malformations in England and Wales are given in Table 5.1, which shows an initial rise and then a fall in the proportion of stillbirths from congenital malformations in the period 1968–84; the neonatal deaths show a fairly steady increase throughout the period.