Provincial and territorial congenital anomalies surveillance: a summary of surveillance programs across Canada

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Abstract

The Canadian Congenital Anomalies Surveillance Network was established in 2002 to address gaps in the national surveillance of congenital anomalies (CAs) and support the sustainability of high-quality, population-based, CA surveillance systems within provinces and territories. This paper highlights the methodologies of each local CA surveillance system, noting similarities and variabilities between each system, to contribute to enhanced national CA surveillance efforts.

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Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis

Albert Reece, Gary Kenneth Hulse (2020)

Objectives: Cannabis is a known teratogen. Data availability addressing both major congenital anomalies and cannabis use allowed us to explore their geospatial relationships. Methods: Data for the years 1998 to 2009 from Canada Health and Statistics Canada was analyzed in R. Maps have been drawn and odds ratios, principal component analysis, correlation matrices, least squares regression and geospatial regression analyses have been conducted using the R packages base, dplyr, epiR, psych, ggplot2, colorplaner and the spml and spreml functions from package splm. Results: Mapping showed cannabis use was more common in the northern Territories of Canada in the Second National Survey of Cannabis Use 2018. Total congenital anomalies, all cardiovascular defects, orofacial clefts, Downs syndrome and gastroschisis were all found to be more common in these same regions and rose as a function of cannabis exposure. When Canada was dichotomized into high and low cannabis use zones by Provinces v Territories the Territories had a higher rate of total congenital anomalies 450.026 v 390.413 (O.R. = 1.16 95%C.I. 1.08-1.25, P = 0.000058; attributable fraction in exposed 13.25%, 95%C.I. 7.04–19.04%). In geospatial analysis in a spreml spatial error model cannabis was significant both alone as a main effect (P < 2.0 × 10−16) and in all its first and second order interactions with both tobacco and opioids from P < 2.0 × 10−16. Conclusion: These results show that the northern Territories of Canada share a higher rate of cannabis use together with elevated rates of total congenital anomalies, all cardiovascular defects, Down's syndrome and gastroschisis. This is the second report of a significant association between cannabis use and both total defects and all cardiovascular anomalies and the fourth published report of a link with Downs syndrome and thereby direct major genotoxicity. The correlative relationships described in this paper are confounded by many features of social disadvantage in Canada's northern territories. However, in the context of a similar broad spectrum of defects described both in animals and in epidemiological reports from Hawaii, Colorado, USA and Australia they are cause for particular concern and indicate further research.

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Congenital anomaly surveillance in England--ascertainment deficiencies in the national system.

Maureen P. Boyd, B Botting, D Wellesley … (2005)

Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variation by defect, geographical area, and socioeconomic deprivation. Secondly, to assess the impact of the lack of data on pregnancies terminated because of fetal anomaly. Comparison of the NCAS with four local congenital anomaly registers in England. Four regions in England covering some 109,000 annual births. Cases of congenital anomalies registered in the NCAS (live births and stillbirths) and independently registered in the four local registers (live births, stillbirths, fetal losses from 20 weeks' gestation, and pregnancies terminated after prenatal diagnosis of fetal anomaly). The ratio of cases identified by the national register to those in local registry files, calculated for different specified anomalies, for whole registry areas, and for hospital catchment areas within registry boundaries. Ascertainment by the NCAS (compared with data from local registers, from which terminations of pregnancy were removed) was 40% (34% for chromosomal anomalies and 42% for non-chromosomal anomalies) and varied markedly by defect, by local register, and by hospital catchment area, but not by area deprivation. When terminations of pregnancy were included in the register data, ascertainment by NCAS was 27% (19% for chromosomal anomalies and 31% for non-chromosomal anomalies), and the geographical variation was of a similar magnitude. The surveillance of congenital anomalies in England is currently inadequate because ascertainment to the national register is low and non-uniform and because no data exist on termination of pregnancy resulting from prenatal diagnosis of fetal anomaly.

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Congenital abnormalities and childhood cancer.

Teresa To, Loraine Marrett, Alvin Zipursky … (2005)

The examination of specific characteristics of neoplasms diagnosed in children have suggested that a significant proportion can be attributed to a genetic mutation or genetic predisposition. Although the study of a genetic predisposition to cancer in children remains in the early stages, congenital abnormalities could provide essential information for mapping predisposing lesions in children with cancer. In the current study, 2 large cohorts of children with and without congenital abnormalities were followed for the occurrence of cancer and death up to 18 years. Through this study, the risk of developing cancer by age at diagnosis, effects of birth characteristics on cancer risk, and possible associations between specific anomalies and tumor types were examined. Based on the follow-up of 90,400 children, the risk of developing cancer during the first year of life was found to be nearly 6 times higher in children with anomalies (rate ratio [RR] of 5.8; 95% confidence interval [95% CI], 3.7-9.1). Children with birth defects were found to be at a higher risk for developing leukemia (RR of 2.7; 95% CI, 2.1-3.6), tumors of the central nervous system (RR of 2.5; 95% CI, 1.8-3.4), sympathetic nervous system tumors (RR of 2.2; 95% CI, 1.4-3.4), and soft tissue sarcomas (RR of 1.9; 95% CI, 1.0-3.5). Among children with birth defects, children with Down syndrome, nervous system anomalies, and anomalies of the urinary system had the highest incidence rates of cancer. In the presence of birth defects, other factors such as birth weight, gestational age, age of the mother, and birth order were not found to be associated significantly with the risk of cancer. The significant relative risks found in the current study provided evidence of links between the presence of abnormalities and the development of cancer. Some "cancer-prone" abnormalities were identified in the current study. Such anomalies may be markers of other exposures or processes that increase the risk of developing cancer. (c) 2005 American Cancer Society.

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Author and article information

Journal

Journal ID (nlm-ta): Health Promot Chronic Dis Prev Can

Journal ID (iso-abbrev): Health Promot Chronic Dis Prev Can

Journal ID (publisher-id): CDIC

Title: Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice

Publisher: Public Health Agency of Canada

ISSN (Electronic): 2368-738X

Publication date (Print): May 2024

Volume: 44

Issue: 5

Pages: 229-235

Affiliations

[1 ] Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada

[2 ] Office of the Provincial Health Officer, BC Ministry of Health, Victoria, British Columbia, Canada

[3 ] Nova Scotia Reproductive Care Program, Halifax, Nova Scotia, Canada

[4 ] Perinatal Surveillance Health PEI, Charlottetown, Prince Edward Island, Canada

[5 ] Government of the Northwest Territories, Department of Health and Social Services, Yellowknife, Northwest Territories, Canada

[6 ] Manitoba Health, Winnipeg, Manitoba, Canada

[7 ] New Brunswick Perinatal Health Program, Moncton, New Brunswick, Canada

[8 ] BORN Ontario, Ottawa, Ontario, Canada

[9 ] Newfoundland and Labrador Health Services, St. John’s, Newfoundland and Labrador, Canada

[10 ] Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada

Author notes

Correspondence: Tanya Bedard, Alberta Congenital Anomalies Surveillance System, Clinical Genetics, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8; Email: tanya.bedard@albertahealthservices.ca

Article

Publisher-manuscript ID: 44_5_4 Publisher ID: 150421_Willis_v7-mthighlights_clean_SD

DOI: 10.24095/hpcdp.44.5.04

PMC ID: 11152185

PubMed ID: 38748480

SO-VID: 720d310a-ae39-4a70-9ef7-570b41912574

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This work is licensed under a Creative Commons Attribution 4.0 International License

Provincial and territorial congenital anomalies surveillance: a summary of surveillance programs across Canada

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Most cited references 18

Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis

Congenital anomaly surveillance in England--ascertainment deficiencies in the national system.

Congenital abnormalities and childhood cancer.

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