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  1. Article ; Online: Neonatal anthropometry of malformed newborns: A large South American population-based study.

    Heisecke, Silvina / Alfaro, Emma L / Martínez, Jorge / Figueroa, Marcelo / Bronberg, Rubén / Ratowiecki, Julia / López Camelo, Jorge S / Dipierri, José E

    Paediatric and perinatal epidemiology

    2022  Volume 36, Issue 2, Page(s) 211–219

    Abstract: Background: Population-based anthropometric evaluation of malformed newborns is scarce.: Objectives: To evaluate malformed newborns' foetal growth using the ICD 10 malformations' classification.: Methods: A study including 33,769 newborns (14,857 ... ...

    Abstract Background: Population-based anthropometric evaluation of malformed newborns is scarce.
    Objectives: To evaluate malformed newborns' foetal growth using the ICD 10 malformations' classification.
    Methods: A study including 33,769 newborns (14,857 malformed and 18,912 nonmalformed), selected from 678,840 births from nine South American countries, period 2010-2018, was conducted. Prevalence of severe small and small for gestational age was calculated for malformed and nonmalformed newborns classified by preterm birth categories. Prevalence and relative risk (RR) with its 95% confidence interval (CI) were calculated. The associations between anthropometric phenotypes and congenital malformations were evaluated with generalized linear models.
    Results: Prevalence of preterm and term severe small and small for gestational age newborns was higher in malformed than that in nonmalformed neonates. For grouped ICD 10 malformations categories, the RR for severe small for gestational age was 2.88 (95% CI 2.51, 3.30) and 2.10 (95% CI 1.92, 2.30) for small for gestational age. For at-term and preterm malformed newborns, the RR for severe small for gestational age was 2.21 (95% CI 1.87, 2.61) and 3.21 (95% CI 2.52, 4.10), respectively; for small for gestational age, the RR was 2.31 (95% CI 2.11, 2.53) for at-term newborns and 2.58 (95% CI 2.16, 3.08) for preterm ones.
    Conclusions: Prevalence and relative risk of severe small and small for gestational age vary according to the group of malformations and gestational age; they increase in congenital malformations of the nervous, respiratory and digestive systems, and in chromosomal abnormalities and are lower for malformations of eye, ear, face and neck and cleft lip and palate. Foetal growth considered together with malformed newborns' gestational age would allow for inferring different risks of morbidity and mortality.
    MeSH term(s) Anthropometry ; Cleft Lip ; Cleft Palate ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Premature Birth
    Language English
    Publishing date 2022-02-21
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639089-4
    ISSN 1365-3016 ; 0269-5022 ; 1353-663X
    ISSN (online) 1365-3016
    ISSN 0269-5022 ; 1353-663X
    DOI 10.1111/ppe.12843
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Impacto emocional y cambios en la conducta profesional a causa del suicidio de pacientes.

    Guzzo, Enzo / Taragano, Fernando / Heisecke, Silvina / Krupitzki, Hugo / Tondo, Leonardo

    Vertex (Buenos Aires, Argentina)

    2019  Volume XXIX, Issue 139, Page(s) 172–177

    Abstract: The objective of the study was to assess the emotional impact on healthcare professionals and changes in their behavior as a result of patients' suicide in Argentina. An anonymous survey was e-mailed to healthcare professionals registered in CEMIC ... ...

    Title translation Patient's suicide: Emotional impact on healthcare professionals and changes in their behavior.
    Abstract The objective of the study was to assess the emotional impact on healthcare professionals and changes in their behavior as a result of patients' suicide in Argentina. An anonymous survey was e-mailed to healthcare professionals registered in CEMIC University Institute Department of Psychiatry database. A total of 250 responses were obtained. Among respondents, 50.6% had provided treatment to patients that committed suicide. The rate rose to 62.5% among psychiatrists. The professionals that gave an affirmative response were assessed with Horowitz Impact of Event Scale to determine the severity of trauma. The mean score for the sample was 19.6 (mild severity), with a higher mean observed in women (21.2). A difference was found in the group of younger professionals (20-29 years), who revealed a higher impact of event, with moderate severity (29.0). This difference was numerical and failed to be statistically significant (chi2 (4)=8.2110 p=0.084). Only 11.5% of respondents referred to the need to undergo treatment as a result of a patient's suicide-related death. However, 41.5% experienced a negative impact on their physical or mental health. About 60% of professionals made changes in their clinical practice after a patient's suicide. About 80% of respondents admitted they had not received enough training about suicide. Acknowledging these difficulties and providing support to healthcare professionals is crucial to face these challenges.
    MeSH term(s) Argentina ; Emotions ; Female ; Health Personnel/psychology ; Humans ; Male ; Psychiatry ; Suicide
    Language Spanish
    Publishing date 2019-02-18
    Publishing country Argentina
    Document type Journal Article
    ISSN 0327-6139
    ISSN 0327-6139
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Paternal age and risk for selected birth defects in a large South American sample.

    Gili, Juan A / Rittler, Monica / Heisecke, Silvina / Campaña, Hebe / Giménez, Lucas / Santos, María Rita / Ratowiecki, Julia / Cosentino, Viviana / López Camelo, Jorge / Poletta, Fernando A

    Birth defects research

    2023  Volume 115, Issue 19, Page(s) 1866–1875

    Abstract: Background: The relationship between maternal age (MA) and birth defects (BD) has been extensively studied while much less research, mostly with discordant results, has focused on the risk of paternal age (PA) for BD. Furthermore, no consensus has been ... ...

    Abstract Background: The relationship between maternal age (MA) and birth defects (BD) has been extensively studied while much less research, mostly with discordant results, has focused on the risk of paternal age (PA) for BD. Furthermore, no consensus has been reached on the best way to control the association of PA with MA.
    Objectives: The aim of the study was to evaluate the risk of PA increase, at 1-year intervals, for selected BD, especially controlling for the confounding effect of MA.
    Methods: The sample comprised of 27,944 liveborns presenting 1 of 18 selected isolated BD. Conditional logistic regressions were applied to evaluate the risk of advanced PA and its yearly increase, adjusting by MA and other variables.
    Results: Of the 18 analyzed BD, only the risk for preaxial polydactyly (PreP) showed a significant association with increasing PA, while advanced MA was of low risk. For esophageal and anal atresia, associations with both PA and MA increases were observed.
    Conclusions: Results support the hypothesis of advanced PA as a risk factor for PreP and helps clarify the so far unexplained nonrandom association between this defect and Down syndrome.
    MeSH term(s) Humans ; Male ; Anus, Imperforate/epidemiology ; Paternal Age ; Risk Factors ; South America/epidemiology ; Polydactyly/epidemiology
    Language English
    Publishing date 2023-09-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2104792-3
    ISSN 2472-1727
    ISSN (online) 2472-1727
    DOI 10.1002/bdr2.2252
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Gene-environment interactions and preterm birth predictors: A Bayesian network approach.

    Elias, Dario E / Santos, Maria R / Campaña, Hebe / Poletta, Fernando A / Heisecke, Silvina L / Gili, Juan A / Ratowiecki, Julia / Cosentino, Viviana R / Uranga, Rocio / Málaga, Diana Rojas / Oliveira Netto, Alice Brinckmann / Brusius-Facchin, Ana Carolina / Saleme, César / Rittler, Mónica / Krupitzki, Hugo B / Camelo, Jorge S Lopez / Gimenez, Lucas G

    Genetics and molecular biology

    2024  Volume 46, Issue 4, Page(s) e20230090

    Abstract: Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to identify gene-environment interactions associated with spontaneous PTB or its predictors. We carried out a retrospective case-control ... ...

    Abstract Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to identify gene-environment interactions associated with spontaneous PTB or its predictors. We carried out a retrospective case-control study including parental sociodemographic and obstetric data as well as newborn genetic variants of 69 preterm and 61 at term newborns born at a maternity hospital from Tucumán, Argentina, between 2005 and 2010. A data-driven Bayesian network including the main PTB predictors was created where we identified gene-environment interactions. We used logistic regressions to calculate the odds ratios and confidence intervals of the interactions. From the main PTB predictors (nine exposures and six genetic variants) we identified an interaction between low neighbourhood socioeconomic status and rs2074351 (PON1, genotype GG) variant that was associated with an increased risk of toxoplasmosis (odds ratio 12.51, confidence interval 95%: 1.71 - 91.36). The results of this exploratory study suggest that structural social disparities could influence the PTB risk by increasing the frequency of exposures that potentiate the risk associated with individual characteristics such as genetic traits. Future studies with larger sample sizes are necessary to confirm these findings.
    Language English
    Publishing date 2024-01-19
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 1445712-x
    ISSN 1678-4685 ; 1415-4757
    ISSN (online) 1678-4685
    ISSN 1415-4757
    DOI 10.1590/1678-4685-GMB-2023-0090
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Genetic susceptibility for retinopathy of prematurity and its associated comorbidities.

    Gimenez, Lucas G / Gili, Juan A / Elias, Darío E / Sagula, Rubén / Comas, Belén / Santos, María R / Campaña, Hebe / Poletta, Fernando A / Heisecke, Silvina L / Ratowiecki, Julia / Cosentino, Viviana R / Uranga, Rocío / Saleme, César / Negri, Mercedes / Rittler, Mónica / Zapata Barrios, Jorge / Krupitzki, Hugo B / López Camelo, Jorge S

    Pediatric research

    2024  

    Abstract: Background: Retinopathy of prematurity (ROP) is one of the leading cause of child blindness. Preterm newborns of very low gestational age (GA) and very low birth weight are at the greatest risk. Our objective was to evaluate the role of genetic variants ...

    Abstract Background: Retinopathy of prematurity (ROP) is one of the leading cause of child blindness. Preterm newborns of very low gestational age (GA) and very low birth weight are at the greatest risk. Our objective was to evaluate the role of genetic variants associated with ROP risk and its comorbidities in an Argentinian sample of premature infants.
    Methods: A sample of 437 preterm infants <33 weeks GA, born at a maternity hospital in Tucumán, Argentina, 2005-2010, was analyzed. Environmental factors, perinatal outcomes, and fourteen single nucleotide polymorphisms associated with ROP were evaluated, comparing ROP with non-ROP newborns. A lasso logistic regression was performed to select variables; then, a conditional logistic regression was used to identify ROP maternal and perinatal risk factors adjusting by maternal and gestational ages, respectively.
    Results: ROP maternal risk factors were alcohol intake, periodontal infections, and severe stress. Respiratory distress, sepsis, and intracranial hemorrhage were the ROP perinatal risk factors. Markers rs186085 of EPAS1 and rs427832 of AGTR1 were significantly associated with ROP newborns.
    Conclusion: We identified three maternal and three perinatal risk factors associated with ROP. Genes EPAS1 and AGTR1, involved in angiogenesis and vascularization, were identified to be of risk for ROP.
    Impact: Genetic and environmental risk factors associated with ROP and its comorbidities are evaluated in a Latin American population. Genes EPAS1 and AGTR1, involved in angiogenesis and vascularization, were identified to be of risk for ROP. Three maternal and three perinatal risk factors associated with ROP were also identified. A matrix of significant relationships among genetic markers and comorbidities is presented. Reported data may help develop more effective preventive measures for ROP in the Latin American region.
    Language English
    Publishing date 2024-02-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-024-03068-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Diseases during pregnancy in a large unselected South American sample.

    Santos, María Rita / Campaña, Hebe / Heisecke, Silvina / Ratowiecki, Julia / Elías, Darío / Giménez, Lucas / Poletta, Fernando Adrián / Gili, Juan / Uranga, Rocío / Cosentino, Viviana / Krupitzki, Hugo / Rittler, Mónica / Camelo, Jorge López

    Revista brasileira de epidemiologia = Brazilian journal of epidemiology

    2022  Volume 25, Page(s) e220043

    Abstract: Objective: Our aim was to describe the prevalence of diseases during pregnancy and the association between fetal exposure to the most frequent maternal diseases and the risk of preterm (PTB) and/or small for gestational age (SGA) newborns in an ... ...

    Abstract Objective: Our aim was to describe the prevalence of diseases during pregnancy and the association between fetal exposure to the most frequent maternal diseases and the risk of preterm (PTB) and/or small for gestational age (SGA) newborns in an unselected sample of women who gave birth in South American countries.
    Methods: We conducted a descriptive, cross-sectional study including 56,232 mothers of non-malformed infants born between 2002 and 2016, using data from the Latin American Collaborative Study of Congenital Malformations (ECLAMC). Diseases with higher- than-expected PTB/SGA frequencies were identified. Odds ratios of confounding variables for diseases and birth outcomes were calculated with a multivariable logistic regression.
    Results: Of the 14 most reported diseases, hypertension, genitourinary infection, epilepsy, hypothyroidism, diabetes, and HIV/AIDS showed higher PTB and/or SGA frequencies. Advanced and low maternal age, previous fetal loss, low socioeconomic level, and African-American ancestry were associated with PTB, while advanced maternal age, primigravidity, previous fetal loss, low socioeconomic level, and African-American ancestry were associated with SGA. After adjusting for the associated variables, the identified illnesses maintained their association with PTB and all, except epilepsy, with SGA.
    Conclusion: The description of an unselected population of mothers allowed identifying the most frequent diseases occurring during gestation and their impact on pregnancy outcomes. Six diseases were associated with PTB and two with SGA newborns. To the best of our knowledge, there are no similar reports about women not intentionally selected by specific diseases during pregnancy in South American populations.
    MeSH term(s) Infant, Newborn ; Female ; Humans ; Pregnancy ; Cross-Sectional Studies ; Brazil
    Language English
    Publishing date 2022-12-05
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2183366-7
    ISSN 1980-5497 ; 1980-5497
    ISSN (online) 1980-5497
    ISSN 1980-5497
    DOI 10.1590/1980-549720220043
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  7. Article: Genes, exposures, and interactions on preterm birth risk: an exploratory study in an Argentine population.

    Elias, Dario E / Santos, Maria R / Campaña, Hebe / Poletta, Fernando A / Heisecke, Silvina L / Gili, Juan A / Ratowiecki, Julia / Cosentino, Viviana / Uranga, Rocio / Málaga, Diana Rojas / Netto, Alice Brinckmann Oliveira / Brusius-Facchin, Ana Carolina / Saleme, César / Rittler, Mónica / Krupitzki, Hugo B / Camelo, Jorge S Lopez / Gimenez, Lucas G

    Journal of community genetics

    2022  Volume 13, Issue 6, Page(s) 557–565

    Abstract: Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to identify associations of spontaneous PTB with genetic variants, exposures, and interactions between and within them. We carried out a ... ...

    Abstract Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to identify associations of spontaneous PTB with genetic variants, exposures, and interactions between and within them. We carried out a retrospective case-control study including parental sociodemographic and obstetric data, and fetal genetic variants. We sequenced the coding and flanking regions of five candidate genes from the placental blood cord of 69 preterm newborns and 61 at term newborns. We identify the characteristics with the greatest predictive power of PTB using penalized regressions, in which we include exposures (E), genetic variants (G), and two-way interactions. Few prenatal visits (< 5) was the main predictor of PTB from 26 G, 35 E, 299 G × G, 564 E × E, and 875 G × E evaluated terms. Within the fetal genetic characteristics, we observed associations of rs4845397 (KCNN3, allele T) variant; G × G interaction between rs12621551 (COL4A3, allele T) and rs73993878 (COL4A3, allele A), which showed sensitivity to anemia; and G × G interaction between rs11680670 (COL4A3, allele T) and rs2074351 (PON1, allele A), which showed sensitivity to vaginal discharge. The results of this exploratory study suggest that social disparities and metabolic pathways linked to uterine relaxation, inflammation/infections, and collagen metabolism would be involved in PTB etiology. Future studies with a larger sample size are necessary to confirm these findings and to analyze a greater number of exposures.
    Language English
    Publishing date 2022-08-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2543127-4
    ISSN 1868-6001 ; 1868-310X
    ISSN (online) 1868-6001
    ISSN 1868-310X
    DOI 10.1007/s12687-022-00605-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Lethality of Birth Defects in Live Born Infants Categorized by Gestational Age and Birth Weight.

    Rittler, Monica / Campaña, Hebe / Heisecke, Silvina / Ratowiecki, Julia / Elias, Dario / Gimenez, Lucas / Poletta, Fernando A / Gili, Juan / Pawluk, Mariela / Santos, Maria Rita / Uranga, Rocio / Cosentino, Viviana / Camelo, Jorge Lopez

    American journal of perinatology

    2021  Volume 40, Issue 13, Page(s) 1406–1412

    Abstract: Objective: This study aimed to describe lethality of birth defects (BDs) in newborns categorized by gestational age and birth weight and to identify BDs associated with prematurity.: Study design: Live born infants (: Results: Overall fewer ... ...

    Abstract Objective: This study aimed to describe lethality of birth defects (BDs) in newborns categorized by gestational age and birth weight and to identify BDs associated with prematurity.
    Study design: Live born infants (
    Results: Overall fewer malformed than nonmalformed infants were of adequate growth, while the opposite occurred in the preterm and SGA categories where gastroschisis and esophageal atresia were among the most outstanding defects. For most severe BDs, the early neonatal death rate was higher than control values in all categories; for mild defects, except cleft lip in the preterm category, they did not differ. Diaphragmatic hernia showed the highest lethality values, while those of spina bifida were among the lowest. Talipes, hypospadias, and septal heart defects were mild defects significantly associated with prematurity.
    Conclusion: Although reasons, such as induced preterm delivery of fetuses with certain anomalies, could partially account for their high prematurity rates, susceptibility to preterm birth might exist through underlying mechanisms related with the defects. The identification of BDs associated with prematurity should serve to improve measures that prevent preterm birth especially of fetuses at risk.
    Key points: · Some BDs predispose to prematurity.. · Prematurity is an additional risk factor for mortality in infants with mild defects.. · Lethality values should be adjusted by gestational age and birth weight..
    MeSH term(s) Male ; Female ; Infant, Newborn ; Infant ; Humans ; Pregnancy ; Birth Weight ; Gestational Age ; Premature Birth ; Infant, Premature ; Infant, Small for Gestational Age ; Fetal Growth Retardation
    Language English
    Publishing date 2021-10-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/s-0041-1735867
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Inequidades sociales en madres adolescentes y la relación con resultados perinatales adversos en poblaciones sudamericanas.

    Ratowiecki, Julia / Santos, María Rita / Poletta, Fernando / Heisecke, Silvina / Elias, Dario / Gili, Juan / Gimenez, Lucas / Pawluk, Mariela / Uranga, Rocio / Cosentino, Viviana / Campaña, Hebe / Rittler, Mónica / Camelo, Jorge S López

    Cadernos de saude publica

    2021  Volume 36, Issue 12, Page(s) e00247719

    Abstract: The aim was to explain differences in the rates of adverse perinatal events in teenage mothers with low and high schooling. The sample was collected from the Latin American Colaborative Study of Congenital Malformations (ECLAMC) database. From a total of ...

    Title translation Social inequities in teenage mothers and the relationship to adverse perinatal outcomes in South American populations.
    Abstract The aim was to explain differences in the rates of adverse perinatal events in teenage mothers with low and high schooling. The sample was collected from the Latin American Colaborative Study of Congenital Malformations (ECLAMC) database. From a total of 2,443,747 births in 93 hospitals, 66,755 live newborns without congenital malformations were recruited from 2000 to 2017. Teenage mothers were classified according to low, medium, and high schooling. A multivariate model was used that included reproductive history, access to health services, demographic and socioeconomic variables, and ethnic group. The Fairlie decomposition model was applied to quantify the contribution of explanatory variables to the adverse perinatal event rates. Of the 66,755 newborns analyzed, 21.1% (n = 14,078) were born to teenage mothers. Distribution of maternal schooling was 24.2%, 59.8%, and 16% for low, medium, and high schooling, respectively. The highest rates of adverse perinatal events were seen in teenage mothers with low schooling. The variable "access to health services" explained 35%, 37%, and 23% of the disparities in low birthweight, prematurity, and intrauterine growth restriction, respectively, among teenage mother with low and high schooling. Low number of prenatal visits was the only risk factor for the two levels of schooling and the variable that best explained the differences between the rates of adverse perinatal events. From the public health perspective, prenatal care represents a low-cost intervention with the possibility of increased implementation through adequate information for the population and systematic measures in primary care.
    MeSH term(s) Adolescent ; Brazil/epidemiology ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Mothers ; Pregnancy ; Pregnancy Outcome/epidemiology ; Pregnancy in Adolescence ; Prenatal Care
    Language Spanish
    Publishing date 2021-01-11
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 1115730-6
    ISSN 1678-4464 ; 0102-311X
    ISSN (online) 1678-4464
    ISSN 0102-311X
    DOI 10.1590/0102-311X00247719
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  10. Article ; Online: A graph theory approach to analyze birth defect associations.

    Elias, Dario / Campaña, Hebe / Poletta, Fernando / Heisecke, Silvina / Gili, Juan / Ratowiecki, Julia / Gimenez, Lucas / Pawluk, Mariela / Santos, Maria Rita / Cosentino, Viviana / Uranga, Rocio / Rittler, Monica / Lopez Camelo, Jorge

    PloS one

    2020  Volume 15, Issue 5, Page(s) e0233529

    Abstract: Birth defects are prenatal morphological or functional anomalies. Associations among them are studied to identify their etiopathogenesis. The graph theory methods allow analyzing relationships among a complete set of anomalies. A graph consists of nodes ... ...

    Abstract Birth defects are prenatal morphological or functional anomalies. Associations among them are studied to identify their etiopathogenesis. The graph theory methods allow analyzing relationships among a complete set of anomalies. A graph consists of nodes which represent the entities (birth defects in the present work), and edges that join nodes indicating the relationships among them. The aim of the present study was to validate the graph theory methods to study birth defect associations. All birth defects monitoring records from the Estudio Colaborativo Latino Americano de Malformaciones Congénitas gathered between 1967 and 2017 were used. From around 5 million live and stillborn infants, 170,430 had one or more birth defects. Volume-adjusted Chi-Square was used to determine the association strength between two birth defects and to weight the graph edges. The complete birth defect graph showed a Log-Normal degree distribution and its characteristics differed from random, scale-free and small-world graphs. The graph comprised 118 nodes and 550 edges. Birth defects with the highest centrality values were nonspecific codes such as Other upper limb anomalies. After partition, the graph yielded 12 groups; most of them were recognizable and included conditions such as VATER and OEIS associations, and Patau syndrome. Our findings validate the graph theory methods to study birth defect associations. This method may contribute to identify underlying etiopathogeneses as well as to improve coding systems.
    MeSH term(s) Congenital Abnormalities/epidemiology ; Data Science/methods ; Databases, Factual ; Humans ; Infant, Newborn ; Statistical Distributions
    Language English
    Publishing date 2020-05-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Validation Study
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0233529
    Database MEDical Literature Analysis and Retrieval System OnLINE

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