Monthly and seasonal variations in the frequency of congenital anomalies.
Monthly and seasonal variations in the frequency of congenital anomalies.
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DOI：
10.1093/ije/19.2.399
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发表时间：
1990-06
影响因子：
7.7
通讯作者：
E. Castilla;I. Orioli;R. Lugarinho;G. Dutra;J. López-Camelo;H. Campaña;Amedeo Spagnolo;P. Mastroiacovo
中科院分区：
文献类型：
--
作者：
E. Castilla;I. Orioli;R. Lugarinho;G. Dutra;J. López-Camelo;H. Campaña;Amedeo Spagnolo;P. Mastroiacovo
三个大的和可比较的系列出生被用来测试工作假设，如果有一个真实的季节变化的频率，一个给定的先天性畸形，它将被证明是由充分的分析，在非热带地区更为明显，并在六个月的相位在北方和南半球。数据集为南美洲热带地区（287，165例出生）和非热带地区（582，585例出生）以及意大利（508，536例出生）的医院出生。测试了16种明确定义的畸形类型：无脑畸形、脊柱裂、头腔突出、脑积水、小耳畸形、腭裂、唇裂、食管闭锁、肛门闭锁、尿道下裂、马蹄内翻足、距外翻足、轴后多指畸形、轴前多指畸形、疝和唐氏综合征。通过Walter和埃尔伍德检验或休伊特等人的非参数检验2，在样本量小于50例的7个实例中，证明三个数据系列中任何畸形类型均无季节性变化（p <0.01）。临界显著性差异（p <0.05）包括南美洲热带地区的食管闭锁，南美洲非热带地区无食管闭锁，以及意大利的无脑畸形。它的结论是，季节性变化的先天性畸形的发生是一种罕见的现象时，测试严格使用其建议的限制。
Three large and comparable series of births were used to test the working hypothesis that if there is a real seasonal variation in the frequency of a given congenital malformation; it would have to be shown by adequate analysis; to be more overt in non-tropical areas; and to be six months out of phase in northern and southern hemispheres. The data set were hospital births from tropical (287,165 births) and non-tropical (582,585 births) South America, and from Italy (508,536 births). Sixteen well-defined malformation types were tested: anencephaly, spina bifida, cephalocoele, hydrocephaly, microtia, cleft palate, cleft lip, oesophageal atresia, anal atresia, hypospadias, pes equino-varus, pes talovalgus, postaxial polydactylyl, pre-axial polydactylyl, diaphragmatic hernia, and Down's syndrome. No seasonal variation was proven (p less than 0.01) for any malformation type in any of the three series of data by means of Walter and Elwood's test, or Hewitt et al's non-parametric test2 applied to seven instances with sample sizes smaller than 50 cases. Variations of borderline significance (p less than 0.05) included oesophageal atresia in tropical South America, none in non-tropical South America, and anencephaly in Italy. It is concluded that seasonal variation in the occurrence of congenital malformations is a rare phenomenon when tests are strictly used within their recommended limitations.