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. 2012 May;9(5):1732-1747.
doi: 10.3390/ijerph9051732. Epub 2012 May 7.

Birth defects in Gaza: prevalence, types, familiarity and correlation with environmental factors

Awny Naim  1 , Hedaya Al Dalies  2 , Mohammed El Balawi  2 , Eman Salem  2 , Kholud Al Meziny  2 , Raneem Al Shawwa  3 , Roberto Minutolo  4 , Paola Manduca  2   5
Affiliations

Birth defects in Gaza: prevalence, types, familiarity and correlation with environmental factors

Awny Naim et al. Int J Environ Res Public Health. 2012 May.

Abstract

This is the first report of registration at birth, and of incidence of major structural birth defects (BD) obtained in Gaza at Al Shifa Hospital, where 28% of total births in Gaza Strip occur. Doctors registered 4,027 deliveries, with a protocol comprehensive of clinical, demographic, kin and environmental questions. Prevalence of BD is 14/1,000, without association with intermarriage or gender of the child. Prevalence of late miscarriages and still births are respectively 23.3/1,000 and 7.4/1,000, and of premature births 19.6/1,000. Couples with a BD child have about 10 times higher frequency of recurrence of a BD in their progeny than those with normal children, but none of their 694 siblings and only 10/1,000 of their 1,423 progeny had BD, similar to the frequency in general population. These data suggest occurrence of novel genetic and epigenetic events in determination of BD. Children with BD were born with higher frequency (p < 0 001) in families where one or both parents were under "white phosphorus" attack, that in the general population. Bombing of the family home and removal of the rubble were also frequently reported by couples with BD occurrence. These data suggests a causative/favoring role of acute exposure of parents to the weapons-associated contaminants, and/or of their chronic exposure from their persistence in the environment on the embryonic development of their children.

Keywords: environmental teratogens; exposure to war related events; familiarity of birth defects; major structural birth defects; registration at birth.

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Figures

Figure 1
Figure 1
Type of Birth defects. The relative presence among BD (top panel) and PBD (bottom panel) is expressed in percentage of the type of defect: GI gastrointestinal, CHD congenital heart disease, ABD Abodminal wall defect, CDH Congenital displasia of hip, O Others undescribed, OSTEP osteopetrosis.
Figure 2
Figure 2
Distribution of the residence of the couples of newborn with Birth Defect (BD), and of late Miscarriages (M), Still Born (SB) and Previous Birth Defects (PBD).
Figure 3
Figure 3
Mapping of the exposure to weaponry.
See this image and copyright information in PMC

References

    1. Ministry of Health, Palestinian National Authority. Health Annual Report, Gaza Strip 2009. Ministry of Health, Palestinian National Authority; Gaza, Palestinian: 2011.
    1. Records of Maternity Hospital Al Shifa. Hospital Al Shifa; Gaza, Palestine: 2010.
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