Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation

Janet D Cragan¹, Jennifer L Isenburg^{1

2}, Samantha E Parker³, C J Alverson¹, Robert E Meyer⁴, Erin B Stallings^{1

2}, Russell S Kirby⁵, Philip J Lupo⁶, Jennifer S Liu^{1

7}, Amanda Seagroves^{1

2}, Mary K Ethen⁸, Sook Ja Cho⁹, MaryAnn Evans¹⁰, Rebecca F Liberman¹¹, Jane Fornoff¹², Marilyn L Browne¹³, Rachel E Rutkowski⁵, Amy E Nance¹⁴, Marlene Anderka¹⁵, Deborah J Fox¹³, Amy Steele¹⁴, Glenn Copeland¹⁶, Paul A Romitti¹⁷, Cara T Mai¹; National Birth Defects Prevention Network

Affiliations

¹ Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
² Carter Consulting Inc., Atlanta, Georgia.
³ Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
⁴ State Center for Health Statistics, N.C. Division of Public Health, Raleigh, North Carolina.
⁵ Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida.
⁶ Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
⁷ Leidos Holdings, Inc., Reston, Virginia.
⁸ Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
⁹ Division of Community and Family Health, Minnesota Department of Health, St. Paul, Minnesota.
¹⁰ Oregon Birth Anomalies Surveillance System, Oregon Public Health Division, Portland, Oregon.
¹¹ Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts.
¹² Division of Epidemiologic Studies, Illinois Department of Public Health, Springfield, Illinois.
¹³ New York State Department of Health, Albany, New York.
¹⁴ Utah Birth Defect Network, Division of Family Health and Preparedness, Utah Department of Health, Salt Lake City, Utah.
¹⁵ National Birth Defects Prevention Network, Houston, Texas.
¹⁶ Division for Vital Records and Health Statistics, Michigan Department of Health and Human Services, Lansing, Michigan.
¹⁷ College of Public Health, University of Iowa, Iowa City, Iowa.

PMID: 27891783
PMCID: PMC5485911
DOI: 10.1002/bdra.23587

Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation

Janet D Cragan et al. Birth Defects Res A Clin Mol Teratol. 2016 Nov.

. 2016 Nov;106(11):972-982.

doi: 10.1002/bdra.23587.

Authors

Affiliations

¹ Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
² Carter Consulting Inc., Atlanta, Georgia.
³ Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
⁴ State Center for Health Statistics, N.C. Division of Public Health, Raleigh, North Carolina.
⁵ Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida.
⁶ Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
⁷ Leidos Holdings, Inc., Reston, Virginia.
⁸ Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
⁹ Division of Community and Family Health, Minnesota Department of Health, St. Paul, Minnesota.
¹⁰ Oregon Birth Anomalies Surveillance System, Oregon Public Health Division, Portland, Oregon.
¹¹ Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts.
¹² Division of Epidemiologic Studies, Illinois Department of Public Health, Springfield, Illinois.
¹³ New York State Department of Health, Albany, New York.
¹⁴ Utah Birth Defect Network, Division of Family Health and Preparedness, Utah Department of Health, Salt Lake City, Utah.
¹⁵ National Birth Defects Prevention Network, Houston, Texas.
¹⁶ Division for Vital Records and Health Statistics, Michigan Department of Health and Human Services, Lansing, Michigan.
¹⁷ College of Public Health, University of Iowa, Iowa City, Iowa.

PMID: 27891783
PMCID: PMC5485911
DOI: 10.1002/bdra.23587

Abstract

Background: Congenital microcephaly has been linked to maternal Zika virus infection. However, ascertaining infants diagnosed with microcephaly can be challenging.

Methods: Thirty birth defects surveillance programs provided data on infants diagnosed with microcephaly born 2009 to 2013. The pooled prevalence of microcephaly per 10,000 live births was estimated overall and by maternal/infant characteristics. Variation in prevalence was examined across case finding methods. Nine programs provided data on head circumference and conditions potentially contributing to microcephaly.

Results: The pooled prevalence of microcephaly was 8.7 per 10,000 live births. Median prevalence (per 10,000 live births) was similar among programs using active (6.7) and passive (6.6) methods; the interdecile range of prevalence estimates was wider among programs using passive methods for all race/ethnicity categories except Hispanic. Prevalence (per 10,000 live births) was lowest among non-Hispanic Whites (6.5) and highest among non-Hispanic Blacks and Hispanics (11.2 and 11.9, respectively); estimates followed a U-shaped distribution by maternal age with the highest prevalence among mothers <20 years (11.5) and ≥40 years (13.2). For gestational age and birth weight, the highest prevalence was among infants <32 weeks gestation and infants <1500 gm. Case definitions varied; 41.8% of cases had an HC ≥ the 10^th percentile for sex and gestational age.

Conclusion: Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. Addressing these factors in the setting of Zika virus infection can improve the quality of prevalence estimates. Birth Defects Research (Part A) 106:972-982, 2016. © 2016 Wiley Periodicals, Inc.

Keywords: head circumference; microcephaly; prevalence; surveillance.

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References

1. Ashwal S, Michelson D, Plawner L, Dobyns WB, et al. Practice parameter: evaluation of the child with microcephaly (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2009;73:887–897. - PMC - PubMed
1. Baxter PS, Rigby AS, Rotsaert MH, Wright I. Acquired microcephaly: causes, patterns, motor and IQ effects, and associated growth changes. Pediatrics. 2009;124:590–595. - PubMed
1. Bray PF, Shields WD, Wolcott GJ, Madsen JA. Occipitofrontal head circumference – an accurate measure of intracranial volume. J Pediatr. 1969;75:303–305. - PubMed
1. Clopper CJ, Pearson ES. The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika. 1934;26:404–413.
1. Cooke RWI, Lucas A, Yudkin PLN, Pryse-Davies J. Head circumference as an index of brain weight in the fetus and newborn. Early Hum Dev. 1977;1:145–149. - PubMed

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Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation

Affiliations

Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation

Authors

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical