COMPARISON OF DEMOGRAPHIC AND DEFECT CHARACTERISTICS AMONG DIFFERENT DEVELOPMENTAL STAGES OF CONGENITAL LIMB REDUCTION DEFECTS

This study investigates how the timing of the development of limb redu ction defects (LRDs) is associated with selected demographic, medical variables and defect characteristics. The LRD cases (n = 281) were asc ertained from the Congenital Malformations Registry of New York State among 1983-87 births. Cases were classified according to five stages o f gestation based on when their earliest LRD developed. A control grou p consisted of a systematic random sample (n = 327) of non-malformed l ivebirths. Demographic and LRD characteristics were abstracted from bi rth certificates and medical charts. Among LRDs, the defects that occu rred in the earlier stages of gestation were found to be more complex involving syndromes, multiple limbs, and previous maternal medical pro blems, compared with those developing in the later stages. Middle or l ate stage LRDs tended to occur more often with syndactyly than early s tage LRDs, and had significantly higher frequencies of non-white infan ts compared with controls. In addition, some perinatal complications, preterm delivery and low birthweight were positively associated with a ny LRD. Our findings suggest that the timing of a disturbance in limb development is important in terms of LRD characteristics. Demographics did not vary consistently with the stage of LRD development. Further studies testing this classification technique are suggested.