DESCRIPTIVE EPIDEMIOLOGY OF ALIMENTARY-TRACT ATRESIA

A study has been made on certain epidemiological characteristics of in fants with alimentary tract atresia: esophageal atresia, small and lar ge gut atresia, and anal atresia. Data were collected from three malfo rmation registries and represent a material of more than 4.5 million b irths. A total of 3,550 infants with alimentary atresia were identifie d corresponding to a total rate of about 8 per 10,000 births. In 167 i nfants (4.7%) more than one of the major atresia types were present si multaneously. Racial differences were found (based on data from Califo rnia) for esophageal atresia where whites had a higher rate than other races. For gastrointestinal atresia, a high rate in blacks was found, while no differences between races were seen for anal atresia. Also, differences in registered rates between the three programs were found, at least partly explainable by different ascertainment. The different forms of atresia were compared from the point of view of sex ratio, t winning rate, maternal age and parity distribution, presence of chromo some anomalies, and types of associated malformations. The pathogenesi s and etiology of the various types of atresia are discussed based on these observations. The conclusion is that although undoubtedly other pathogenetic mechanisms may exist for gastrointestinal atresia, a subs tantial proportion of all infants with alimentary atresia had their ma lformations as a result of early disturbances of intestinal morphogene sis. Within each subgroup, apparently different etiologies may exist, resulting in differences in epidemiological characteristics. (C) 1995 Wiley-Liss, Inc.