Different policies on prenatal ultrasound screening programmes and inducedabortions explain regional variations in infant mortality with congenital malformations

Objective: To compare the impact of induced abortions (IA) on the mortality of infants with congenital malformations in four European regions with dif ferent policies on IA and prenatal ultrasound screening for congenital malf ormations. Methods: A registry-based collection of data on congenital malfo rmations in four different countries: Ireland (Dublin), Denmark (Funen Coun ty), Austria (Styria), and France (Strasbourg), Results: The proportion of infant deaths with malformations ranged from 23 to 44% of a II infant death s with the highest proportion in Dublin, where IA is not allowed and prenat al ultrasound screening not performed, There were highly significant differ ences in the prevalences of IA (p < 0.001), fetal deaths (p < 0.01), and de aths in infants with congenital malformations (p < 0.001) between the four regions. The differences in total mortality with congenital malformations ( IA + fetal deaths + infant deaths) between regions decreased, and only Stra sbourg differs significantly from the other three regions. Conclusion: Pren atal ultrasound screening programmes have only a minor impact on total mort ality with congenital malformations from 2nd trimester of pregnancy to 1 ye ar of age, but seem to change the time of death which may be important for both the parents and the community. Copyright (C) 2001S.KargerAG,Basel.