VATER non-random association of congenital malformations: Study based on data from four malformation registers

This study was undertaken to find a strict, unbiased epidemiological deline ation of the VATER non-random association of congenital malformations and, based on registry information, to identify a group of probable VATER associ ation infants suitable for etiological analyses. Information on 5.260 infan ts with multiple malformations was collected from four large registers of c ongenital malformations. Data were analyzed using a statistical method in w hich various putative confounders were controlled for. Our results indicate the existence of a distinct group of malformations corresponding to the VA TER association: esophageal atresia, anal atresia, upper preaxial limb redu ction defects, and costo-vertebral malformations. A subdivision into an upp er and a lower group of VATER association was indicated, with heart malform ations associated with the upper group and kidney malformations associated with the lower group. Restricting the inclusion criteria for VATER associat ion to the above mentioned core malformations, few infants seem to belong t o the VATER association, thus limiting the possibilities of carrying out et iological analyses. A relatively large number of infants may belong to a fa mily of related conditions among which VATER association is a subgroup. In the search for risk factors, a strict definition of the VATER association i s needed in order to not dilute the study material with irrelevant cases. T he present study provides such strict inclusion criteria, (C) 2001 Wiley-Li ss, Inc.