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Title: The effect of maternal age on the risk and prevalence of congenital anomalies in Europe : design and analysis of a collaborative database
Author: Loane, Maria Annette
ISNI:       0000 0004 5348 1020
Awarding Body: University of Ulster
Current Institution: Ulster University
Date of Award: 2014
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Since 1980, average maternal age in Europe has increased each year due to societal, educational and economic factors, while the proportion of teenage pregnancies, often associated with social deprivation, has decreased slightly. The aim of this research was to assess maternal age-specific risk of congenital anomalies (CA) and how these impact on the prevalence of CA in Europe using a central database. Part I of the thesis reviews the design, functions and quality of the central database, while Part II evaluates maternal age risk associated with 89 subgroups of chromosomal and non-chromosomal congenital anomalies (NCA). EUROCAT population-based registries provided data on cases of CA including livebirths (LB), fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly (TOPFA), 1980-2009. Poisson regression models assessed the influence of time, region, maternal age and their interaction on risk of CA. Overall, teenage mothers were found to have a 10% excess risk of NCA, with gastroschisis contributing to this disproportionately. The maternal age specific risk of gastroschisis increased over time for mothers of all ages and varied greatly between countries. No increased risk of NCA overall was found in mothers ~35 years. Relative risk associated with maternal age varied between countries suggesting environmental influences. For trisomies 13 and 18, increased risk was found in older mothers similar to the well-known increased risk of trisomy 21. The changing maternal age profile has led to increasing trends of total prevalence for autosomal trisomies, while LB prevalence has remained stable due to the increasing number of TOPFA. Methodological advances included correcting prevalence rates of chromosomal anomalies for fetal survival to 20 weeks gestational age, and correcting maternal age to expected date of delivery.' This research demonstrates the feasibility and usefulness of a central database for conducting surveillance of CA at a European level.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available