{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:05:41Z","timestamp":1781193941293,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,3,28]],"date-time":"2021-03-28T00:00:00Z","timestamp":1616889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2021,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To determine the frequency of malformations that would be identified in the limited surface examination of a newborn by the delivering nurse midwife in a resource\u2010limited setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The limited surface examination will identify visible external anomalies, but not abnormalities inside the mouth, most heart defects, undescended testes, inguinal hernias, hip dysplasia, peripheral vascular anomalies, and some internal anomalies. The findings in a malformations surveillance program, involving 289,365 births in Boston, have been used to establish the prevalence rate of malformations that would be identified and not identified. In African countries, the number of anomalies to be identified should also be reduced by excluding polydactyly, postaxial, type B, a common minor finding, from the list of potential malformations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of note, 2.05% (<jats:italic>n<\/jats:italic> = 5,941) of the 289,365 births surveyed had one or more malformations. The abnormalities that would have been missed, using surface exam alone, accounted for 0.5% of all of malformations identified and reduced the overall prevalence rate of malformations to 1.5%. In addition, excluding all infants with isolated postaxial polydactyly, type B reduced the expected prevalence rate of malformations to 1.3% in unexposed newborn infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A limited surface examination can detect the majority of malformations among newborn infants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1887","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T05:59:31Z","timestamp":1616997571000},"page":"702-707","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Limited surface examination to evaluate potential teratogens in a resource\u2010limited setting"],"prefix":"10.1002","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0259-4848","authenticated-orcid":false,"given":"Lewis B.","family":"Holmes","sequence":"first","affiliation":[{"name":"Medical Genetics and Metabolism Unit MassGeneral Hospital for Children  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanah Z.","family":"Nasri","sequence":"additional","affiliation":[{"name":"Medical Genetics and Metabolism Unit MassGeneral Hospital for Children  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Therese","family":"Hunt","sequence":"additional","affiliation":[{"name":"Hunt Consulting Associates  Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Zash","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Beth Israel Deaconess Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Beth Israel Deaconess Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2018.12.031"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055202"},{"key":"e_1_2_8_4_1","first-page":"65","article-title":"Metropolitan Atlanta congenital defects program (MACDP) 40th anniversary edition surveillance report. 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