{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:04:21Z","timestamp":1781193861036,"version":"3.54.1"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HD080465"],"award-info":[{"award-number":["R01HD080465"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01AI069924"],"award-info":[{"award-number":["U01AI069924"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV\u2010004508"],"award-info":[{"award-number":["INV\u2010004508"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lack of data on the burden and scope of congenital disorders (CDs) in South Africa undermines resource allocation and limits the ability to detect signals from potentially teratogenic pregnancy exposures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used routine electronic data in the Western Cape Pregnancy Exposure Registry (PER) to determine the overall and individual prevalence of CD identified on neonatal surface examination at birth in the Western Cape, South Africa, 2016\u20132022. CD was confirmed by record review. The contribution of late (\u226424\u2009months) and antenatal diagnoses was assessed. We compared demographic and obstetric characteristics between women with\/without pregnancies affected by CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women with a viable pregnancy (&gt;22\u2009weeks gestation; birth weight\u2009\u2265\u2009500\u2009g) (<jats:italic>n<\/jats:italic>\u2009=\u200932,494) were included. Of 1106 potential CD identified, 56.1% were confirmed on folder review. When internal and minor CD were excluded the prevalence of major CD identified on surface examination at birth was 7.2\/1000 births. When missed\/late diagnoses on examination (16.8%) and ultrasound (6.8%) were included, the prevalence was 9.2\/1000 births: 8.9\/1000 livebirths and 21.5\/1000 stillbirths. The PER did not detect 21.5% of major CD visible at birth. Older maternal age and diabetes mellitus were associated with an increased prevalence of CD. Women living with\/without HIV (or the timing of antiretroviral therapy, before\/after conception), hypertension or obesity did not significantly affect prevalence of CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A surveillance system based on routine data successfully determined the prevalence of major CD identified on surface examination at birth at rates slightly higher than in equivalent studies. Overall rates, modeled at ~2%, are likely underestimated. Strengthening routine neonatal examination and clinical record\u2010keeping could improve CD ascertainment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2388","type":"journal-article","created":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T05:45:07Z","timestamp":1723182307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Population\u2010based prevalence of congenital defects in a routine sentinel site\u2010based surveillance system in the Western Cape, South Africa"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7706-6866","authenticated-orcid":false,"given":"Emma","family":"Kalk","sequence":"first","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Sub\u2010Saharan African Congenital Anomalies Network University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Heekes","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Health Intelligence Directorate, Western Cape Government Department of Health &amp; Wellness  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Lavies","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Sub\u2010Saharan African Congenital Anomalies Network University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizel","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Sub\u2010Saharan African Congenital Anomalies Network University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Careni","family":"Spencer","sequence":"additional","affiliation":[{"name":"Division of Human Genetics, Department of Medicine University of Cape Town &amp; Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Boutall","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University of Cape Town &amp; Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University of Cape Town &amp; Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology University of Cape Town &amp; Mowbray Maternity Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary\u2010Ann","family":"Davies","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Health Intelligence Directorate, Western Cape Government Department of Health &amp; Wellness  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"van Niekerk","sequence":"additional","affiliation":[{"name":"Sub\u2010Saharan African Congenital Anomalies Network University of Cape Town  Cape Town South Africa"},{"name":"Department of Paediatrics &amp; Child Health University of Cape Town &amp; Mowbray Maternity Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Fieggen","sequence":"additional","affiliation":[{"name":"Sub\u2010Saharan African Congenital Anomalies Network University of Cape Town  Cape Town South Africa"},{"name":"Division of Human Genetics, Department of Medicine University of Cape Town &amp; Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Boulle","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Health Intelligence Directorate, Western Cape Government Department of Health &amp; Wellness  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ushma","family":"Mehta","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology &amp; Research, School of Public Health University of Cape Town  Cape Town South Africa"},{"name":"Sub\u2010Saharan African Congenital Anomalies Network University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173800"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1964"},{"key":"e_1_2_11_4_1","unstructured":"Bello G. S.\u2010S. J. Williamson D. Taulo F. Kabaghe A. Thomson K. Kagoli M. et al. (2022).\u201cEditor Prevalence of Adverse Birth Outcomes and External Birth Defects among Women Living with HIV in Malawi.\u201dAIDS2022: The 24th international AIDS conference; Montreal Canada & Virtual."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2242"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.23889\/ijpds.v4i2.1143"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311845"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-077743"},{"issue":"1","key":"e_1_2_11_10_1","first-page":"1","article-title":"Update on overall prevalence of major birth defects\u2014Atlanta, Georgia, 1978\u20132005","volume":"57","author":"Center for Disease Control and Prevention","year":"2008","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5128"},{"key":"e_1_2_11_12_1","volume-title":"March of dimes global report on birth defects: The hidden toll of dying and disabled children","author":"Christianson A.","year":"2014"},{"key":"e_1_2_11_13_1","unstructured":"Division of Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention. (2019).Birth defects surveillance toolkit: Congenital anomalies: Centers for Disease Control and Prevention. [updated 30 October 2019]. Available from:https:\/\/www.cdc.gov\/ncbddd\/birthdefects\/surveillancemanual\/facilitators\u2010guide\/module\u20101\/mod1\u20102.html#:~:text=Major%20anomalies%20are%20structural%20changes heart%20defects%20and%20orofacial%20clefts"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1898"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2249"},{"key":"e_1_2_11_16_1","volume-title":"Western Cape saving babies triennial report 2017\u20132019","author":"Gebhardt S.","year":"2020"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad441"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1097"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1887"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20842"},{"key":"e_1_2_11_21_1","unstructured":"Jacobs L. Dietrich L. &vanBalla L.(2018).Perinatal mortality indicators metro west 2018. Cape Town."},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-060205"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00837-5"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2016.v106i10.11314"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2021.01.006"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12687-021-00513-8"},{"key":"e_1_2_11_28_1","unstructured":"Medicines for Malaria Venture. (2024).MiMBa: Malaria in mothers and babies 2020. [cited January 24 2024]. Available from:https:\/\/www.mmv.org\/newsroom\/news-resources-search\/mimba-malaria-mothers-and-babies"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v20i1.971"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-047463"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2023-002022"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12687-018-0384-2"},{"key":"e_1_2_11_33_1","volume-title":"Software for women's health","author":"NEXUS\/ASTRAIA","year":"2024"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2018.v108i8.12980"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(21)00311-4"},{"issue":"3","key":"e_1_2_11_36_1","article-title":"Pulse oximetry screening for critical congenital heart defects","volume":"3","author":"Plana M. N.","year":"2018","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20442"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004760"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00496-5"},{"key":"e_1_2_11_40_1","unstructured":"Wools\u2010Kaloustian K.(2023).Measuring adverse pregnancy and newborn congenital outcomes (MANGO) ClinicalTrials.Gov ID: National library of medicine. Available from:https:\/\/clinicaltrials.gov\/study\/NCT04405700"},{"key":"e_1_2_11_41_1","unstructured":"World Health Organization. (2019).International statistical classification of diseases and related health problems 10th revision Geneva. Available from:https:\/\/icd.who.int\/browse10\/2019\/en"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1905230"},{"key":"e_1_2_11_43_1","unstructured":"Zash R. Holmes L. Diseko M. Jacobson D. L. Myondi G. K. Mabuta J. et al. (2022).Update on neural tube defects with antiretroviral exposure in the Tsepamo study Botswana.AIDS2022: The 24th International AIDS Conference. July 29\u2013August 2 2022; Montreal Canada."},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1807653"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003047"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.2388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T12:43:04Z","timestamp":1737204184000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.2388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":44,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/bdr2.2388"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.2388","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]},"assertion":[{"value":"2024-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2388"}}