{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:19:12Z","timestamp":1759882752327,"version":"build-2065373602"},"reference-count":37,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[1989,12]]},"abstract":"<jats:p>The seasonal prevalence of major congenital malformations was studied in a prospective survey of 88,449 children born in the circumscribed Fylde of Lancashire to residents there over 25 years. Ascertainment was thought to be as complete as was practically possible because cases were recorded daily by one, and for 17 years the only, paediatrician and a very high rate of necropsies was maintained. The number of malformations were classified by month of maternal last menstrual period and seasonal variation was assessed by three statistical models. Neural tube defects showed a significant seasonal variation in month of last menstrual period but not in month of birth. From May 1956 to April 1968, when the prevalence of neural tube defects was high (5.5 per 1000 total births), conceptions were significantly more common in December to May. For anencephaly alone the figures were not significant, but spina bifida and cranium bifidum were more common in March to May. From May 1968 to April 1981, when the prevalence of neural tube defects fell below the national average, the significant variations disappeared. Seasonality for spina bifida and cranium bifidum was seen only in \"singles\" (cases with no other major lesion), but for anencephaly it was seen only in \"multiples\" (cases with other lesions). The three types of cardiac septal defect and persistent ductus each showed a higher prevalence of conceptions at some time during May to October. In contrast the commonest group of cyanotic cases showed no such pattern but with greater numbers in winter. There was evidence of a seasonal variation for bilateral renal agenesis and for vesicoureteric reflux as ascertained. Seasonal prevalence in an aetiological factor for certain malformations of the central nervous system, cardiac and urinary systems.<\/jats:p>","DOI":"10.1136\/jech.43.4.330","type":"journal-article","created":{"date-parts":[[2008,11,12]],"date-time":"2008-11-12T15:10:54Z","timestamp":1226502654000},"page":"330-342","source":"Crossref","is-referenced-by-count":27,"title":["Seasonal prevalence of major congenital malformations in the Fylde of Lancashire 1957-1981."],"prefix":"10.1136","volume":"43","author":[{"given":"J P","family":"Bound","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P W","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B J","family":"Francis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1989,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0140-6736(51)93354-5","article-title":"Seasonal incidence of congenital malformations of the central nervous system","volume":"i:","author":"McKeown, T.; Record, R.G.","year":"1951","unstructured":"McKeown T, Record RG. Seasonal incidence of congenital malformations of the central nervous system. Lancet 1951; i: 192-6.","journal-title":"Lancet"},{"key":"ref_2","article-title":"Diseases of children","author":"Jolly, H.; Levene, M.I.","unstructured":"Jolly H, Levene MI. Diseases of children. 5th ed. Oxford: Blackwell Scientific Publications, 1985: 133.","edition":"5th ed"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1136\/bmj.2.5467.895","article-title":"Causes of malformations of the heart","volume":"ii:","author":"Campbell, M.","year":"1965","unstructured":"Campbell M. Causes of malformations of the heart. Br Med J 1965; ii: 895-904.","journal-title":"Br Med J"},{"key":"ref_4","first-page":"146","article-title":"Major central nervous system malformations in South Wales","volume":"21","author":"Laurence, K.M.; Carter, C.O.; David, P.A.","year":"1967","unstructured":"Laurence KM, Carter CO, David PA. Major central nervous system malformations in South Wales. Br J Prev Soc Med 1967; 21: 146-60.","journal-title":"Br J Prev Soc Med"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1136\/bmj.2.5515.661","article-title":"Population and clinic studies of congenital heart disease in","volume":"ii:","author":"Hay, J.D.","year":"1966","unstructured":"Hay JD. Population and clinic studies of congenital heart disease in Liverpool. Br Med J 1966; ii: 661-7.","journal-title":"Liverpool. Br Med J"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1136\/hrt.39.4.445","article-title":"Incidence of congenital heart disease in Blackpool 1957-1971","volume":"39","author":"Bound, J.P.; Logan, W.F.W.E.","year":"1977","unstructured":"Bound JP, Logan WFWE. Incidence of congenital heart disease in Blackpool 1957-1971. Br Heart J 1977; 39: 445-50.","journal-title":"Br Heart J"},{"key":"ref_7","first-page":"794","article-title":"Incidence of congenital heart disease in children born to residents of Olmsted County, Minnesota","volume-title":"1950-1969. Mayo Clin Proc 1971","volume":"46","author":"Feldt, R.H.; Avasthey, P.; Yoshimasu, F.; Kurland, L.T.; Titus, J.L.","unstructured":"Feldt RH, Avasthey P, Yoshimasu F, Kurland LT, Titus JL. Incidence of congenital heart disease in children born to residents of Olmsted County, Minnesota, 1950-1969. Mayo Clin Proc 1971; 46: 794-9."},{"key":"ref_8","first-page":"17","article-title":"Congenital heart disease in Liverpool: 1960-69","volume":"43","author":"Kenna, A.P.; Smithells, R.W.; Fielding, D.W.","year":"1975","unstructured":"Kenna AP, Smithells RW, Fielding DW. Congenital heart disease in Liverpool: 1960-69. Q J Med 1975; 43: 17-44.","journal-title":"Q J Med"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/oxfordjournals.aje.a113335","article-title":"Etiologic heterogeneity of neural tube defects: clues from epidemiology","volume":"115","author":"Khoury, M.J.; Erickson, J.D.; James, L.M.","year":"1982","unstructured":"Khoury MJ, Erickson JD, James LM. Etiologic heterogeneity of neural tube defects: clues from epidemiology. Am J Epidemiol 1982; 115: 538-48.","journal-title":"Am J Epidemiol"},{"key":"ref_10","article-title":"Classification ofheart disease in childhood","author":"of Cardiology, International Society","year":"1970","unstructured":"International Society of Cardiology. Classification ofheart disease in childhood. Groningen: VRB Offsetdrukkerij, 1970."},{"article-title":"Pathology of congenital heart disease","author":"Becker, A.E.; Anderson, R.H.","key":"ref_11","unstructured":"Becker AE, Anderson RH. Pathology of congenital heart disease. London: Butterworths, 1981: 353."},{"issue":"25","key":"ref_12","first-page":"83","article-title":"The recognition and estimation of cyclic trends","volume":"1961","author":"Edwards, J.H.","unstructured":"Edwards JH. The recognition and estimation of cyclic trends. Ann Hum Genet 1961; 25: 83-7.","journal-title":"Ann Hum Genet"},{"key":"ref_13","first-page":"174","article-title":"On Edwards' criterion of seasonality and non-parametric alternative","volume":"25","author":"Hewitt, D.; Milner, J.; Csima, A.; Pakula, A.","year":"1971","unstructured":"Hewitt D, Milner J, Csima A, Pakula A. On Edwards' criterion of seasonality and non-parametric alternative. Br J Prev Soc Med 1971; 25: 174-6.","journal-title":"Br J Prev Soc Med"},{"key":"ref_14","first-page":"18","article-title":"A test for seasonality of events with a variable population at risk","volume":"29","author":"Walter, S.D.; Elwood, J.M.","year":"1975","unstructured":"Walter SD, Elwood JM. A test for seasonality of events with a variable population at risk. Br J Prev Soc Med 1975; 29: 18-21.","journal-title":"Br J Prev Soc Med"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"280","DOI":"10.2307\/2347236","article-title":"Comparison of two tests of seasonality in epidemiological data","volume":"25","author":"AS, St Leger","year":"1976","unstructured":"St Leger AS. Comparison of two tests of seasonality in epidemiological data. Appl Statist 1976; 25: 280-6.","journal-title":"Appl Statist"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/biomet\/64.1.152","article-title":"A significance test for cyclic trends in incidence data","volume":"64","author":"Roger, J.H.","year":"1977","unstructured":"Roger JH. A significance test for cyclic trends in incidence data. Biometrika 1977; 64: 152-5.","journal-title":"Biometrika"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1080\/03610928308828515","article-title":"Efficient method for identification of cyclic trends in incidence","volume":"12","author":"Nam, J.","year":"1983","unstructured":"Nam J. Efficient method for identification of cyclic trends in incidence. Commun Statist Theor Meth 1983; 12: 1053-68.","journal-title":"Commun Statist Theor Meth"},{"key":"ref_18","article-title":"Generalised linear models","author":"McCullagh, P.; Nelder, J.A.","year":"1983","unstructured":"McCullagh P, Nelder JA. Generalised linear models. London: John Wiley, 1983."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1651-2227.1977.tb07809.x","article-title":"Seasonal Incidence of some congenital malformations in the central nervous system in Sweden 1965-1972","volume":"66","author":"Sandahl, B.","year":"1977","unstructured":"Sandahl B. Seasonal Incidence of some congenital malformations in the central nervous system in Sweden 1965-1972. Acta Paediatr Scand 1977; 66: 65-72.","journal-title":"Acta Paediatr Scand"},{"key":"ref_20","article-title":"The GLIM system release 3.77 Users' Guide","author":"Baker, R.; Clarke, M.R.B.; Francis, B.","year":"1986","unstructured":"Baker R, Clarke MRB, Francis B, et al. The GLIM system release 3.77 Users' Guide. 2nd ed. Oxford: Numerical Algorithms Group, 1986.","edition":"2nd ed"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/jech.35.2.102","article-title":"The incidence ofanencephalus in the Fylde peninsula 1956-76 and changes in water hardness","volume":"35","author":"Bound, J.P.; Harvey, P.W.; Brookes, D.M.; BMcA, Sayers","year":"1981","unstructured":"Bound JP, Harvey PW, Brookes DM, Sayers BMcA. The incidence ofanencephalus in the Fylde peninsula 1956-76 and changes in water hardness. J Epidemiol Community Health 1981; 35: 102-5.","journal-title":"J Epidemiol Community Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1136\/bmj.2.5111.1510","article-title":"Death certification of children","volume":"ii:","author":"Emery, J.L.; Irvine, K.A.","year":"1958","unstructured":"Emery JL, Irvine KA. Death certification of children. Br Med J 1958; ii: 1510-2.","journal-title":"Br Med J"},{"key":"ref_23","first-page":"67","article-title":"Seasonal incidence of anencephalus","volume":"20","author":"Leck, I.; Record, R.G.","year":"1966","unstructured":"Leck I, Record RG. Seasonal incidence of anencephalus. Br J Prev Soc Med 1966; 20: 67-75.","journal-title":"Br J Prev Soc Med"},{"key":"ref_24","article-title":"Anencephalus, spina bifida and congenital hydrocephalus. England and Wales 19641972. Office of Population Censuses and Surveys","volume":"32","author":"Rogers, S.C.; Weatherall, J.A.C.","year":"1976","unstructured":"Rogers SC, Weatherall JAC. Anencephalus, spina bifida and congenital hydrocephalus. England and Wales 19641972. Office of Population Censuses and Surveys. Studies on Medical and Population Subjects No. 32. London: HMSO, 1976.","journal-title":"Studies on Medical and Population Subjects"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/S0140-6736(66)92768-1","article-title":"Incidence and epidemicity of Down's syndrome","volume":"ii:","author":"Leck, I.","year":"1966","unstructured":"Leck I. Incidence and epidemicity of Down's syndrome. Lancet 1966; ii: 457-60.","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1093\/oxfordjournals.aje.a121604","article-title":"A time-series analysis ofthe incidence of Down's syndrome in","volume":"99","author":"Harlap, S.","year":"1974","unstructured":"Harlap S. A time-series analysis ofthe incidence of Down's syndrome in West Jerusalem. Am J Epidemiol 1974; 99: 210-7.","journal-title":"West Jerusalem. Am J Epidemiol"},{"key":"ref_27","first-page":"211","article-title":"Epidemiology of trisomy 21: population, periand antenatal data","volume":"2","author":"Mikkelsen, M.","year":"1981","unstructured":"Mikkelsen M. Epidemiology of trisomy 21: population, periand antenatal data. Hum Genet 1981; 2: 211-26.","journal-title":"Hum Genet"},{"key":"ref_28","first-page":"212","article-title":"Cyclic variations in date of last menstrual period of mothers of infants with congenital malformations in South Wales, 1964-66","volume":"26","author":"Roberts, C.J.; Lowe, C.R.; Lloyd, S.","year":"1972","unstructured":"Roberts CJ, Lowe CR, Lloyd S. Cyclic variations in date of last menstrual period of mothers of infants with congenital malformations in South Wales, 1964-66. Br J Prev Soc Med 1972; 26: 212-8.","journal-title":"Br J Prev Soc Med"},{"key":"ref_29","first-page":"165","article-title":"Growth and development of the cardiovascular system: anatomical development","volume-title":"foundations of paediatrfcs","author":"Anderson, R.H.; Ashley, G.T.","year":"1974","unstructured":"Anderson RH, Ashley GT. Growth and development of the cardiovascular system: anatomical development. In: Davis JA, Dobbing J, eds. Scientifc foundations of paediatrfcs. London: William Heineman, 1974: 165-98."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1136\/hrt.32.1.103","article-title":"Seasonal incidence of coarctation of the aorta","volume":"32","author":"Miettinen, O.S.; Reiner, M.L.; Nadas, A.S.","year":"1970","unstructured":"Miettinen OS, Reiner ML, Nadas AS. Seasonal incidence of coarctation of the aorta. Br Heart J 1970; 32: 103-7.","journal-title":"Br Heart J"},{"key":"ref_31","first-page":"1","article-title":"Seasonal variation in congenital abnormalities","volume":"18","author":"Slater, B.C.S.; Watson, G.I.; McDonald, J.C.","year":"1964","unstructured":"Slater BCS, Watson GI, McDonald JC. Seasonal variation in congenital abnormalities. Br J Prev Soc Med 1964; 18: 1-7.","journal-title":"Br J Prev Soc Med"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1136\/adc.62.4.421","article-title":"Management of urinary tract infection","volume":"62","author":"White, R.H.R.","year":"1987","unstructured":"White RHR. Management of urinary tract infection. Arch Dis Child 1987; 62: 421-7.","journal-title":"Arch Dis Child"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1136\/adc.60.6.521","article-title":"Epidemiology of facial clefting","volume":"60","author":"Owens, JR, Jones; JW, Harris; F.","year":"1985","unstructured":"Owens JR, Jones JW, Harris F. Epidemiology of facial clefting. Arch Dis Child 1985; 60: 521-4.","journal-title":"Arch Dis Child"},{"issue":"25","key":"ref_34","first-page":"89","article-title":"Seasonal incidence of congenital disease in Birmingham","volume":"1961","author":"Edwards, J.H.","unstructured":"Edwards JH. Seasonal incidence of congenital disease in Birmingham. Ann Hum Genet 1961; 25: 89-93.","journal-title":"Ann Hum Genet"},{"issue":"36","key":"ref_35","first-page":"420","article-title":"Cleft lip and palate: seasonal incidence, birth weight, birth rank, sex, site, associated malformations and parental age","volume":"1961","author":"Fraser, G.R.; Calnan, J.S.","unstructured":"Fraser GR, Calnan JS. Cleft lip and palate: seasonal incidence, birth weight, birth rank, sex, site, associated malformations and parental age. Arch Dis Child 1961; 36: 420-3.","journal-title":"Arch Dis Child"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"39","DOI":"10.3109\/02844317709025495","article-title":"Seasonal incidence ofcleft lips and cleft palates in Sweden, 1965-1974","volume":"11","author":"Sandahl, B.","year":"1977","unstructured":"Sandahl B. Seasonal incidence ofcleft lips and cleft palates in Sweden, 1965-1974. Scand J Plast Reconstr Surg 1977; 11: 39-43.","journal-title":"Scand J Plast Reconstr Surg"},{"article-title":"Acceptedfor publication","year":"1989","key":"ref_37","unstructured":"Acceptedfor publication April 1989."}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech.43.4.330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T11:14:11Z","timestamp":1759835651000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech.43.4.330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,12]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1989,12,1]]},"published-print":{"date-parts":[[1989,12]]}},"alternative-id":["10.1136\/jech.43.4.330"],"URL":"https:\/\/doi.org\/10.1136\/jech.43.4.330","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"type":"print","value":"0143-005X"},{"type":"electronic","value":"1470-2738"}],"subject":[],"published":{"date-parts":[[1989,12]]}}}