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Study Question: Do children born after donor ART have an increased risk of developing childhood cancer in comparison to the general population?Summary Answer: This study showed no overall increased risk of childhood cancer in individuals born after donor ART.What Is Known Already: Most large population-based studies have shown no increase in overall childhood cancer incidence after non-donor ART; however, other studies have suggested small increased risks in specific cancer types, including haematological cancers. Cancer risk specifically in children born after donor ART has not been investigated to date.Study Design, Size, Duration: This retrospective cohort study utilized record linkage to determine the outcome status of all children born in Great Britain (1992-2008) after donor ART. The cohort included 12 137 members who contributed 95 389 person-years of follow-up (average follow-up 7.86 years).Participants/materials, Setting, Methods: Records of all children born in Great Britain (England, Wales, Scotland) after all forms of donor ART (1992-2008) were linked to the UK National Registry of Childhood Tumours (NRCT) to determine the number who subsequently developed cancer by 15 years of age, by the end of 2008. Rates of overall and type specific cancer (selected a priori) were compared with age, sex and calendar year standardized population-based rates, stratifying for potential mediating/moderating factors including sex, age at diagnosis, birth weight, multiple births, maternal previous live births, assisted conception type and fresh/ cryopreserved cycles.Main Results and the Role Of Chance: In our cohort of 12 137 children born after donor ART (52% male, 55% singleton births), no overall increased risk of cancer was identified. There were 12 cancers detected compared to 14.4 expected (standardized incidence ratio (SIR) 0.83; 95% CI 0.43-1.45; P = 0.50). A small, significant increased risk of hepatoblastoma was found, but the numbers and absolute risks were small (<5 cases observed; SIR 10.28; 95% CI 1.25-37.14; P < 0.05). This increased hepatoblastoma risk was associated with low birthweight.Limitations Reasons For Caution: Although this study includes a large number of children born after donor ART, the rarity of specific diagnostic subgroups of childhood cancer results in few cases and therefore wide CIs for such outcomes. As this is an observational study, it is not possible to adjust for all potential confounders; we have instead used stratification to explore potential moderating and mediating factors, where data were available.Wider Implications Of the Findings: This is the first study to investigate cancer risk in children born after donor ART. Although based on small numbers, results are reassuring for families and clinicians. The small but significant increased risk of hepatoblastoma detected was associated with low birthweight, a known risk factor for this tumour type. It should be emphasized that the absolute risks are very small. However, on-going investigation with a longer follow-up is needed.Study Funding/competing Interest(s): This work was funded by Cancer Research UK (C36038/A12535) and the National Institute for Health Research (405526) and supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London. The work of the Childhood Cancer Research Group (CCRG) was supported by the charity CHILDREN with CANCER UK, the National Cancer Intelligence Network, the Scottish Government and the Department of Health for England and Wales. There are no competing interests.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

The authors estimated the prevalence of heart malformation during the first year of life, using five data sets with varying degrees of completeness from two English regional health authorities. These areas covered a total population of 6, 872, 000. Analysis was carried out using capture-recapture methods, including log-linear modeling, on data collected between June 1993 and August 1994. A large number of cases in the community were unrecorded by any of the current sources of information. In South East Thames, where an antenatal training screening program for detecting heart malformations had been implemented in the late 1980s, the estimated prevalence rate varied from 5.5 per 1, 000 births (95% confidence interval (Cl): 3.5, 10.8) to 9.0 per 1, 000 births (95% Cl: 6.4, 14.2), depending on the assumptions in the model and the number of sources used in the analysis. In the Wessex region, which did not have a formal training program, prevalence was lower and varied little, from 4.3 per 1, 000 (95% Cl: 3.4, 6.0) to 5.1 per 1, 000 (95% Cl: 4.0, 7.2), according to assumptions. These two estimates were reasonable rates in comparison with reports in the literature. This analysis was helpful in demonstrating that the training program designed to identify servere heart malformations during the antenatal period in one of these regions had no lasting impact on prevalence. Am J Epidemiol 1999; 150: 778–85. [ABSTRACT FROM PUBLISHER]

This article focuses on he national evaluation of Sure Start local programmes in England. Sure Start local programmes are central to the Great Britain's government's policy for combating the adverse effects of poverty and disadvantage on young children and their families. Sure Start local programmes are designed to be comprehensive, community-based projects adapted to local needs, and making maximal use of local expertise and enthusiasms. The Sure Start programmes recognized the need for rigorous evaluation and after a competitive commissioning process the National evaluation of Sure Start was initiated. Sure Start local programmes involve changes to existing services. Improved services and community functioning are presumed to lead to enhanced family community functioning that enhance child development.

Provides information on a study that analyzed the relation between risk of hypospadias and maternal occupation, particularly with regard to exposure to potential endocrine disrupting chemicals. Methodology of the study; Results and discussion on the study; Conclusions.

To examine time trends in neural tube defects (NTD) prevalence from 1987 to 1996 in relation to the primary prevention policies for folic acid supplementation strategies in different countries. Retrospective time trends analysis of NTD prevalence. 11 birth defect registries of congenital malformations participating in the International Clearinghouse for Birth Defects Monitoring System, in the period from 1 July 1987 to 30 June 1996. 8207 live births, stillbirths and terminated pregnancies affected by anencephaly or spina bifida registered by the 11 participating centres 1987-1996. Prevalence rate ratios based on the annual rates, using the Poisson regression model. During the study period a significant fall in prevalence rates for all NTD is present in Atlanta (USA), England and Wales, Hungary and Japan, and a significant rise in Norway and South America. After adjusting for the secular trends observed in the earlier years of the study, no significant trend can be attributed to preventive strategies. Data on NTD prevalence are supplemented with information on folate awareness among some of the populations studied. There is no evidence that, up to the middle of 1996, any change in time trend was attributable to the introduction of national folate supplementation policies. The possible effectiveness of folate supplementation policies for the reduction of NTD clearly needs to be tried and studied for several more years. Considering that in the Western world about 50% of pregnancies are unplanned, a policy that rests on action taken before conception can only have limited success. Strategies based on food enrichment, such as was introduced in the USA from the beginning of 1998, may prove to be more successful. [ABSTRACT FROM AUTHOR]

Perinatal and postneonatal mortality among immigrants to England and Wales from India, Pakistan and Bangladesh (Asians) for the years 1982-85 showed significant differences not only between the immigrant and indigenous populations, but also among the different groups from the Indian subcontinent. Compared with the perinatal mortality rate of 10.1 per 1000 total births in UK born mothers, rates in infants of mothers born in India, Bangladesh, and Pakistan were 12.5, 14.3 and 18.8 respectively. In contrast, postneonatal mortality in infants of Indian and Bangladeshi origin (3.9 and 2.8 per 1000 live births respectively) was lower than in the indigenous population (4.1), with Pakistani infants experiencing the highest rate (6.4). Excess perinatal mortality in infants of Asian origin was apparent at most maternal ages and parities. Pakistani infants had the highest rates of perinatal and postneonatal mortality in all age, parity and birth weight groups. The Asian groups showed higher mortality from congenital anomalies in both the perinatal and the postneonatal period, the rates in Pakistani infants being almost double those in Indian and Bangladeshi infants. A significant finding was the lower rates of sudden infant death in all the groups of Asian origin. [ABSTRACT FROM AUTHOR]

To evaluate the completeness of notification of deaths by the National Health Service Central Register (NHSCR) for England and Wales. Deaths for a birth cohort were ascertained through scanning the relevant volumes of NHSCR. Attempts were made to confirm these deaths and additional deaths were ascertained through searching local records. Logistic regression was used to investigate how the probability of a death being missed by NHSCR varied with the year of birth, age at death, sex, and social class. Deaths up to the end of 1989 in the CA postal area among 264,046 children born between 1950 and 1989 to mothers living in Cumbria. NHSCR originally ascertained 4139 deaths; local searches confirmed 3338 (81%) of these and found an additional 342. Most deaths missed by the NHSCR were neonatal deaths in the 1950s and 1960s. In the 1950s, 31% of children who died in the neonatal period either were not entered on NHSCR or, if they were entered, there was no record of their death. For children born from 1970 onwards, ascertainment of deaths through NHSCR was over 99% complete. The NHSCR was started in 1948 for the administration of records of National Health Service patients. It seems that many babies who died soon after birth were not therefore recorded. In parallel with the increasing use of NHSCR for epidemiological purposes, there has been a substantial and continuing improvement in its clerical procedures since the mid 1960's. [ABSTRACT FROM AUTHOR]

STUDY OBJECTIVE: To evaluate the completeness of notification of deaths by the National Health Service Central Register (NHSCR) for England and Wales. DESIGN: Deaths for a birth cohort were ascertained through scanning the relevant volumes of NHSCR. Attempts were made to confirm these deaths and additional deaths were ascertained through searching local records. Logistic regression was used to investigate how the probability of a death being missed by NHSCR varied with the year of birth, age at death, sex, and social class. SETTING: Deaths up to the end of 1989 in the CA postal area among 264,046 children born between 1950 and 1989 to mothers living in Cumbria. RESULTS: NHSCR originally ascertained 4139 deaths; local searches confirmed 3338 (81%) of these and found an additional 342. Most deaths missed by the NHSCR were neonatal deaths in the 1950s and 1960s. In the 1950s, 31% of children who died in the neonatal period either were not entered on NHSCR or, if they were entered, there was no record of their death. For children born from 1970 onwards, ascertainment of deaths through NHSCR was over 99% complete. CONCLUSIONS: The NHSCR was started in 1948 for the administration of records of National Health Service patients. It seems that many babies who died soon after birth were not therefore recorded. In parallel with the increasing use of NHSCR for epidemiological purposes, there has been a substantial and continuing improvement in its clerical procedures since the mid 1960's. [ABSTRACT FROM PUBLISHER]

STUDY OBJECTIVE--The aim was to compare congenital malformation rates in twin births with those in singleton births. DESIGN--The study was an analysis of malformation rates in singleton and twin births using data from the Office of Population Censuses and Survey's Congenital Malformation Notification Scheme. SETTING--This was a national survey of births in England and Wales in 1979-1980 and 1982-1985. PARTICIPANTS--The data comprised 95,510 reported malformations in 3.7 million singleton births, and 1925 reported malformations in 76,000 twin births. MEASUREMENTS AND MAIN RESULTS--Twin malformation ratios were calculated using maternal age specific singleton rates as standard. In comparison with singleton births, twins have significantly higher reported frequencies of indeterminate sex and pseudohermaphroditism; anencephaly; patent ductus arteriosis; exomphalos; hydrocephalus; anomalies of the umbilical vessels; atresia or stenosis of the large intestine or anus; and tracheo-oesophageal fistula, atresia or stenosis. Twins also have significant reported deficits of polydactyly and syndactyly; congenital dislocation of the hip; anomalies of the tongue, branchial cleft and auricular sinus; post-anal dimple; and Down's syndrome. CONCLUSIONS--Several major malformations were significantly more common in twins than in singletons. The excess of indeterminate sex and pseudohermaphroditism has not been described before and may be analogous to freemartinism in cattle. Most of the conditions less common in twins are minor, and the reported deficits may be due to underascertainment of the less serious conditions in twins. Down's syndrome is an exception, and the deficit may well be real. [ABSTRACT FROM PUBLISHER]

To conduct a number of studies into the prevalence of neural tube defects (NTD) in the area covered by the Oxford Record Linkage Study (ORLS), multiple sources were used to build a local register of cases occurring in Oxfordshire and West Berkshire between 1968-1990. One source of potential cases--namely, termination and congenital malformation monitoring data available for the locality from the Office of Population Censuses and Surveys (OPCS) data--were kept separate. Comparison of the local cases recorded by OPCS and those known to the register from 1974-1990, using the method of capture-recapture, suggested that national data are only about two thirds complete, but that this underreporting is likely to be reasonably consistent from year to year. OPCS data can therefore be used to study NTD trends if not absolute risks. The local register seemed, by the same yardstick, to be very complete and is being used in a variety of studies of the occurrence of NTD. Survival to one year in this area, over the period 1968-1990, has only improved in the recent past, if at all. Most NTD pregnancies now end in termination rather than birth, and there has been a true decline in the occurrence of NTDs, and likewise the different subtypes. [ABSTRACT FROM PUBLISHER]

Examines the incidence of sudden infant death syndrome among immigrants in Great Britain. Influence of ethnic differences in postneonatal mortality; Variations in postneonatal mortality by maternal age; Use of mother's country of birth in determining ethnic differences in mortality.

In 1986 The Office of Population Censuses and Surveys (OPCS) introduced new certificates for stillbirths and neonatal deaths. This allowed certifiers more flexibility in the completion of the certificate, and the number and ordering of the causes given. Tabulations have been published of the fetal and maternal causes of death mentioned on the certificates for every year from 1986 to 1991 in annual reference volumes. It has not been possible either to derive a single cause group for each death, however, or to compare the information available on neonatal deaths with that on postneonatal deaths, which are still derived from the standard death certificate. The aim of the work described here was to adapt previous classifications to derive a single cause grouping for stillbirths and infant deaths which would provide the maximum information about preventability and yet meet the national and international responsibilities of OPCS. The methods used and the tests carried out on the validity and consistency of the chosen classification are described. [ABSTRACT FROM AUTHOR]

Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights recorded when the birth was registered. Trends in occurrence and one year survival of those who weighed under 1500 g at birth have been calculated in 100 g groups, separately for single and multiple births. By 1987 singleton live births in England and Wales who weighed between 700 and 799 g had a 43% chance of surviving to 1 year compared with a 32% chance five years earlier; those who weighed 800 to 899 g had a 55% chance compared with 46%. The absolute number of survivors weighing between 500 and 999 g at birth increased by nearly 50% between 1983 and 1987, and there was a 30% increase overall in survivors weighing less than 1500 g. [ABSTRACT FROM AUTHOR]

Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 was investigated according to the mother's country of birth. Significant differences remained after standardising for maternal age and social class. The highest overall mortality was in infants of mothers born in Pakistan (standardised mortality ratio 237), followed by infants of mothers born in India (standardised mortality ratio 134), East Africa (standardised mortality ratio 126), and Bangladesh (standardised mortality ratio 118). Caribbean and West African mothers showed an overall deficit. Mortality was inversely related to social class in all groups except the Afro-Caribbean. Infants of mothers born in Pakistan had the highest mortality in every social class except I, and for most anomalies investigated. Their ratios were particularly high for limb and musculoskeletal anomalies (standardised mortality ratio 362), genitourinary anomalies (standardised mortality ratio 268), and central nervous system anomalies (standardised mortality ratio 239). Our findings highlight the need for further research to identify the causes underlying these differences. [ABSTRACT FROM AUTHOR]

The overall incidence of multiple births in England and Wales, which had been declining since the early 1950s, started to increase in the early 1980s in all age groups except for women under 20. This followed a rise in the incidence of triplet and higher order multiple births which had started in the late 1970s. Analyses of data for births between 1978 and 1983 showed that while stillbirth, perinatal, neonatal, and post-neonatal mortalities among multiple births fell considerably, they remained consistently higher than those for singleton births. Differences in the distribution of birth weight do not wholly explain these differences. Analyses of certified causes of stillbirth and death are difficult to interpret because a considerable proportion were attributed to 'multiple pregnancy'. [ABSTRACT FROM AUTHOR]

The authors reflect on a study on the medical surveillance for congenital eye anomalies in England and Wales. They state that they compared the number of children identified in a national active surveillance study with a National Congenital Anomaly System (NCAS) data set. They also mention that their study reveals significant underreporting of eye anomalies to NCAS in England and Wales.

Presents a study to assess the National Congenital Anomaly System and evaluate the impact of the lack of data. Design, setting, participants, main outcome measure, and results; Conclusion the surveillance in England is inadequate because registration is non-uniform and data on the termination of pregnancy because of prenatal diagnosis of fetal anomaly is unavailable.

A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was analysed for the frequency of appearance of maternal and fetal conditions anywhere on the certificate, not just as the underlying cause. The results suggest there is presently no need to extend the use of the new stillbirth and neonatal death certificates, introduced in 1986, to the postneonatal period. Periodic multicause analysis of the old style death certificate should be sufficient to reveal the detail of conditions incriminated in postneonatal deaths. [ABSTRACT FROM AUTHOR]

A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was analysed for the frequency of appearance of maternal and fetal conditions anywhere on the certificate, not just as the underlying cause. The results suggest there is presently no need to extend the use of the new stillbirth and neonatal death certificates, introduced in 1986, to the postneonatal period. Periodic multicause analysis of the old style death certificate should be sufficient to reveal the detail of conditions incriminated in postneonatal deaths. [ABSTRACT FROM PUBLISHER]

We examined like and unlike sex twinning rates in Great Britain by social class over the period 1974-85. Although twinning rates are believed to have changed over that period, we found no evidence of differential change by social class, suggesting that any factors affecting twinning are widespread in the population. [ABSTRACT FROM AUTHOR]

Aims: To describe accurately the total prevalence of neural tube defects (NTDs) in England and Wales over time, and to provide a benchmark up to 1994.Methods: National data about NTDs reported as births or terminations are available from 1974-94, but reporting is incomplete. A local register of NTDs covering Oxfordshire/west Berkshire from 1965-94 was used to validate national data for the locality, using the method of capture and recapture, and hence to estimate incompleteness of reporting nationally.Results: National underreporting is consistent at about two thirds of the true number of cases reaching at least the second trimester. The local register is much more complete, but time trends locally and nationally are similar. In England and Wales total prevalence declined from about 34 per 10000 live and stillbirths in 1974 to a plateau of just under 8 per 10000 in the 1990s.Conclusions: The decline in NTD prevalence is real and seems to have stopped. How this relates to changes in diet or the practice of vitamin supplementation is unknown, and the implications of the plateau are uncertain. OPCS figures of 500 NTDs annually in England and Wales represent about two thirds of the true number of cases. [ABSTRACT FROM AUTHOR]

Presents a letter related to registration of ovarian cancer in England and Wales. Efforts of the Office for National Statistics team in obtaining information on cancer; Need for researchers to be aware about incomplete registration; Implications of information for the design of clinical trials.