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© 1990 Oxford University Press

research-article

Monthly and Seasonal Variations in the Frequency of Congenital Anomalies

EDUARDO E CASTILLA*,**,, IEDA M ORIOLI{dagger}, REGINA LUGARINHO{ddagger}, GRACA P DUTRA{dagger}, JORGE S LOPEZ-CAMELO*,**, HEBE E CAMPANA*, AMEDEO SPAGNOLO$ and PIERPAOLO MASTROIACOVO§

*Instituto Multidisciplinario de Biologia Celular: IMBICE La Plata, Argentina.
**Dept Genetica, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro Brazil.
{dagger}Dept Genetica, Instituto de Biologia, Universidade Federal do Rio de Janeiro Brazil.
{ddagger}Disciplina de Genetica, Centro de Ciencias Biologicas e da Saude, Universidade do Rio de Janeiro (UNI-RIO) Brazil.
$S.Lab de Epidemiologia e Bioestatistica, Istituto Superiore di Sanita Rome, Italy.
§Clinica Pediatrica, Universita Cattolica Rome, Italy.

Reprint requests to: Eduardo E Castilla, ECLAMC/Genetica/ FIOCRUZ, Caixa Postal 926, 21.040, Rio de Janeiro, Brazil.

Castilla E E (Instituo Multidisciplinario de Biologica Celular; IMBICE, La Plata, Argentina), Orioli I M, Lugarinho R, Dutra G P, Lopez-Camelo J S, Campana H E, Spagnolo A and Mastroiacovo P. Monthly and seasonal variations in the frequency of congenital anomalies. International Journal of Epidemiology 1990, 19: 399–404

Three large and comparable series of births were used to test the working hypothesis that if there is a real seasonal variation in the frequency of a given congenital malformation; it would have to be shown by adequate analysis; to be more overt in non-tropical areas; and to be six months out of phase in northern and southern hemispheres. The date set were hospital births from tropical (287 165 births) and non-tropical (582 585 births) South America, and from Italy (508 536 births).

Sixteen well-defined malformation types were tested: anencephaly, spina bifida, cephalocoele, hydrocephaly, microtia, cleft palate, cleft lip, oesophageal atresia, anal atresia, hypospadias, pes equino-varus, pes talovalgus, postaxial polydactyly, pre-axial polydactyly, diaphragmatic hernia, and Down's syndrome. No seasonal variation was proven (p<0.01)for any malformation type in any of the three series of data by means of Walter and Elwood's1 test, or Hewitt et al's non-parametric test2 applied to seven instances with sample sizes smaller than 50 cases.

Variations of borderline significance (p<0. 05) included oesophageal atresia in tropical South America, none in non-tropical South America, and anencephaly in Italy. It is concluded that seasonal variation in the occurrence of congenital malformations is a rare phenomenon when tests are strictly used within their recommended limitations.

Revised 1 September 1989


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