Public health and prevention of congenital anomalies

Two to three percent of all infants are born with a major congenital anomaly. Often these children are born to parents who did not have any known increase in risk for bearing children with such anomalies. In recent decades the possibilities for primary prevention and for intervention after prenatal diagnosis have increased. Different countries have developed divergent policies in this respect, and this Symposium set out to discuss the basis for making such a choice and the potential effects of policy. Epidemiologists working in the field of congenital anomalies, clinical geneticists, obstetricians involved in prenatal diagnosis, and health policy makers were all involved. Prominent topics at the Symposium included Down’s syndrome, the influence of ultrasound, and the role of vitamins; striking was the fact that alongside the purely scientific issues so much attention was devoted to resolving the ethical and political issues which arise where congenital defects are concerned. In association with the Symposium there was an annual meeting of registry leaders of the EUROCATnetwork (“European Registration of Congenital Anomalies”).1 EUROCAT is a network of 30 registries in 16 countries, mainly within the European Union, which aims to collect information on congenital anomalies since 1979. Details of EUROCAT, and the texts of papers and posters from the Symposium are available from EUROCAT-registration, Ant. Deusinglaan 4, NL-9713 AW Groningen. What follows here is a brief report of some highlights of the Symposium; they comprise a paper by two representatives of the Netherlands parents’ organisation for Down’s syndrome, another by Prof. E. Borst-Eilers, Minister of Public Health, Welfare and Sports, the Netherlands, and a summary of the general discussion.