Population-based surveillance of congenital anomalies over 40 years (1981-2020): results from the Paris Registry of Congenital Malformations (remaPAR)

In France, there are 7 registers of congenital malformations, including the Paris register (remaPAR). This registry records all births (live births and fetal deaths ≥22 weeks of amenorrhea, and medical terminations of pregnancy [IMG] regardless of gestational age) with congenital anomalies detected during pregnancy up to the child’s discharge from maternity or hospitalization. We have reviewed 40 years of epidemiological surveillance of congenital anomalies from this registry, between 1981 and 2020.

For women domiciled and giving birth in Paris, the prevalence of congenital anomalies was stable overall during the period studied, representing 2.9% of total births and 2.1% of live births. Genetic anomalies were the most frequent anomalies (≈23%) followed by congenital heart disease (≈22%) and limb anomalies (≈20%). Live births and IMGs accounted for around 70% and 25% of births, and these proportions have remained stable since the 1990s. Prenatal diagnosis has improved considerably, rising from 17% in the 1980s to 70% in more recent years. However, certain congenital anomalies, such as hypospades, are still poorly detected prenatally.

Finally, the proportion of women aged over 35 more than doubled over the study period (16.9% in 1981-1984 to 43.9% in 2018-2020). The increase in maternal age at childbirth is a phenomenon that has been observed globally in France for several years, as shown in the National Perinatal Surveys, but this increase is more pronounced in Ile-de-France compared to other regions. In line with this increase in maternal age, remaPAR reports the highest prevalence of trisomy 21 compared with other French congenital malformation registries, with a prevalence of 40.8 per 10,000 births and 7.4 per 10,000 live births.

  • Monier I, Hachem S, Goffinet F, Martinez-Marin A, Khoshnood B, Lelong N. Population-based surveillance of congenital anomalies over 40 years (1981-2020): Results from the Paris Registry of Congenital Malformations (remaPAR). J Gynecol Obstet Hum Reprod. 2024 Mar 27;53(6):102780.

By Isabelle Monier, Nathalie Lelong


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