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American Journal of Epidemiology Vol. 102, No. 4: 275-290
Copyright © 1975 by The Johns Hopkins University School of Hygiene and Public Health

other

SPONTANEOUS ABORTION AS A SCREENING DEVICE

THE EFFECT OF FETAL SURVIVAL ON THE INCIDENCE OF BIRTH DEFECTS1

ZENA STEIN2, MERVYN SUSSER3, DOROTHY WARBURTON4, JANET WITTES3 and JENNIE KLINE3

2Division of Epidemiology, Columbia University, and Director, New York State Dept. of Mental Hygiene, Epidemiology Research Unit New York, 10032
3Division of Epidemiology, Columbia University New York, 10032
4Dept. of Human Genetics and Development, Columbia University New York, 10032

Stein. Z. A. (New York State Dept. of Mental Hygiene, Columbia University.600 W. 168thSt. New York, NY 10032). M. Susser. D. Warburton, J. Wittes and J. Kline. Spontaneous abortion as a screening device: the effect of fetal survival on the incidence of birth defects. Am J Epidemiol 102: 275–290.1975.

To make sound inferences about the distribution, causes and risks of congenital anomalies requires an understanding of selective survival among fetuses. Studies of spontaneousabortions are therefore advocated. A simple model is proposed of the distribution, among spontaneous abortions and births, of conceptuses with and without anomalies. The resulting equation accomo-dates both maternal and fetal factors. Interaction between maternal andfetal factors is hypothesized, in the form of a maternal device for screening out anomalous conceptuses. A number of the known facts about congenital anomalies are shown to be plausibly interpreted in terms of the proposed model. Finally, some clinical and epidemiologic implications of the model for the study of spontaneous abortions are pointed out.

abortion, spontaneous; embryopathies; fetal death; chromosome abnormalities

1From Columbia University, College of Physicians and Surgeons New York, New York, 10032.


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