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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Thursday, June 05, 2003

    Gulf War Birth Defects: A study published in April that claims an increase in birth defects among the children whose parents served in the first Gulf War is sprouting up in the media this week:

    The study by the Department of Defense Naval Health Research Center and Centers for Disease Control and Prevention examined birth defect data from 1989-93.

    In all, researchers identified 11,961 children born to Gulf War veterans and 33,052 children of veterans who had not been deployed in the Gulf. Of those, 450 had mothers who served in the Gulf and 3,966 had non-deployed mothers.

    They found four sons of female Gulf War veterans with a condition known as hypospadia, making children in that group about six times more likely to be born with the defect. Boys born with the condition have urethra openings located in the middle or the back of the penis.

    In postwar conceived infants of male Gulf War veterans, researchers found 10 children with tricuspid valve insufficiency, making children in that group 2.7 times more likely to have the defect, and five with aortic valve stenosis, a six-fold difference. Both are conditions in which heart valves do not function properly.

    Five postwar children of male Gulf War veterans had renal agenesis, a condition in which part of the kidney fails to grow and develop properly.
    (Emphasis mine.)

    Those are very small numbers, and the conditions are ones that occur rarely to begin with. Hypospadias has an incidence of 3 in 1000. Tricuspid insufficiency is usually an acquired defect, and not generally listed in textbooks as a congential cardiac anomaly in and of itself, but usually in conjunction with other cardiac anomalies. In fact, tricuspid insufficiency in a newborn can be the normal physiologic response to the shift in circulation patterns from those needed by the fetus to those needed by the air-breathing newborn. Aortic stenosis is also often associated with other congential heart disorders. It's interesting that they chose to break the findings down into the two separate lesions rather than report the overall incidence of congental heart disease (with which the two are usually associated) in the two groups. Could it be that there was no statistically significant difference? It’s hard to tell from the study’s abstract since it only reports the results in terms of relative risk and gives no data on the incidence in non-Gulf War veterans (also something the press report neglects to provide.)

    Renal agenesis also comes in different forms. It can be bilateral, which has an incidence rate of 1 to 3 per 10,000 births. It can also be unilateral, but according to my source, the incidence of that version isn’t known.

    But, the most critical point is that when you’re dealing with such small numbers, it really isn’t possible to say that there’s a clinically significant increase in incidence. Especially when the incidence itself can vary a factor of three per 10,000.

    posted by Sydney on 6/05/2003 08:36:00 AM 0 comments


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