Human Abnormal Development
Embryology - 5 Dec 2023 ![]() ![]() ![]() |
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Introduction
How and why do things go wrong in development?
These notes cover abnormalities that can occur during development (abnormal development) often described as congenital abnormalities or birth defects. There are many different ways that developmental abnormalities can occur the 3 major types are Genetic (inherited), Environmental (maternal) and Idiopathic (unknown, not determined) derived abnormalities. The environmental factors that cause or lead to any of these abnormalities are described as teratogens. Congenital abnormalities are classified under the system called the International Classification of Diseases ( ICD-11) that version updated in 2018.
Note that genetic and environmental effects can also interact and it is this and the group, now classified as idiopathic or "unknown causes", that require further research to place them in either or both of the two real categories. Furthermore developmental organizer genes, for example Hedgehog[1], have been recently implicated in adult carcinogenesis.
Please note that abnormal development pages may contain clinical images not suitable for children.
Prenatal Diagnosis
Prenatal diagnosis are the clinical tools used to determine both normal and abnormal development. There are a growing number of new diagnostic techniques that are being applied to human embryonic development. Tests that occur after birth are described in Neonatal Diagnosis.
Diagnosis Links: Prenatal Diagnosis | pregnancy test | amniocentesis | chorionic villus sampling | ultrasound | Alpha-Fetoprotein | Pregnancy-associated plasma protein-A | Fetal Blood Sampling | Magnetic Resonance Imaging | Computed Tomography | Non-Invasive Prenatal Testing | Fetal Cells in Maternal Blood | Preimplantation Genetic Screening | Comparative Genomic Hybridization | Genome Sequencing | Neonatal Diagnosis | Category:Prenatal Diagnosis | Fetal Surgery | Classification of Diseases | Category:Neonatal Diagnosis |
| BGD Tutorial - Applied Embryology and Teratology
Neonatal Diagnosis
Neonatal Diagnosis Links: neonatal diagnosis | Apgar test | Guthrie test | hearing test | Electrocardiogram (ECG/EKG) | X-ray | Tandem mass spectrometry | Classification of Diseases |
Genetic
Genetic Links: genetic abnormalities | maternal age | Trisomy 21 | Trisomy 18 | Trisomy 13 | Trisomy X | trisomy mosaicism | Monosomy | Fragile X | Williams | Alagille | Philadelphia chromosome | mitochondria | VACTERL | hydatidiform mole | epigenetics | Prenatal Diagnosis | Neonatal Diagnosis | meiosis | mitosis | International Classification of Diseases | genetics |
Environmental
While genetic abnormalities will have well-defined impacts upon development, environmentally derived effects can be harder to define and often variable depending on many different factors (timing, exposure level, and the combination effects with other factors). This combination effect can also be seen between genetic and environmental interacting to give an even broader spectrum of both major and minor abnormalities.
Environmental Links: Introduction | low folic acid | iodine deficiency | Nutrition | Drugs | Australian Drug Categories | USA Drug Categories | thalidomide | herbal drugs | Illegal Drugs | smoking | Fetal Alcohol Syndrome | TORCH | viral infection | bacterial infection | fungal infection | zoonotic infection | toxoplasmosis | Malaria | maternal diabetes | maternal hypertension | maternal hyperthermia | Maternal Inflammation | Maternal Obesity | hypoxia | biological toxins | chemicals | heavy metals | air pollution | radiation | Prenatal Diagnosis | Neonatal Diagnosis | International Classification of Diseases | Fetal Origins Hypothesis |
Often not considered, is that pregnancy itself can also expose abnormalities in the mother (congenital heart disease, diabetes, reproductive disorders) that until then had gone undetected. This section of notes also includes links to prenatal diagnosis techniques, twinning and statistical information relating to abnormalities at birth from several different countries.
Undergraduate Science Projects
The links below are to Science student group projects prepared on the topics of prenatal diagnosis (2010) and abnormal development (2011).
- 2011 Student Projects: Turner Syndrome | DiGeorge Syndrome | Klinefelter's Syndrome | Huntington's Disease | Fragile X Syndrome | Tetralogy of Fallot | Angelman Syndrome | Friedreich's Ataxia | Williams-Beuren Syndrome | Duchenne Muscular Dystrolphy | Cleft Palate and Lip
- 2010 Student Projects: Ultrasound | Chorionic villus sampling | Amniocentesis | Percutaneous Umbilical Cord Blood Sampling | Fetal Fibronectin | Maternal serum alpha-fetoprotein
Statistics
Sex Bias
Some developmental abnormalities show a difference in distribution related to embryo sex, Male and Female. While other genetic abnormalities are related to maternal mitochondrial inheritance sex chromosomes {{ChrX)} and {{ChrY).
Some examples of some abnormalities sex related statistics are shown below.
Male preponderance | Female preponderance |
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Cardiac defects | |
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Table data[2] Links: abnormal development | cardiovascular abnormalities | USA | Male | Female | cleft lip and palate |
Hirschsprung's disease (intestinal aganglionosis, aganglionic colon, megacolon, congenital aganglionic megacolon, congenital megacolon, HSCR) a congenital intestinal motility disorder with an incidence of 1:5000, with a male to female predominance of 4:1.
Some neural abnormalities, such as autism and intellectual disability, have a Male sex bias. This can be affected by the presence of specific comorbidities, specific copy number variants, mutational burden, and pre-existing family history of neurodevelopmental phenotypes.[3]
Neural tube defects: Sex ratio changes after fortification with folic acid[4] "Historically, neural tube defects (NTDs) have predominated in Female infants but the reasons remain unclear. In South America, the pre- folic acid fortification (FAF) rates of NTDs were around 18/10,000 births for females and 12/10,000 births for males, with an estimated sex ratio (male/female) of 0.67.
More than 80% of autoimmune disease predominantly affects Females.[5]
Other abnormalities of development are considered "anatomical variations" as they do not have any serious impacts. For example, the thyroid has a common anatomical variation of a pyramidal lobe seen more frequently in Male than in Female.[6]
Australia - Top 10
Congenital Anomalies in Australia 2002-2003 |
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Congenital anomalies in Australia 2002-2003[7] was published in 2008 as part a new revised series on 33 selected congenital anomalies also monitored internationally by the International Clearinghouse of Birth Defects Surveillance and Research.
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External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation. |
The ten most frequently reported birth defects in Victoria between 2003-2004.
- Hypospadias
- Obstructive Defects of the Renal Pelvis or Obstructive Genitourinary Defects
- Ventricular Septal Defect
- Congenital Dislocated Hip
- Trisomy 21 or Down syndrome
- Hydrocephalus
- Cleft Palate
- Trisomy 18 or Edward Syndrome - multiple abnormalities of the heart, diaphragm, lungs, kidneys, ureters and palate 86% discontinued.
- Renal Agenesis/Dysgenesis - reduction in neonatal death and stillbirth since 1993 may be due to the more severe cases being identified in utero and being represented amongst the increased proportion of terminations (approximately 31%).
- Cleft Lip and Palate - occur with another defect in 33.7% of cases.
- Links: ACAMS | Australian Statistics
USA - Selected
USA Statistics | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Birth Defects Sex Ratios
USA National Birth Defects Prevention Study (1997-2009)[2]
This study presents estimates of sex ratio for both isolated cases and those with multiple congenital anomalies, as well as by race/ethnicity. Male-female sex ratios and their 95% confidence intervals were calculated for 25,952 clinically reviewed case infants included in the National Birth Defects Prevention Study (1997-2009), a large population-based case-control study of birth defects.
Male preponderance | Female preponderance |
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Cardiac defects | |
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Table data[2] Links: abnormal development | cardiovascular abnormalities | USA | Male | Female | cleft lip and palate |
Differences were observed by race/ethnicity for some but not for most types of birth defects. The sex differences we observed for specific defects, between those with isolated versus multiple defects, as well as by race/ethnicity, demonstrate patterns that may suggest etiology and improve classification.
- Links: USA Monitoring Programmes | USA Statistics
Nigeria
Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria[8]
- "The results of this study show that congenital abnormal- ities occur in 2.8% of newborns admitted in the neonatal unit of the University Of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu and that the commonest forms seen are cleft lip/cleft palate and neural tube defects. The prevalence rate obtained in this study, however, may not reflect the true situation in the general population for reasons adduced in the discussion above but gives a clue to the existence of the problem and could serve as a stimulus for further studies on the subject."
Neural Tube Defects
Neural tube defects that were just outside the top ten most common birth defects but are widely known.
- spina bifida - (73%) of parents choose to discontinue a pregnancy affected by spina bifida.
- anencephaly - (94%) of parents choose to discontinue a pregnancy affected by anencephaly.
- Data: from the Victorian Perinatal Data Collection Unit
Links: folate | anencephaly | Neural System - Abnormalities
Genetic (inherited)
Genetic Links: genetic abnormalities | maternal age | Trisomy 21 | Trisomy 18 | Trisomy 13 | Trisomy X | trisomy mosaicism | Monosomy | Fragile X | Williams | Alagille | Philadelphia chromosome | mitochondria | VACTERL | hydatidiform mole | epigenetics | Prenatal Diagnosis | Neonatal Diagnosis | meiosis | mitosis | International Classification of Diseases | genetics |
Environmental (maternal)
Environmental Links: Introduction | low folic acid | iodine deficiency | Nutrition | Drugs | Australian Drug Categories | USA Drug Categories | thalidomide | herbal drugs | Illegal Drugs | smoking | Fetal Alcohol Syndrome | TORCH | viral infection | bacterial infection | fungal infection | zoonotic infection | toxoplasmosis | Malaria | maternal diabetes | maternal hypertension | maternal hyperthermia | Maternal Inflammation | Maternal Obesity | hypoxia | biological toxins | chemicals | heavy metals | air pollution | radiation | Prenatal Diagnosis | Neonatal Diagnosis | International Classification of Diseases | Fetal Origins Hypothesis |
Critical Periods
During prenatal development there are "windows of time" or "critical periods", that following exposure to teratogens can lead to developmental abnormalities (anomalies, congenital). In general, the effects for each system are more severe (major anomalies) in the earlier embryonic period during organogenesis in the first trimester. Later teratogen exposure are less severe (minor anomalies) in the fetal period during continued growth and differentiation in the second and third trimester.
Critical Periods of Human Development | ||||||||||||||||||||
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Conceptus | Embryonic development (weeks) | Fetal period (weeks) | ||||||||||||||||||
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Neural | ||||||||||||||||||||
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Heart | |||||||||||||||||||
Upper limbs | ||||||||||||||||||||
Lower limbs | ||||||||||||||||||||
Ear | ||||||||||||||||||||
Eye | ||||||||||||||||||||
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Palate | |||||||||||||||||||
Teeth | ||||||||||||||||||||
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External genitalia | |||||||||||||||||||
Loss | Major abnormalities | Functional and Minor abnormalities | ||||||||||||||||||
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Cardiac Critical Periods
As an example, the table below shows the "critical periods" of cardiac development.
Lesion | Start of Susceptibility to Malformation |
End of Susceptibility to Malformation | |||
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Interatrial communications | |||||
Oval fossa defect | 6 weeks (E13.5) | Term | |||
Sinus venosus defect | 8 weeks | 12 weeks | |||
Coronary sinus defect | 8 weeks | Term | |||
Vestibular defect | 7 weeks | 8 weeks | |||
Ventricular Septal Defect | |||||
Muscular | 8 weeks | Difficult to predict | |||
Perimembranous | 6 weeks | 8 weeks | |||
Doubly committed | 7 weeks | 8 weeks | |||
Atrioventricular Septal Defect | |||||
Ostium primum | 5 weeks | 6 weeks | |||
“Complete” | 5 weeks | 6 weeks | |||
Aortic coarctation | |||||
With VSD | 5 weeks | 8 weeks | |||
With intact ventricular septum | 8 weeks | Term | |||
Double Outlet Right Ventricle | 6 weeks | 8 weeks | |||
Transposition of Great Arteries | 6 weeks | 8 weeks | |||
Ebstein’s malformation | 6 weeks | 8 weeks | |||
Hypoplastic left heart syndrome | |||||
With mitral atresia | 5 weeks | 8 weeks | |||
With mitral stenosis | 8 weeks | Term | |||
Pulmonary atresia | |||||
With VSD | 6 weeks | 8 weeks | |||
With intact ventricular septum | 8 weeks | Term | |||
Other | |||||
Functionally single ventricle | 5 weeks | 6 weeks | |||
Tetralogy of Fallot | 7 weeks | 8 weeks | |||
Totally anomalous pulmonary venous return | 8 weeks | 12 weeks | |||
Tricuspid atresia | 5 weeks | 6 weeks | |||
Common arterial trunk | 5 weeks | 7 weeks | |||
Bicuspid aortic valve | 6 weeks | Term | |||
Notes | |||||
For approximate clinical Gestational Age GA add 2 weeks; number in brackets is mouse equivalent. Data Reference[9] | Links: heart | abnormal development | timeline | Category:Timeline |
Table 2. Summary of Timing (Post Fertilization) of Cardiac Susceptibility to a Drug-Induced Malformation | ||
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Lesion | Start of Susceptibility to Malformation |
End of Susceptibility to Malformation |
Interatrial communications | ||
Oval fossa defect | 6 weeks (E13.5) | Term |
Sinus venosus defect | 8 weeks | 12 weeks |
Coronary sinus defect | 8 weeks | Term |
Vestibular defect | 7 weeks | 8 weeks |
Ventricular Septal Defect | ||
Muscular | 8 weeks | Difficult to predict |
Perimembranous | 6 weeks | 8 weeks |
Doubly committed | 7 weeks | 8 weeks |
Atrioventricular Septal Defect | ||
Ostium primum | 5 weeks | 6 weeks |
“Complete” | 5 weeks | 6 weeks |
Aortic coarctation | ||
With VSD | 5 weeks | 8 weeks |
With intact ventricular septum | 8 weeks | Term |
Double Outlet Right Ventricle | 6 weeks | 8 weeks |
Transposition of Great Arteries | 6 weeks | 8 weeks |
Ebstein’s malformation | 6 weeks | 8 weeks |
Hypoplastic left heart syndrome | ||
With mitral atresia | 5 weeks | 8 weeks |
With mitral stenosis | 8 weeks | Term |
Pulmonary atresia | ||
With VSD | 6 weeks | 8 weeks |
With intact ventricular septum | 8 weeks | Term |
Other | ||
Functionally single ventricle | 5 weeks | 6 weeks |
Tetralogy of Fallot | 7 weeks | 8 weeks |
Totally anomalous pulmonary venous return | 8 weeks | 12 weeks |
Tricuspid atresia | 5 weeks | 6 weeks |
Common arterial trunk | 5 weeks | 7 weeks |
Bicuspid aortic valve | 6 weeks | Term |
Notes: For approximate clinical Gestational Age GA add 2 weeks; number in brackets is mouse equivalent. Reference: Anderson RH. Teratogenecity in the setting of cardiac development and maldevelopment. (2016) |
Teratology
Now consider how different environmental effects during pregnancy may influence developmental outcomes. The terms listed below are often used to describe these environmental effects
- Teratogen (Greek, teraton = monster) any agent that causes a structural abnormality (congenital abnormalities) following fetal exposure during pregnancy. The overall effect depends on dosage and time of exposure. (More? Critical Periods of Development)
- Absolute risk the rate of occurrence of an abnormal phenotype among individuals exposed to the agent. (e.g. fetal alcohol syndrome)
- Relative risk the ratio of the rate of the condition among the exposed and the nonexposed. (e.g. smokers risk of having a low birth weight baby compared to non-smokers) A high relative risk may indicate a low absolute risk if the condition is rare.
- Mutagen a chemical or agent that can cause permanent damage to the deoxyribonucleic acid (DNA) in a cell. DNA damage in the human egg or sperm may lead to reduced fertility, spontaneous abortion (miscarriage), birth defects and heritable diseases.
- Fetotoxicant is a chemical that adversely affects the developing fetus, resulting in low birth weight, symptoms of poisoning at birth or stillbirth (fetus dies before it is born).
- Synergism when the combined effect of exposure to more than one chemical at one time, or to a chemical in combination with other hazards (heat, radiation, infection) results in effects of such exposure to be greater than the sum of the individual effects of each hazard by itself.
- Toxicogenomics the interaction between the genome, chemicals in the environment, and disease. Cells exposed to a stress, drug or toxicant respond by altering the pattern of expression of genes within their chromosomes. Based on new genetic and microarray technologies.
Australian Congenital Anomalies Monitoring System
Congenital Anomalies in Australia 2002-2003 |
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Congenital anomalies in Australia 2002-2003[10] was published in 2008 as part a new revised series on 33 selected congenital anomalies also monitored internationally by the International Clearinghouse of Birth Defects Surveillance and Research.
|
External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation. |
The following text is from AIHW National Perinatal Epidemiology and Statistics Unit Australian Congenital Anomalies Monitoring System (ACAMS)
- "The Australian Congenital Anomalies Monitoring System (ACAMS) contains data based on notifications of major congenital anomalies to birth defects registers in New South Wales, Victoria, Western Australia and South Australia and on data collected on congenital anomalies in Queensland, Tasmania and the Australian Capital Territory. The Northern Territory is currently unable to provide data in a format enabling it to be compiled with data from the other states and territories. Some summary data have been provided by the Northern Territory for inclusion in the ACAS. Congenital anomalies are mainly notified from data collected as part of perinatal collections. Other sources of data include perinatal death certificates, cytogenetic or pathology reports, admitted patient data, maternal and child health nurses and medical officers.
- Information is included on live births and stillbirths of 20 weeks gestational age or more or 400 grams birthweight or more (including induced abortions) with a congenital anomaly for all states and the Australian Capital Territory. Information on induced abortions of less than 20 weeks gestational age and less than 400 grams weight with a congenital anomaly is only available for four states and is included for: New South Wales, Victoria, Western Australia and South Australia. Births included in the ACAS are also included in the National Perinatal Data Collection.
- The period of notification varies among the state and territory collections and ranges from prenatal diagnosis to notification up to 15 years of age. For New South Wales, the data include births with congenital anomalies notified up to 1 year of age. The data for Victoria, Western Australia and South Australia include births with congenital anomalies notified up to 15 years, 6 years and 5 years of age respectively. The data for Queensland, Tasmania, and the Australia Capital Territory include births with congenital anomalies notified in the perinatal period.
- Data items relating to the woman, including demographic characteristics and factors relating to the birth, and data items relating to the baby, including, birthweight, gestational age and sex, are included. Congenital anomalies are coded using the British Paediatric Association Classification of Diseases (ICD-9-BPA), which is based on the International Classification of Diseases, 9th Revision (ICD-9).
- ACAS supersedes the National Congenital Malformations and Birth Defects Data Collection (NCM&BD), which commenced in 1981 in response to claims of increased incidence of congenital anomalies in small areas of Australia. Data were provided by four jurisdictions in 1998–1985 and all states and territories provided data from 1986. Data are included up to and including the 1997 birth cohort. The NCM&BD data collection was reviewed in 2004 and the development of the ACAS was a recommendation of the review."
Previous - Australian Birth Anomalies System |
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(Modified from Australian Institute of Health and Welfare (AIHW)) |
Congenital Anomalies in Australia 2002-2003
- Links: Australian Congenital Anomalies Monitoring System (ACAMS) | Australian Institute of Health and Welfare (AIHW)
New Zealand
New Zealand Birth Defects Monitoring Programme (NZBDMP)
- monitoring the occurrence of birth defects among livebirths and fetal deaths in New Zealand.
- provide data on the prevalence of birth defects for ad hoc.
- provide annual data to the Ministry of Health and International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR)
- investigate clusters of birth defects
- provide expert technical assistance and advice on the epidemiology of birth defects
USA Monitoring Programmes
Centers for Disease Control (CDC) conducted two birth defects surveillance systems[11] and each state also maintain their own programs (see External Links).
- Metropolitan Atlanta Congenital Defects Programme (MACDP)
- established in 1967
- an intensive surveillance system using several methods to identify infants born with birth defects in the Atlanta area.
- 40th Edition Surveillance Report February 2007
- Birth Defects Monitoring Programme (BDMP)
- a nationwide surveillance system that monitors 1 million births per year.
USA Selected Abnormalities (CDC National estimates for 21 selected major birth defects 2004–2006) | ||
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Birth Defects | Cases per Births (1 in ...) | Estimated Annual Number of Cases |
anencephaly | 4,859 | 859 |
spina bifida without anencephaly | 2,858 | 1,460 |
encephalocele | 12,235 | 341 |
Anophthalmia/microphthalmia | 5,349 | 780 |
patent ductus arteriosus/common truncus | 13,876 | 301 |
transposition of the great vessels | 3,333 | 1,252 |
Tetralogy of Fallot | 2,518 | 1,657 |
atrial septal defects/ventricular septal defects | 2,122 | 1,966 |
hypoplastic left heart | 4,344 | 960 |
cleft palate without cleft lip | 1,574 | 2,651 |
cleft lip with and without cleft palate | 940 | 4,437 |
Esophageal atresia/tracheoesophageal fistula | 4,608 | 905 |
Rectal and large intestinal atresia/stenosis | 2,138 | 1,952 |
Reduction deformity, upper limbs | 2,869 | 1,454 |
Reduction deformity, lower limbs | 5,949 | 701 |
gastroschisis | 2,229 | 1,871 |
omphalocele | 5,386 | 775 |
Diaphragmatic hernia | 3,836 | 1,088 |
Trisomy 13 | 7,906 | 528 |
Trisomy 21 (Down syndrome) | 691 | 6,037 |
Trisomy 18 | 3,762 | 1,109 |
International Classification of Diseases
The International Classification of Diseases version 11 ( ICD-11) is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.
ICD-11 20 Developmental anomalies - Structural developmental anomalies primarily affecting one body system | |
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System ICD-11 | Embryology page link |
nervous system | neural abnormalities |
eye, eyelid or lacrimal apparatus | vision abnormalities |
ear | hearing abnormalities |
face, mouth or teeth | tooth abnormalities |
neck | head abnormalities |
respiratory system | respiratory abnormalities |
circulatory system | cardiovascular abnormalities |
diaphragm, abdominal wall or umbilical cord | diaphragm abnormalities | placenta abnormalities |
digestive tract | gastrointestinal abnormalities |
liver, biliary tract, pancreas or spleen | liver abnormalities | gall bladder abnormalities | pancreas abnormalities |
urinary system | renal abnormalities |
female genital system | genital abnormalities |
male genital system | genital abnormalities |
breast | mammary abnormalities |
skeleton | musculoskeletal abnormalities |
skin | integumentary abnormalities |
adrenal glands | adrenal abnormalities |
ICD-11 | abnormal development | prenatal diagnosis | neonatal diagnosis |
Germline Gene Editing
Technology development in germline gene editing has allowed the development of many animal models of human congenital defects. More recently there has been debate around the ethics of using similar methods in "correcting" these abnormalities using similar techniques in humans. In 2018 the European Society of Human Reproduction and Embryology (ESHRE) and the European Society of Human Genetics (ESHG) together developed a background document and recommendations to inform and stimulate ongoing societal debates.[12][13] The European Society of Human Genetics and the European Society for Human Reproduction and Embryology have developed a similar consensus covering this topic and other ART-related topics.[14]
References
- ↑ Bajpai A & Sinha P. (2019). Hh signaling from de novo organizers drive lgl neoplasia in Drosophila epithelium. Dev. Biol. , , . PMID: 31557471 DOI.
- ↑ 2.0 2.1 2.2 Michalski AM, Richardson SD, Browne ML, Carmichael SL, Canfield MA, VanZutphen AR, Anderka MT, Marshall EG & Druschel CM. (2015). Sex ratios among infants with birth defects, National Birth Defects Prevention Study, 1997-2009. Am. J. Med. Genet. A , 167A, 1071-81. PMID: 25711982 DOI.
- ↑ Polyak A, Rosenfeld JA & Girirajan S. (2015). An assessment of sex bias in neurodevelopmental disorders. Genome Med , 7, 94. PMID: 26307204 DOI.
- ↑ Poletta FA, Rittler M, Saleme C, Campaña H, Gili JA, Pawluk MS, Gimenez LG, Cosentino VR, Castilla EE & López-Camelo JS. (2018). Neural tube defects: Sex ratio changes after fortification with folic acid. PLoS ONE , 13, e0193127. PMID: 29538416 DOI.
- ↑ Liu K, Kurien BT, Zimmerman SL, Kaufman KM, Taft DH, Kottyan LC, Lazaro S, Weaver CA, Ice JA, Adler AJ, Chodosh J, Radfar L, Rasmussen A, Stone DU, Lewis DM, Li S, Koelsch KA, Igoe A, Talsania M, Kumar J, Maier-Moore JS, Harris VM, Gopalakrishnan R, Jonsson R, Lessard JA, Lu X, Gottenberg JE, Anaya JM, Cunninghame-Graham DS, Huang AJW, Brennan MT, Hughes P, Illei GG, Miceli-Richard C, Keystone EC, Bykerk VP, Hirschfield G, Xie G, Ng WF, Nordmark G, Eriksson P, Omdal R, Rhodus NL, Rischmueller M, Rohrer M, Segal BM, Vyse TJ, Wahren-Herlenius M, Witte T, Pons-Estel B, Alarcon-Riquelme ME, Guthridge JM, James JA, Lessard CJ, Kelly JA, Thompson SD, Gaffney PM, Montgomery CG, Edberg JC, Kimberly RP, Alarcón GS, Langefeld CL, Gilkeson GS, Kamen DL, Tsao BP, McCune WJ, Salmon JE, Merrill JT, Weisman MH, Wallace DJ, Utset TO, Bottinger EP, Amos CI, Siminovitch KA, Mariette X, Sivils KL, Harley JB & Scofield RH. (2016). X Chromosome Dose and Sex Bias in Autoimmune Diseases: Increased Prevalence of 47,XXX in Systemic Lupus Erythematosus and Sjögren's Syndrome. , 68, 1290-1300. PMID: 26713507 DOI.
- ↑ Braun EM, Windisch G, Wolf G, Hausleitner L & Anderhuber F. (2007). The pyramidal lobe: clinical anatomy and its importance in thyroid surgery. Surg Radiol Anat , 29, 21-7. PMID: 17146601 DOI.
- ↑ Abeywardana S & Sullivan EA 2008. Congenital anomalies in Australia 2002–2003. Birth anomalies series no. 3 Cat. no. PER 41. Sydney: AIHW National Perinatal Statistics Unit.
- ↑ Obu HA, Chinawa JM, Uleanya ND, Adimora GN & Obi IE. (2012). Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria--a retrospective study. BMC Res Notes , 5, 177. PMID: 22472067 DOI.
- ↑ Anderson RH. Teratogenecity in the setting of cardiac development and maldevelopment. (2016)
- ↑ Abeywardana S & Sullivan EA 2008. Congenital anomalies in Australia 2002–2003. Birth anomalies series no. 3 Cat. no. PER 41. Sydney: AIHW National Perinatal Statistics Unit.
- ↑ <pubmed>7287285</pubmed>
- ↑ de Wert G, Pennings G, Clarke A, Eichenlaub-Ritter U, van El CG, Forzano F, Goddijn M, Heindryckx B, Howard HC, Radojkovic D, Rial-Sebbag E, Tarlatzis BC & Cornel MC. (2018). Human germline gene editing: Recommendations of ESHG and ESHRE. Eur. J. Hum. Genet. , 26, 445-449. PMID: 29326428 DOI.
- ↑ De Wert G, Heindryckx B, Pennings G, Clarke A, Eichenlaub-Ritter U, van El CG, Forzano F, Goddijn M, Howard HC, Radojkovic D, Rial-Sebbag E, Dondorp W, Tarlatzis BC & Cornel MC. (2018). Responsible innovation in human germline gene editing: Background document to the recommendations of ESHG and ESHRE. Eur. J. Hum. Genet. , , . PMID: 29326429 DOI.
- ↑ Harper JC, Aittomäki K, Borry P, Cornel MC, de Wert G, Dondorp W, Geraedts J, Gianaroli L, Ketterson K, Liebaers I, Lundin K, Mertes H, Morris M, Pennings G, Sermon K, Spits C, Soini S, van Montfoort APA, Veiga A, Vermeesch JR, Viville S & Macek M. (2018). Recent developments in genetics and medically assisted reproduction: from research to clinical applications. Eur. J. Hum. Genet. , 26, 12-33. PMID: 29199274 DOI.
Terms
- abnormal - term describing development that is different from normal or not typical, usual, or regular.
- agenesis congenital abnormality of complete failure of organ or tissue development during embryonic growth.
- association - term referring to a nonrandom occurrence in two or more individuals of multiple defects not known to be a polytopic field defect, sequence, or syndrome.
- Australian Congenital Anomalies Monitoring System - (ACAMS) contains data based on notifications of major congenital anomalies to birth defects registers in Australian states and territories, except the Northern Territory. Information is included on live births and stillbirths of 20 weeks gestational age or more or 400 grams birthweight or more (including induced abortions) with a congenital anomaly. ACAMS replaces the National Congenital Malformations and Birth Defects Data Collection that began in 1981. (More? Australian Statistics | AIHW National Perinatal Epidemiology and Statistics Unit)
- congenital - (Latin, congenitus = born together) refers to developmental disorder that is present at birth (or during the neonatal period) due to genetic, environmental or a combination of known and unknown factors.
- dysmorphology - term referring to the study of birth defects.
- environmental - term used to describe effects due to the physical and biological factors resulting in abnormal development.
- expanded carrier screening - (ECS) term related to additional genetic testing for carrier status.
- genetic - term used to describe effects due to embryo genes, their mutation, altered expression or epigenetic effects resulting in abnormal development.
- hypogenesis - congenital abnormality of an under-development of either parts or organs of the body.
- International Classification of Diseases - (ICD) is the standard diagnostic tool for epidemiology, health management and clinical purposes. This classification has been developed by the World Health Organization (WHO). ICD-10 came into use in 1994, ICD-11 revision has begun and will continue until 2015. (More? International Classification of Diseases | WHO - ICD)
- polytopic field defect - term describing developmental defects that are all concentrated in one particular area of the body (developmental field).
- sequence - clinical term for a pattern of multiple defects derived from a single known or presumed structural defect or mechanical factor.
- syndrome - clinical term for a pattern of multiple defects related pathogenetically though not known to represent a single sequence or a polytopic field defect.
- unknown - term used to describe abnormal development due to single or multiple genetic and or environmental effects that have not yet been completely identified or described.
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- Australia
- USA National Center on Birth Defects and Developmental Disabilities
- Arizona Birth Defects Monitoring Program (ABDMP)
- California Birth Defects Monitoring Program (CBDMP)
- North Carolina Birth Defects Monitoring Program (NCBDMP)
- Louisiana Birth Defects Monitoring Network (http://new.dhh.louisiana.gov/index.cfm/page/771 LBDMN)
Glossary Links
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Cite this page: Hill, M.A. (2023, December 5) Embryology Human Abnormal Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Human_Abnormal_Development
- © Dr Mark Hill 2023, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G