Congenital Malformations of the Central Nervous System : II--Maternal Reproductive History and Familial Incidence

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Abstract
In an attempt to assess the relative importance of uterine environment and heredity as causes of malformation, the authors examined (a) case-, and (b) family-histories of 1484 Birmingham mothers and compared the 742 who gave birth to malformations of the central nervous system with 742 random-chosen mothers of normal births or stillbirths (i.e., a control group). Data were gleaned not from hospital or clinic records but by interrogating the subjects: the authors therefore guarantee neither accuracy nor completeness of detail, but draw conclusions from "gross differences" between selected and control groups. From (a) they discover little or no significant difference between the groups in history of menstruation, lactation, and fertility; but note that avg. age at marriage is higher in the selected than in the control group; and that the stillbirth rate for sibs of anencephalic and hydrocephalic malformations, and the abortion rate for sibs of all central nervous malformations, are higher than the rates for sibs of controls. From (b) they find that, for central nervous malformations, incidence among sibs of the selected group is significantly greater than among sibs of controls, but for other major malformations shows no difference between the groups. The occurrence of central nervous malformations is also more frequent among other relatives of the selected group than among those of the control group. After birth of one malformation (particularly if spina bifida) risk for subsequent sibs is much greater than average; and recurrence of the same is commoner than occurrence of a different type of malformation. No conclusions were drawn from data on consanguinity of parents; and no figures for Rh incompatibility were obtained.

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