Towards a register of birth and major birth defects in the Gaza Strip: pilot registration study and environmental exposure.

In Al Shifa Hospital, covering 30% of deliveries in government hospitals in the Gaza strip, along 5 months we registered 4027 deliveries. Prevalence of major structural birth defects (BD) diagnosized only clinically was 1.36%, without significant association with gender or intermarriage. We did not found the expected frequency of congenital hearth defects (CHD), since only very severe CHD were diagnosed at birth in the hospital.

The 55 couples with a BD and the couples (75) with a normal child but a previous BD child have a chance about 10 times higher of having recurrence of BD in their progeny. Nonetheless, the progeny of their siblings (509 sibling and 1406 of their progeny), shows a prevalence of BD not higher than that of general population.

BD recurrence in the some couple was analyzed for 12 couples with 1 BD in their progeny. In 5 cases the same BD recurred, 4 of which were neural tube diseases, and one CHD. For the other 7 couples, the diagnosis for BD previous and present were different. Recurrence of BD was not significantly associated to intermarriage. The unusual high rate of BD in couples with already one BD and no familiarity is compatible with, although does not prove, novel events of mutational or events of epigenetic type.

Children with BD were born with higher frequency (p<0,001) in families where one or both parents were under “white phosphorus” attack that in the general population. Bombing of the house and removal of bombing-derived rubble were also significantly correlated to BD.