Defect Monitoring System Research Articles

A Multifaceted AI-Driven Radio Network

This paper discusses a unique and revolutionary type of radio network which is driven by various AI techniques. Besides the traditional features of any FM radio network, Radio Logos has incorporated into its system a variety of automated features like weather forecasts, earthquake announcements, monetary exchange rates, listener song requester capability, and the monitoring of equipment. In addition, an advanced real-time defect monitoring system for RF signals has been developed and implemented to monitor the network 24/7. These methodologies are based upon AI techniques ranging from the simple to the advanced.

Defect monitoring system of the internal structures of a sodium fast reactor using an artificial intelligence model

This study developed a defect-monitoring system with an artificial intelligence model, YOLOv7, which is tailored for processing image data from an ultrasonic visualization system within sodium fast reactor (SFR) internal structures. For the safety of SFR internal structures, although it is a crucial inspection for defect monitoring, it is difficult to identify structural defects because of the invisible environment. Therefore, we applied the YOLOv7 model in this study; however, we encountered challenges including decreased accuracy with complex defect shapes and complications from data augmentation during pre-training. To solve these problems, we additionally applied the enhanced super-resolution generative adversarial network for higher resolution and a Sobel noise-filtering algorithm to enhance the defect detection accuracy. And we evaluated our system by comparing it with a confidence score. This underscores the effectiveness of the approach in enhancing the defect detection capabilities. Therefore, this defect-monitoring system should be designed to preemptively identify internal structure deformations and enhance SFR safety and maintenance practices.

A novel deep learning method for on-line monitoring of grate bar defects in sintering machine system

The defective grate bars at the bottom of the sintering machine system pose a serious safety risk to steel enterprises. Cracking and missing of these grate bars lead to severe production accidents and economic losses. Implementation of an efficient defect monitoring system plays a crucial role in ensuring continuous and stable sintering production. This paper presents a novel on-line grate bar defects monitoring method to address the following two key challenges. Firstly, a light-weight location model called Multi Scale Separated Convolutional Attention Network-LiteSeg (MSSCAN-LiteSeg) is proposed to identify the optimal shooting position of the moving trolley and simultaneously segment the horizontal and vertical grate bars. By separating the attention calculation into independent channel spaces, MSSCAN-LiteSeg can effectively handle the imbalanced sample distributions. Secondly, an innovative few-shot segmentation network named Response Forgetting Attention-Hypercorrelation Squeeze Network (RFA-HSNet) is proposed for defect detection by employing a "Forgetting-Enhancing-Recalling" method. Extensive experiments have demonstrated that our method can achieve a precision rate of 93.3% and provide a satisfactory performance in the on-line grate bar defects monitoring system.

The prevalence of hypospadias in newborn males in Hangzhou, China from 2011 to 2020: A cross-sectional population-based study

Hypospadias is one of the most common anomalies of the human genitourinary system. The prevalence of hypospadias varies considerably by region, ethnicity, and clinical practice. This research was designed to investigate the prevalence and related influencing factors of neonatal hypospadias in Hangzhou from 2011 to 2020 in order to provide a scientific basis for the clinical prevention and treatment of hypospadias. This study retrospectively analyzed the Hangzhou Maternal Child Information System and Birth Defect Monitoring System and included data from a total of 1,008,754 pregnant women between October 2010 and September 2020. The chi-square test was adopted to compare the prevalence of hypospadias at different maternal ages and different years. The prevalence of neonatal hypospadias in Hangzhou, China, was 2.89 per 10,000, with a total of 292 newborns diagnosed with hypospadias from 2011 to 2020. The prevalence of hypospadias in Hangzhou showed temporal, regional, and age distribution characteristics: from 1.08/10,000 in 2011 to 7.03/10,000 in 2020; the prevalence was higher in suburban areas than that in the urban area and the counties, with statistically significant differences (P<0.001); the prevalence of hypospadias was lowest in maternal age < 25 years (1.20/10,000) and highest in maternal age ≥ 40 years old (14.59/10,000). The difference was statistically significant (P<0.001). The risk factor for hypospadias in the offspring of advanced pregnant women was 3.86 times higher than that of younger pregnant women. The overall prevalence of neonatal hypospadias in Hangzhou from 2011 to 2020 was 2.89/10,000 and showed temporal, regional, and age distribution characteristics.

Maternal exposure to ambient air pollution and risk of congenital heart defects in Suzhou, China.

More and more studies have investigated the association between maternal exposure to ambient air pollution during pregnancy and incidence of congenital heart defects (CHDs), but results are controversial. The aim of this study was to investigate whether maternal exposure to air pollutants (PM10, PM2.5, NO2, CO, SO2) are associated with an increased risk of congenital heart defects in Suzhou city, China. Based on the birth defect monitoring system of Suzhou city and the Environmental Health Department of Suzhou CDC, the birth defect monitoring data and concentrations of five air pollutants (PM10, PM2.5, NO2, CO, SO2) in Suzhou city from 2015 to 2019 were obtained. The distribution of demographic characteristics of children with birth defects and exposure to air pollutant concentrations during different pregnancy periods were analyzed, Chi-square test was used to analyze whether there were statistical differences in the distribution of parturient woman age, pregnant weeks, times of pregnancy, as well as fetal sex and birth weight among children with congenital heart defects and other defects. Logistic regression model was further established to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the association between exposure to these ambient air pollutants during pregnancy and CHDs. A total of 5,213 infants with birth defects were recruited in this study from 2015 to 2019, the top five birth defects in Suzhou were syndactyly, congenital heart disease, ear malformation, cleft lip and palate, and hypospadias, and the proportion of congenital heart disease increased. The level of maternal exposures (mean ± sd) was highest in first trimester amongst pregnant women in Suzhou city. Compared to other birth defects, we observed significant increasing associations between PM2.5 exposure during second and third trimester with risk of CHDs, aORs were 1.228 and 1.236 (95% CI: 1.141-1.322, 1.154-1.324 separately) per a 10 μg/m3 change in PM2.5 concentration. Maternal NO2 exposure was significantly associated with CHDs in first trimester (aOR = 1.318; 95% CI: 1.210-1.435). Our study contributes to explore the current state of Suzhou air quality and the association between maternal air pollution exposure and congenital heart defects. Exposure to PM2.5 and NO2 is thought to increase the risk of CHDs, but comprehensive description of these associations will be needed in future studies.

Towards intelligent monitoring system in wire arc additive manufacturing: a surface anomaly detector on a small dataset

Rapid developments in artificial intelligence and image processing have presented many new opportunities for defect detection in manufacturing processes. In this work, an intelligent image processing system has been developed to monitor inter-layer deposition quality during a wire arc additive manufacturing (WAAM) process. This system reveals the feasibility and future potential of using computer vision knowledge in WAAM. Information produced from this system is to be used in conjunction with other quality monitoring systems to verify the quality of fabricated components. It is tailored to identify the presence of defects relating to lack of fusion and voids immediately after the deposition of a given layer. The image processing system is built upon the YOLOv3 architecture and through moderate changes on anchor settings and achieves 53% precision on surface anomaly detection and 100% accuracy in identifying the fabricated components’ location, providing a prerequisite for high-precision assessment of welding quality. The work presented in this paper presents an inter-layer vision-based defect monitoring system in WAAM and serves to highlight the feasibility of developing such intelligent computer vision systems for monitoring the WAAM process for defects.

Real-time monitoring of immobilized oxide defects on bead surface in welding of high-strength galvanized steel

Welding is widely used for joining steel components in the automobile industry. With the use of high-quality materials, welding defects began to become increasingly complex. Immobilized oxide is one of the recent complex defects. Immobilized oxide defects generated in gas metal arc welding (GMAW) of high-strength steel and high-strength galvanized steel result in unpainted part on the surface of welding beads. Thus, it is necessary to be eliminated by using grinding and peening. However, it is difficult to find where oxides generate and how oxides generate in order to eliminate it. Few studies have explored the mechanism of immobilized oxide formation in other fields so far. In this study, the generation patterns of oxide defects were confirmed. Further, an oxide defect monitoring system for GMAW was developed by using an infrared camera and image processing equipment. The chemical properties of the immobilized oxide were verified by performing energy dispersive spectroscopy (EDS). The oxide appeared to be brighter in the infrared image, and then, image processing was conducted to determine the boundary of oxide defects. The processed images were laid over the original images, and the oxide defect area was displayed on the monitoring panel. Patterns of oxide defect generation were confirmed when it was combined with the following molten pool area moving in the opposite direction of the welding direction in our results. The developed monitoring system can be easily applied to the automatic welding process in the automobile industry.

Development of a defect monitoring system (DMOSYS) for building maintenance at polytechnic

PurposeThe current maintenance management method has affected the efficiency of the building facility management at Polytechnics. Many issues such as poor service delivery, inadequate finance, poor maintenance planning and maintenance backlogs have emerged due to the usage of conventional method application (paper-based form and unsystematic database. The purpose of this paper is to review existing literature and case studies project of the technologies in maintenance management at Polytechnic, and subsequently to identify the challenge in improving the current maintenance management technologies.Design/methodology/approachThe purpose of this paper is to review existing literature and case studies project of the technologies in maintenance management at Polytechnic, and subsequently to identify the challenges of information and communication technology (ICT) implementation for strategic defect diagnosis and decision-making in improving the current maintenance management technologies. Eight Polytechnics are selected on the basis of the major problems of using the conventional method in the comparison to investigate the maintenance management practices in each Polytechnic. There are around 32 Polytechnics in Malaysia and most are using conventional methods.FindingsThe findings reveal the need for a more sophisticated maintenance management system that provides guidelines for decision-making processes with the implementation of ICT. The interview results also reveal irregularities within the Malaysian Polytechnics’ maintenance management database. The system architecture and the information system prototype are presented to integrate the information database and maintenance management processes in improving the building diagnosis approach and decision-making process for managing building maintenance.Originality/valueThis new system is expected to become the successful technology in assisting the maintenance contractors, clients and developer for effective management of maintenance defects at Polytechnic.

Remote defect visualization of standard composite coupons using a mobile pulse-echo ultrasonic propagation imager

A new laser-ultrasonic-based defect monitoring system, a mobile pulse-echo ultrasonic propagation imager, has been developed to evaluate damage to composite and metallic structures. The system integrates a Q-switched Nd:YAG laser for the generation of thermoelastic waves, a laser Doppler vibrometry sensor for sensing ultrasound and a two-axis translation stage for raster scanning of the combined generation and sensing laser beams. The system allows scanning of both ultrasound generation and sensing laser beams simultaneously. Thus, a full-field pulse-echo ultrasound, as large as the scan area, can be generated that visualizes the longitudinal wave propagation through the thickness. The full-field pulse-echo ultrasonic wave propagation imaging algorithm is used for real-time structural damage evaluation. Four F-16 Lockheed Martin aircraft reference standard composite specimens with different shapes, sizes, thicknesses, compositions, and aspect ratio of damages were tested: the stepped graphite-to-aluminum, the graphite-to-graphite, and the steel-to-graphite composite panel with flat bottom holes and the graphite-to-aluminum core sandwich structure with core missing. Moreover, the effects of laser pulse energy on damage visualization using the system has been presented and tested on the 4-mm-thick aluminum plate with 2-mm-thick wall-thinning. The proposed system successfully detected and visualized all the artificially introduced defects in the standard coupons.

Epidemiological Survey of 214 Families With Bladder Exstrophy-Epispadias Complex

We sought to identify causative nongenetic and genetic risk factors for the bladder exstrophy-epispadias complex. A total of 237 families with the bladder exstrophy-epispadias complex were invited to participate in the study, and information was obtained from 214 families, mainly from European countries. Two families showed familial occurrence. Male predominance was found among all subgroups comprising epispadias, classic bladder exstrophy and cloacal exstrophy, with male-to-female ratios of 1.4:1, 2.8:1 and 2.0:1, respectively (p = 0.001). No association with parental age, maternal reproductive history or periconceptional maternal exposure to alcohol, drugs, chemical noxae, radiation or infections was found. However, periconceptional maternal exposure to smoking was significantly more common in patients with cloacal exstrophy than in the combined group of patients with epispadias/classic bladder exstrophy (p = 0.009). Only 16.8% of mothers followed the current recommendations of periconceptional folic acid supplementation, and 17.6% had started supplementation before 10 weeks of gestation. Interestingly, in the latter group mothers of patients with cloacal exstrophy were more compliant with folic acid supplementation than were mothers of the combined group of patients with epispadias/classic bladder exstrophy (p = 0.037). Furthermore, mothers of children with cloacal exstrophy knew significantly more often prenatally that their child would have a congenital malformation than did mothers of children with epispadias/classic bladder exstrophy (p <0.0001). Our study corroborates the hypothesis that epispadias, classic bladder exstrophy and cloacal exstrophy are causally related, representing a spectrum of the same developmental defect, with a small risk of recurrence within families. Embryonic exposure to maternal smoking appears to enforce the severity, whereas periconceptional folic acid supplementation does not seem to alleviate it. There is a disproportional prenatal ultrasound detection rate between severe and mild phenotypes, possibly due to the neglect of imaging of full bladders with a focus on neural tube defects.

Increase in use of selective serotonin reuptake inhibitors in pregnancy during the last decade, a population‐based cohort study from the Netherlands

* Recently, the use of selective serotonin reuptake inhibitors (SSRIs), particularly paroxetine, in pregnancy has been associated with an increased risk on specific birth defects or other adverse pregnancy outcomes. * However, the extent of SSRI use in pregnancy is largely unknown. * In the last decade the use of SSRIs in the year preceding delivery has increased twofold. * This increase runs parallel with the increase in use of SSRIs among women of fertile age. * Paroxetine is one of the most commonly used SSRIs. * Only recently have sufficient data become available on the use of paroxetine to detect moderate increased risks for specific malformations. * The safety of SSRIs which are less frequently used is not yet established. * Case-control birth defect-monitoring systems may be helpful in providing safety and risk estimates that become more precise as data accumulate for these drugs. Recent case-control studies suggest a relationship between the use of selective serotonin reuptake inhibitors (SSRIs) and the occurrence of birth defects and other adverse pregnancy outcomes. The aim was to determine the extent of the use of SSRIs before and during pregnancy and its trend over the years 1995-2004 in the Netherlands. The study was performed with data from a population-based prescription database. Within this database, women giving birth to a child between 1995 and 2004 were identified. The exposure rate and 95% confidence interval (CI) were calculated as the number of pregnancies per 1000 that were exposed to an SSRI in a defined period (per trimester or in the year preceding delivery). Exposure rates were calculated for 2-year periods: 1995/1996, 1997/1998, 1999/2000, 2001/2002 and 2003/2004. Trends in exposure rates were analysed using the chi(2) test for trend. Included were 14,902 pregnancies for which complete pharmacy records were available from 3 months before pregnancy until delivery. A total of 310 pregnancies were exposed to an SSRI in the year preceding delivery. The exposure rate increased from 12.2 (95% CI 7.0, 19.8) in 1995/1996 to 28.5 (95% CI 23.0, 34.9) in 2003/2004. There has been a significant increase in the use of SSRIs among pregnant women in the Netherlands over the last 10 years, parallel with the increase in exposure in women of fertile age. In light of the recent warnings about the use of SSRIs in pregnancy, healthcare professionals should be careful in prescribing SSRIs to women planning a pregnancy.

Josephine Alice Coreen Weatherall (née Ogston)

Born on 19 May 1922 in Kingston upon Thames, the fifth of six children, Jo Ogston studied medicine at the University of Edinburgh from 1939 to 1945. Several placements before...

A multi-center study for birth defect monitoring systems in Korea.

The aim of this study was to establish a multi-center birth defects monitoring system to evaluate the prevalence and the serial occurrence of birth defects in Korea. Ten medical centers participated in this program. A trained nurse collected relevant records from delivery units and pediatric clinics in participating hospitals on a monthly basis. We observed 1,537 cases of birth defects among 86,622 deliveries, which included live births and stillbirths. The prevalence of birth defects was 1.8%, and the sex distribution of the birth defect cases was 55.2% male and 41.6% female. The highest proportion of birth defects was in the cardiovascular system (17.5%), followed by birth defects involving in the genitourinary system (15.6%). Chromosomal anomalies were detected 30.0 per 10,000 births. Of these chromosomal anomalies, Down syndrome was most frequently observed. This study led to an establishment of a multi-center active monitoring system for birth defects. To better understand the serial occurrence of birth defects in Korea, it is necessary to increase the number of participating hospitals and to launch on a nation-wide multi-center study.

Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990-1998).

Prevalence rates of birth defects in the Federal Republic of Germany are informative to assess the general background risk of having a child with a birth defect. They provide basic figures to determine temporal and regional prevalence trends, to evaluate and initiate preventive measures and to initiate research projects. To avoid observer, definition and collection bias, active monitoring systems are required. Data collected in the active monitoring system of the Mainz Birth Defects Registry are presented. From 1990-1998, 30,940 live-births, stillbirths and abortions underwent standardized physical and sonographic examinations. Anamnestic data were collected from prenatal care records, maternity files and hospital records. Major malformations were diagnosed in 2144 (6.9%) and mild errors of morphogenesis in 11,104 (35.8%) of all infants. Risk factors associated with the occurrence of major malformations were identified by comparing anamnestic data from infants with and without major malformations. Using multivariate regression models, statistically significant associations were established for 9 risk factors. Causally related risk factors were parents or siblings with malformations, parental consanguinity, more than 3 minor errors of morphogenesis in the proband, maternal diabetes mellitus and ingestion of antiallergic drugs in the first trimester of pregnancy. Conjunctional risk factors were polyhydramnios, oligohydramnios and gestational age <32 weeks at birth. Using these risk factors, populations at risk for the occurrence of major malformation can be identified.

Consideration on the methodology of a simple and effective birth defect monitoring system

ABSTRACT In detecting changes of the occurrence of birth malformation it is important to indicate the prevalence of environmental hazards. The Tottori Monitoring System for Birth Defects (TOM) is a small regional system covering 6,000 births yearly which was started in 1974. The system is made up mainly of two projects: a monitoring system for reporting congenital malformation and an epidemiological and genetic study for neuro‐developmental and genetic disorders. The former system has changed its sampling procedure four times during the past 26 years because of the difficulty in getting cooperation from local administrations and from all maternity clinics in the Tottori prefecture. We have compared those four changes in the system with the following criteria: availability, reliability, durability, operationality and confidentiality. Our conclusion is that the population‐based system which received positive support from the administration and almost all obstetricians in the field was the best in quality. On the other hand, the hospital‐based system organized by a small group of pediatricians and obstetricians who belong to core hospitals in the field was a simpler but useful system for maintaining durability, operationality and confidentiality. It is, however, important to note that the data collected by the hospital‐based system showed a relatively lower frequency in serious malformations like anencephaly and non‐emergency malformations like syndactylia as compared with those collected by the population‐based system. If an inter‐regional collaboration among the similar local systems in Japan could be set‐up, a useful network could be developed eventually acting as an ideal population‐based system.

Pre- and postpartum ultrasound examinations for diagnosis of urogenital abnormalities

The aim of the study was to evaluate prenatal and postpartal sonographic investigations to diagnose congenital uropathies. The Mainz birth defect monitoring system, the "Mainzer Model", was launched in 1990. Over a period of five years (1/90 to 1/95) 19,028 newborns underwent postpartal sonographic examination. Anamnestic data including prepartal sonographic examination were collected. According to a defined ultrasound criteria list, ultrasound findings were considered normal in 94.8% of the neonates, 4.4% were defined as requiring a follow-up examination and 0.8% were pathological. In the current study we analyzed patients with pathological findings with their pre- and postpartal sonographic investigations as well as their clinical data (urinary tract infections, operative procedures). In the study group prenatal ultrasonography showed evidence of severe anomalies only in 51 fetuses (32.9%). Surgical correction was required in 39 cases. 20 (51%) have been diagnosed prenatally. 28 patients presented with urinary tract infections. Out of this group only 11 patients have been detected by prenatal ultrasound. In conclusion, postnatal ultrasound is more effective to diagnose anomalies of the urinary tract. To prevent complications i.e. urinary tract infections a neonatal screening program would be valuable.

Population-based birth-defect and risk-factor surveillance: data from the Northern Netherlands

In many countries, birth defect monitoring systems have been set up in order to identify new teratogens as soon as possible. The usual approach to monitoring involves analysis of the frequency of specific birth defects over time. This approach has been criticized as having poor statistical power to detect epidemics due to new rare teratogenic exposures. A proposed alternative approach is the on-going analysis of risk-factor data with a case-control approach. In this paper, we present birth-defects and risk-factor surveillance data from the Northern Netherlands (NNL). For years of birth 1981-1994, 4014 cases had been registered. We investigated combinations of 32 diagnostic categories and 77 risk factors. For 10 combinations a P value < 0.01 was found; for another 25, the P value was between 0.01 and 0.05. We then checked these positive associations against data from the Metropolitan Atlanta Congenital Defects Program (MACDP) and the MAternal DRug Exposure surveillance project (MADRE). In all three data sets, an association between maternal use of psychotropic drugs (psycholeptics) and cleft lip with or without cleft palate (CLP) was present. The highest odds ratio was found for CLP and maternal use of oxazepam in the NNL data (OR = 8.17, 95% CI 1.26-42.2). Both in the MACDP data and in the NNL data, an association between maternal smoking and clubfoot was found. Although the odds ratios were low, the attributable fraction derived from the NNL data was 11%. Methodologic issues that should be considered in this approach include exposure ascertainment and classification, outcome specificity, and type I errors. The strengths of this approach include its population-based nature and the ability of users to check results against results from other similar systems.

MAINZ CONGENITAL BIRTH DEFECT MONITORING SYSTEM

The two most important aims of tho Mainz Congenital Birth Defect Monitoring Syitem wore to find “incidence” rates and to took for etiological causes of congenital malformations. All babies born in Mainz underwent a standardized physical and sonographic examination. Anamnestic data of family history, enviromental factors, drug exposure etc. were collected. Using case controll studies we looked for special correlations between morphologic defects and anamnestic data as factors of risk. The relative risk was calculated as odds ratio. Results: In 1990 and 1991 we examinated 8430 newborns. 656 (7,8%) children had major and 2609 (31,1%) minor malformations. Systemic localisation of major defects: Skeletal 2,6%, urogenital, 1.8%, cardiovascular 1,3%, nervouo 0,6%, digostive 0,5%, chromanomal anomalies 0,3% and others 0,6%. Localisat ion of minor defects: Simian crease 3,9%, Darwinian tubercle 3,8%, facial haemangioma 3,2%, auricular tag 3,0%, haemangioma 2,7%, auricular pits 2,3% and others 12,2%. Increased relative risks (odds ratios) were found for following factors: Sibling (2,4*)/parent (1,4) with major malformation, alcohol abuse (2,3), medication (1,8*) during pregnancy, consanguinity (1,8), diabetes mellitus (mother; 1,7), placental insufficiency (1,4) etc. (“:statistically significant).Conclusions: The Mainz Congenital Birth Defect Monitoring System is able to find regional “incidence” rates and represent a further step in the search for new etiological factors. More patients and a longer study period is necessary for in depth evalution. Comparisons with other regional monitoring systems are required.

Malformation surveillance and maternal drug exposure: the MADRE project

A project implemented within the framework of the International Clearinghouse for Birth Defect Monitoring Systems is named MADRE: MAlformation DRug Exposure surveillance. The idea is to survey the simultaneous occurrence of malformations and first-trimester drug exposures. In a 2-year period 1990-91, this has yielded 1448 infants known to have been exposed to drugs and that are known to have malformations. Cases have been reported by eight programs: Australia, Central-East France, Israel, Italy IPIMC, Italy IMER, Japan Red Cross Hospitals, Japan Maternal Health and Welfare, and South America. By searching this databank for associations between drugs and malformations, specific relationships can be detected.The 9th revision of the WHO International Classification of Diseases, adapted by the British Paediatric Association, known as ICD9/BPA is used for coding malformations. This is a hierarchical system with 5 digits as the maximum level of specification of each malformation.The ATC (Anatomical Therapeutic Chemical) classifications system is used for coding drugs. This is a multiple level, hierarchical classification with up to 7 digits for specifying each drug.Up to five drugs and malformations are coded for each case using ATC and ICD9/BPA classifications, and all observed drug-malformation pairs form the basis for the analysis. For each drug-malformation combination where three or more cases are observed, a set of 2×2 tables is formed and analyzed as in case-control studies. The odds ratio for the pair, stratified for program, gives the relative risk for the malformation in question, comparing use of the specific drug with all other drugs.Well known or controversial associations were tested in the collected material, and at this stage only one new association is suggested, that is between cardiac defects and maternal treatment with thyroid hormones. This finding has to be further explored with new data.

Registration of drug use in a birth defect monitoring system: a priority worthy of emphasis!

This article examines sources of information on drug use during pregnancy in the northeastern part of The Netherlands, comparing data from a congenital anomalies registry and figures obtained from community pharmacy records for a drug utilization study. Physicians and midwives report to the congenital anomalies registry on a voluntary basis. A limited quantity of exposure data is registered. According to the congenital anomalies registry, drug use during pregnancy is significantly less than it is according to the drug utilization study in the same area, suggesting that the former obtains incomplete data.For anomalies occurring spontaneously in a relatively high frequency, any link between a small further increase in the frequency of these anomalies and the maternal use of certain drugs is likely to go undetected if one monitors only the frequency of these anomalies, the increase being rendered inconspicuous by spontaneous variations. Routine monitoring of drug use in association with congenital anomalies will be needed if such links are to be profiled. Preferably, a complete and correct registration of all drug use should be assured, from three months before conception to the time of delivery.Data retrieved from the records of community pharmacies on the use of prescription drugs, complemented by data on hospital drug use and information from the women themselves on their self-medication is likely to produce a relatively complete picture of drug utilization for the purpose of a register of congenital anomalies.