Congenital clubfoot in Europe: A population-based study

We aimed to assess prevalence, birth outcome, associated anomalies and prenatal diagnosis ofcongenital clubfoot in Europe using data from the EUROCAT network, and to validate therecording of congenital clubfoot as a major congenital anomaly by EUROCAT registries. Cases ofcongenital clubfoot were included from 18 EUROCAT registries covering more than 4.8 millionbirths in 1995-2011. Cases without chromosomal anomalies born during 2005-2009, were randomlyselected for validation using a questionnaire on diagnostic details and treatment. Therewas 5,458 congenital clubfoot cases of which 5,056 (93%) were liveborn infants. Total prevalenceof congenital clubfoot was 1.13 per 1,000 births (95% CI 1.10-1.16). Prevalence of congenitalclubfoot without chromosomal anomaly was 1.08 per 1,000 births (95% CI 1.05-1.11)and prevalence of isolated congenital clubfoot was 0.92 per 1,000 births (95% CI 0.90-0.95),both with decreasing trends over time and large variations in prevalence by registry. The majorityof cases were isolated congenital clubfoot (82%) and 11% had associated major congenitalanomalies. Prenatal detection rate of isolated congenital clubfoot was 22% and increased overtime. Among 301 validated congenital clubfoot cases, diagnosis was confirmed for 286 (95%). Inconclusion, this large population-based study found a decreasing trend of congenital clubfoot inEurope after 1999-2002, an increasing prenatal detection rate, and a high standard of coding ofcongenital clubfoot in EUROCAT.