- Wladimir Wertelecki, MD: http://pediatrics.aappublications.org/
OBJECTIVE: One of the populations most exposed to chronic low-dose radiation from Chornobyl (Chernobyl in Russian) lives in Polissia, the region representing the northern half of Rivne Province (Oblast) in Ukraine. Here the patterns and population rates of malformations are reported and possible etiologic factors and regional contrasts are explored.
PATIENTS AND METHODS: Malformations, as defined by international standards, noted among all 96 438 births in Rivne between 2000 and 2006, were analyzed statistically. Contrasts of rates in Polissia compared with the rest of Rivne also were investigated.
RESULTS: The overall rate of neural tube defects in Rivne is among the highest in Europe (22.2 per 10 000 live births). The rates of conjoined twins and teratomas also seem to be elevated. In Polissia, the overall rates of neural tube defects are even higher (27.0 vs 18.3, respectively; odds ratio: 1.46 [95% confidence interval: 1.13–1.93]), and the rates of microcephaly and microphthalmia may also be elevated.
CONCLUSIONS: The malformation patterns observed suggest early disruptions of blastogenesis, manifesting as alterations of body axes, twinning, duplications, laterality, and midline formation. The results are sufficiently compelling to justify continuing and expanding this investigation of malformations in chronic low-dose radiation-impacted regions of Ukraine.
WHAT THIS STUDY ADDS:
Population-based rates of NTDs and other malformations in Ukraine that may reflect composite impacts of low-dose radiation, folate deficiencies, and prenatal alcohol teratogenesis are provided. This study provides a baseline for prospective investigations.
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