B Botting

Publications of B Botting

• Congenital eye anomaly surveillance in England and Wales. How effective is the national system?

  Authors: S P Shah, B Botting, A Taylor, Y Abou-Rayyah, J Rahi, C E Gilbert

  Eye (London, England). 10/2011; 25(10):1247-9.

• Congenital anomaly surveillance in England--ascertainment deficiencies in the national system.

  Authors: P A Boyd, B Armstrong, H Dolk, B Botting, S Pattenden, L Abramsky, J Rankin, M Vrijheid, D Wellesley

  BMJ (Clinical research ed.). 02/2005; 330(7481):27.

  OBJECTIVE: Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variationOBJECTIVE: Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variation by defect, geographical area, and socioeconomic deprivation. Secondly, to assess the impact of the lack of data on pregnancies terminated because of fetal anomaly. DESIGN: Comparison of the NCAS with four local congenital anomaly registers in England. SETTING: Four regions in England covering some 109,000 annual births. PARTICIPANTS: Cases of congenital anomalies registered in the NCAS (live births and stillbirths) and independently registered in the four local registers (live births, stillbirths, fetal losses from 20 weeks' gestation, and pregnancies terminated after prenatal diagnosis of fetal anomaly). MAIN OUTCOME MEASURE: The ratio of cases identified by the national register to those in local registry files, calculated for different specified anomalies, for whole registry areas, and for hospital catchment areas within registry boundaries. RESULTS: Ascertainment by the NCAS (compared with data from local registers, from which terminations of pregnancy were removed) was 40% (34% for chromosomal anomalies and 42% for non-chromosomal anomalies) and varied markedly by defect, by local register, and by hospital catchment area, but not by area deprivation. When terminations of pregnancy were included in the register data, ascertainment by NCAS was 27% (19% for chromosomal anomalies and 31% for non-chromosomal anomalies), and the geographical variation was of a similar magnitude. CONCLUSION: The surveillance of congenital anomalies in England is currently inadequate because ascertainment to the national register is low and non-uniform and because no data exist on termination of pregnancy resulting from prenatal diagnosis of fetal anomaly.

• Risk of hypospadias in relation to maternal occupational exposure to potential endocrine disrupting chemicals.

  Authors: M Vrijheid, B Armstrong, H Dolk, M van Tongeren, B Botting

  Occupational and environmental medicine. 09/2003; 60(8):543-50.

  BACKGROUND: Reported rises in the prevalence of hypospadias and other abnormalities of the male reproductive system may be a result of exposure to endocrine disrupting chemicals. AIMS: To analyse theBACKGROUND: Reported rises in the prevalence of hypospadias and other abnormalities of the male reproductive system may be a result of exposure to endocrine disrupting chemicals. AIMS: To analyse the relation between risk of hypospadias and maternal occupation, particularly with regard to exposure to potential endocrine disrupting chemicals (EDCs). METHODS: Data (1980-96) from the National Congenital Anomaly System (NCAS) were used to analyse the proportion of all congenital anomaly cases (n = 35 962) which were notified with hypospadias (n = 3471) by occupational codes (348 individual job titles) and by categories of exposure to potential EDCs from a job exposure matrix. RESULTS: Five individual occupations (of 348) showed nominally statistically significant excesses, none of which had possible or probable exposure to potential EDCs. Odds ratios for "possible" or "probable" compared to "unlikely" exposure to potential EDCs did not show statistically significant increases in any of the EDC categories after adjustment for social class of the mother and father, nor was there evidence of an upward trend in risk with likelihood of exposure. In the 1992-96 time period odds ratios were increased for hairdressers (the largest group exposed to potential EDCs) and for probable exposure to phthalates (of which hairdressers form the largest group) before social class adjustment. CONCLUSIONS: There was little evidence for a relation between risk of hypospadias and maternal occupation or occupational exposure to potential EDCs, but as the exposure classification was necessarily crude, these findings should be interpreted with caution.

• Ascertainment of children with congenital cataract through the National Congenital Anomaly System in England and Wales.

  Authors: J S Rahi, B Botting

  The British journal of ophthalmology. 10/2001; 85(9):1049-51.

  BACKGROUND/AIMS: Congenital ocular anomalies contribute significantly to childhood visual morbidity, with congenital cataract being a major cause of visual impairment throughout the world. As in manyBACKGROUND/AIMS: Congenital ocular anomalies contribute significantly to childhood visual morbidity, with congenital cataract being a major cause of visual impairment throughout the world. As in many other countries, a National Congenital Anomaly System (NCAS) exists in England and Wales to monitor the frequency of ocular and other anomalies in order to identify new public health hazards and inform aetiological research. The aim of this study was to assess level of ascertainment by the NCAS of children with congenital cataract. METHODS: Using independent ophthalmic and paediatric national active surveillance schemes, all infants (< or =1 year) newly diagnosed with congenital and infantile cataract in England and Wales in 1 year from September 1995 were identified. These notifications were compared with those made independently to the NCAS during the same period. The proportion of cases identified by the active surveillance schemes and also notified to the NCAS was determined. RESULTS: 10% (15/149) of eligible children with newly diagnosed congenital or infantile cataract were actually notified to the NCAS. A higher proportion of those diagnosed as neonates (16%, 14/85) than in later infancy (2%, 1/64) was ascertained through the NCAS. There is a need for better verification of notifications and reported information in the NCAS. CONCLUSION: Currently, ascertainment of congenital cataract through the NCAS is low and the system is likely to be insensitive to small but important changes in risk factors for this disorder. This limits its use for monitoring secular and other trends in ocular anomalies. Strategies to improve its future use are discussed, including enhancing the awareness and participation of ophthalmic professionals involved in managing children with anomalies.

• Dietary folate and the prevalence of neural tube defects in the British Isles: the past two decades.

  Authors: M Murphy, D Whiteman, D Stone, B Botting, C Schorah, J Wild

  BJOG : an international journal of obstetrics and gynaecology. 08/2000; 107(7):885-9.

  OBJECTIVES: To measure the changes in folate consumption and the prevalence of neural tube defects in the British and Irish populations during the past two decades. DESIGN: Ecological study. MAINOBJECTIVES: To measure the changes in folate consumption and the prevalence of neural tube defects in the British and Irish populations during the past two decades. DESIGN: Ecological study. MAIN OUTCOME MEASURES: Average daily dietary folate consumption for Britain for the period 1980-1996 was estimated from the National Food Survey. Annual neural tube defect prevalences for the same period were obtained from the Oxford Record Linkage Study Neural Tube Defect register, the Glasgow EUROCAT register, and the three Irish EUROCAT registers (Belfast, Dublin and Galway). RESULTS: Dietary folate consumption increased on average by 1.6% per annum in Scotland and 1.4% in England during the study period. The annual rate of decline of neural tube defect prevalence averaged 10.4% in the Irish population, 8.2% in Glasgow, and 5.2% in Oxfordshire and West Berkshire. CONCLUSIONS: The decline in neural tube defect prevalence observed in all British and Irish populations since the early 1970s continued with the introduction of folate fortification of cereals, which produced measurable increases in average daily folate consumption. Further declines in neural tube defect prevalence may be achieved by targeted folate supplementation during the periconceptual period.

• Effect of the worldwide epidemic on HIV prevalence in the United Kingdom: record linkage in anonymous neonatal seroprevalence surveys.

  Authors: A E Ades, J Walker, B Botting, S Parker, D Cubitt, R Jones

  AIDS (London, England). 01/2000; 13(17):2437-43.

  OBJECTIVE: To assess the impact of the worldwide HIV/AIDS epidemic on the prevalence of HIV in women in the United Kingdom (UK), particularly in the large immigrant and ethnic minority communities.OBJECTIVE: To assess the impact of the worldwide HIV/AIDS epidemic on the prevalence of HIV in women in the United Kingdom (UK), particularly in the large immigrant and ethnic minority communities. METHOD: Unlinked anonymous neonatal seroprevalence survey with electronic record linkage of data from child health computers (maternal age and ethnic status) and birth registration (parent's country of birth). RESULTS: Of a total 137456 samples collected in 1997-1998, 188 (0.14%) were anti-HIV-1 seropositive. Seroprevalence was highest in women born in East Africa (2.3%) and Central Africa (1.9%). 76.4% of seropositive newborns were delivered to mothers born in sub-Saharan Africa; a further 6.0% had fathers from sub-Saharan Africa. However, there was little evidence of HIV in women born in Southern Asia [prevalence 0.0081%; 95% confidence interval (CI) 0-0.04], and none within UK-born Asian communities. Prevalence among the UK-born Black African community was low (0.14%; 95% CI 0-0.6). Among infants with both parents known to be born in the UK, seroprevalence was 0.023% (95% CI 0.01-0.04) in London, and zero (95% CI 0-0.007) in non-Metropolitan areas. Irrespective of mother's region of birth, seroprevalence was 4.2 times higher (95% CI 3.0-5.8) in newborns whose father's details were not recorded at birth registration, a marker for single unsupported mothers. CONCLUSION: The risk of HIV among pregnant women from sub-Saharan Africa has been recognized. However, in southern England, HIV is very rare in women from Southern Asia and in UK-born women in ethnic minority communities, in spite of cultural and travel ties to high-prevalence countries. Data linkage in anonymous surveys assists in monitoring the impact of the worldwide epidemic on prevalence and incidence locally.

• Has advice on periconceptional folate supplementation reduced neural-tube defects?

  Authors: L Abramsky, B Botting, J Chapple, D Stone

  Lancet. 10/1999; 354(9183):998-9.

  Periconceptional folate supplementation has been encouraged in the UK since the early 1990s, but no concurrent decline in neural-tube-defect pregnancies has been observed by regional congenitalPericonceptional folate supplementation has been encouraged in the UK since the early 1990s, but no concurrent decline in neural-tube-defect pregnancies has been observed by regional congenital anomaly registers.

• Medical causes on stillbirth certificates in England and Wales: distribution and results of hierarchical classifications tested by the Office for National Statistics.

  Authors: E Alberman, N Blatchley, B Botting, J Schuman, A Dunn

  British journal of obstetrics and gynaecology. 10/1997; 104(9):1043-9.

  OBJECTIVE: To produce a classification of stillbirths registered in England and Wales compatible with a previously described classification for neonatal deaths; to compare national data forOBJECTIVE: To produce a classification of stillbirths registered in England and Wales compatible with a previously described classification for neonatal deaths; to compare national data for intrapartum stillbirths with those for the remaining stillbirths; and to report on stillbirths with a gestational age of 24 to 27 completed weeks first made registrable on 1 October 1992. DESIGN: Algorithms were developed and tested to derive hierarchical cause classifications making use of multiple causes mentioned on stillbirth certificates. RESULTS: The additional information available since 1986 on cause and time of death of stillbirths, classified in a hierarchical fashion allows a more meaningful interpretation of the available information on the causes of stillbirth than was previously possible and does not perturb ongoing trends. Antepartum deaths without a classifiable cause contributed the majority: between 1992 and 1994 they accounted for 43% if mentions of asphyxial conditions are regarded as classifiable causes, and 82% if not considered as causal. Stillbirths described as occurring intrapartum are consistently of higher gestational age and birthweight than the remainder, lending validity to the time of death given. CONCLUSIONS: The national use of a classification including reported time of death of the fetus and mentions of asphyxial conditions is justifiable, providing a distinction is made between associated mentions and causal conditions. Better and more complete clinical information on stillbirth certificates will contribute further to understanding of their causes.

• Recommendations for improving national data on congenital anomalies are being implemented.

  Authors: E Alberman, B Botting

  BMJ (Clinical research ed.). 05/1997; 314(7089):1278.

• Neural tube defects 1974-94--down but not out.

  Authors: M Murphy, V Seagroatt, K Hey, M O'Donnell, M Godden, N Jones, B Botting

  Archives of disease in childhood. Fetal and neonatal edition. 10/1996; 75(2):F133-4.

  AIMS: To describe accurately the total prevalence of neural tube defects (NTDs) in England and Wales over time, and to provide a benchmark up to 1994. METHODS: National data about NTDs reported asAIMS: To describe accurately the total prevalence of neural tube defects (NTDs) in England and Wales over time, and to provide a benchmark up to 1994. METHODS: National data about NTDs reported as births or terminations are available from 1974-94, but reporting is incomplete. A local register of NTDs covering Oxfordshire/west Berkshire from 1965-94 was used to validate national data for the locality, using the method of capture and recapture, and hence to estimate incompleteness of reporting nationally. RESULTS: National underreporting is consistent at about two thirds of the true number of cases reaching at least the second trimester. The local register is much more complete, but time trends locally and nationally are similar. In England and Wales total prevalence declined from about 34 per 10000 live and stillbirths in 1974 to a plateau of just under 8 per 10000 in the 1990s. CONCLUSIONS: The decline in NTD prevalence is real and seems to have stopped. How this relates to changes in diet or the practice of vitamin supplementation is unknown, and the implications of the plateau are uncertain. OPCS figures of 500 NTDs annually in England and Wales represent about two thirds of the true number of cases.

• Use of local neural tube defect registers to interpret national trends.

  Authors: K Hey, M O'Donnell, M Murphy, N Jones, B Botting

  Archives of disease in childhood. Fetal and neonatal edition. 12/1994; 71(3):F198-202.

  To conduct a number of studies into the prevalence of neural tube defects (NTD) in the area covered by the Oxford Record Linkage Study (ORLS), multiple sources were used to build a local register ofTo conduct a number of studies into the prevalence of neural tube defects (NTD) in the area covered by the Oxford Record Linkage Study (ORLS), multiple sources were used to build a local register of cases occurring in Oxfordshire and West Berkshire between 1968-1990. One source of potential cases--namely, termination and congenital malformation monitoring data available for the locality from the Office of Population Censuses and Surveys (OPCS) data--were kept separate. Comparison of the local cases recorded by OPCS and those known to the register from 1974-1990, using the method of capture-recapture, suggested that national data are only about two thirds complete, but that this underreporting is likely to be reasonably consistent from year to year. OPCS data can therefore be used to study NTD trends if not absolute risks. The local register seemed, by the same yardstick, to be very complete and is being used in a variety of studies of the occurrence of NTD. Survival to one year in this area, over the period 1968-1990, has only improved in the recent past, if at all. Most NTD pregnancies now end in termination rather than birth, and there has been a true decline in the occurrence of NTDs, and likewise the different subtypes.

• A new hierarchical classification of causes of infant deaths in England and Wales.

  Authors: E Alberman, B Botting, N Blatchley, A Twidell

  Archives of disease in childhood. 06/1994; 70(5):403-9.

  In 1986 The Office of Population Censuses and Surveys (OPCS) introduced new certificates for stillbirths and neonatal deaths. This allowed certifiers more flexibility in the completion of theIn 1986 The Office of Population Censuses and Surveys (OPCS) introduced new certificates for stillbirths and neonatal deaths. This allowed certifiers more flexibility in the completion of the certificate, and the number and ordering of the causes given. Tabulations have been published of the fetal and maternal causes of death mentioned on the certificates for every year from 1986 to 1991 in annual reference volumes. It has not been possible either to derive a single cause group for each death, however, or to compare the information available on neonatal deaths with that on postneonatal deaths, which are still derived from the standard death certificate. The aim of the work described here was to adapt previous classifications to derive a single cause grouping for stillbirths and infant deaths which would provide the maximum information about preventability and yet meet the national and international responsibilities of OPCS. The methods used and the tests carried out on the validity and consistency of the chosen classification are described.

• Trends in prevalence and survival of very low birthweight infants, England and Wales: 1983-7.

  Authors: E Alberman, B Botting

  Archives of disease in childhood. 12/1991; 66(11):1304-8.

  Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights recorded when the birth was registered. Trends in occurrence and one year survival of those who weighedBetween 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights recorded when the birth was registered. Trends in occurrence and one year survival of those who weighed under 1500 g at birth have been calculated in 100 g groups, separately for single and multiple births. By 1987 singleton live births in England and Wales who weighed between 700 and 799 g had a 43% chance of surviving to 1 year compared with a 32% chance five years earlier; those who weighed 800 to 899 g had a 55% chance compared with 46%. The absolute number of survivors weighing between 500 and 999 g at birth increased by nearly 50% between 1983 and 1987, and there was a 30% increase overall in survivors weighing less than 1500 g.

• Congenital malformations in twins in England and Wales.

  Authors: P E Doyle, V Beral, B Botting, C J Wale

  Journal of epidemiology and community health. 04/1991; 45(1):43-8.

  STUDY OBJECTIVE--The aim was to compare congenital malformation rates in twin births with those in singleton births. DESIGN--The study was an analysis of malformation rates in singleton and twinSTUDY OBJECTIVE--The aim was to compare congenital malformation rates in twin births with those in singleton births. DESIGN--The study was an analysis of malformation rates in singleton and twin births using data from the Office of Population Censuses and Survey's Congenital Malformation Notification Scheme. SETTING--This was a national survey of births in England and Wales in 1979-1980 and 1982-1985. PARTICIPANTS--The data comprised 95,510 reported malformations in 3.7 million singleton births, and 1925 reported malformations in 76,000 twin births. MEASUREMENTS AND MAIN RESULTS--Twin malformation ratios were calculated using maternal age specific singleton rates as standard. In comparison with singleton births, twins have significantly higher reported frequencies of indeterminate sex and pseudohermaphroditism; anencephaly; patent ductus arteriosis; exomphalos; hydrocephalus; anomalies of the umbilical vessels; atresia or stenosis of the large intestine or anus; and tracheo-oesophageal fistula, atresia or stenosis. Twins also have significant reported deficits of polydactyly and syndactyly; congenital dislocation of the hip; anomalies of the tongue, branchial cleft and auricular sinus; post-anal dimple; and Down's syndrome. CONCLUSIONS--Several major malformations were significantly more common in twins than in singletons. The excess of indeterminate sex and pseudohermaphroditism has not been described before and may be analogous to freemartinism in cattle. Most of the conditions less common in twins are minor, and the reported deficits may be due to underascertainment of the less serious conditions in twins. Down's syndrome is an exception, and the deficit may well be real.

• Contrasts in the multiple causes of stillbirth, neonatal death and postneonatal death.

  Authors: M Murphy, B Botting

  Journal of epidemiology and community health. 01/1990; 43(4):343-5.

  A large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was analysed for the frequency of appearance of maternal and fetal conditions anywhere on theA large sample of stillbirth and infant death certificates for England and Wales from 1979-81 was analysed for the frequency of appearance of maternal and fetal conditions anywhere on the certificate, not just as the underlying cause. The results suggest there is presently no need to extend the use of the new stillbirth and neonatal death certificates, introduced in 1986, to the postneonatal period. Periodic multicause analysis of the old style death certificate should be sufficient to reveal the detail of conditions incriminated in postneonatal deaths.

• Mortality from congenital malformations in England and Wales: variations by mother's country of birth.

  Authors: R Balarajan, V Soni Raleigh, B Botting

  Archives of disease in childhood. 11/1989; 64(10):1457-62.

  Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 was investigated according to the mother's country of birth. Significant differences remained afterStillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 was investigated according to the mother's country of birth. Significant differences remained after standardising for maternal age and social class. The highest overall mortality was in infants of mothers born in Pakistan (standardised mortality ratio 237), followed by infants of mothers born in India (standardised mortality ratio 134), East Africa (standardised mortality ratio 126), and Bangladesh (standardised mortality ratio 118). Caribbean and West African mothers showed an overall deficit. Mortality was inversely related to social class in all groups except the Afro-Caribbean. Infants of mothers born in Pakistan had the highest mortality in every social class except I, and for most anomalies investigated. Their ratios were particularly high for limb and musculoskeletal anomalies (standardised mortality ratio 362), genitourinary anomalies (standardised mortality ratio 268), and central nervous system anomalies (standardised mortality ratio 239). Our findings highlight the need for further research to identify the causes underlying these differences.

• Sudden infant death syndrome and postneonatal mortality in immigrants in England and Wales.

  Authors: R Balarajan, V Soni Raleigh, B Botting

  BMJ (Clinical research ed.). 04/1989; 298(6675):716-20.

  To examine ethnic differences in postneonatal mortality and the incidence of sudden infant death in England and Wales during 1982-5 records were analysed, the mother's country of birth being used toTo examine ethnic differences in postneonatal mortality and the incidence of sudden infant death in England and Wales during 1982-5 records were analysed, the mother's country of birth being used to determine ethnic group. Postneonatal mortality was highest in infants of mothers born in Pakistan (6.4/1000 live births) followed by infants of mothers born in the Caribbean (4.5) and the United Kingdom and Republic of Ireland (4.1). Crude rates were lower in infants of mothers born in India (3.9/1000), east and west Africa (3.0), and Bangladesh (2.8) than in infants of mothers born in the United Kingdom despite less favourable birth weights. Mortality ratios standardised separately for maternal age, parity, and social class were significantly higher in infants of mothers born in Pakistan and lower in those of mothers born in Bangladesh. The ratio for infants of Caribbean mothers was significantly higher when adjusted for maternal age. Ratios for infants of Indian and east African mothers did not show significant differences after standardisation. An important finding was a low incidence of sudden infant death in infants of Asian origin. This was paralleled by lower mortality from respiratory causes. During 1975-85 postneonatal mortality in all immigrant groups except Pakistanis fell to a similar or lower rate than that in the United Kingdom group; Pakistanis showed a persistent excess. During 1984-5 several immigrant groups (from the Republic of Ireland, India, west Africa, and the Caribbean) recorded an increase in postneonatal mortality. Surveillance of postneonatal mortality among ethnic communities should be continued, and research is needed to identify the causes underlying the differences.

• Twinning rates and social class in Great Britain.

  Authors: M Murphy, B Botting

  Archives of disease in childhood. 03/1989; 64(2):272-4.

  We examined like and unlike sex twinning rates in Great Britain by social class over the period 1974-85. Although twinning rates are believed to have changed over that period, we found no evidence ofWe examined like and unlike sex twinning rates in Great Britain by social class over the period 1974-85. Although twinning rates are believed to have changed over that period, we found no evidence of differential change by social class, suggesting that any factors affecting twinning are widespread in the population.

• Perinatal and postneonatal mortality in England and Wales among immigrants from the Indian subcontinent.

  Authors: V S Raleigh, B Botting, R Balarajan

  Indian journal of pediatrics. 57(4):551-62.

  Perinatal and postneonatal mortality among immigrants to England and Wales from India, Pakistan and Bangladesh (Asians) for the years 1982-85 showed significant differences not only between thePerinatal and postneonatal mortality among immigrants to England and Wales from India, Pakistan and Bangladesh (Asians) for the years 1982-85 showed significant differences not only between the immigrant and indigenous populations, but also among the different groups from the Indian subcontinent. Compared with the perinatal mortality rate of 10.1 per 1000 total births in UK born mothers, rates in infants of mothers born in India, Bangladesh, and Pakistan were 12.5, 14.3 and 18.8 respectively. In contrast, postneonatal mortality in infants of Indian and Bangladeshi origin (3.9 and 2.8 per 1000 live births respectively) was lower than in the indigenous population (4.1), with Pakistani infants experiencing the highest rate (6.4). Excess perinatal mortality in infants of Asian origin was apparent at most maternal ages and parities. Pakistani infants had the highest rates of perinatal and postneonatal mortality in all age, parity and birth weight groups. The Asian groups showed higher mortality from congenital anomalies in both the perinatal and the postneonatal period, the rates in Pakistani infants being almost double those in Indian and Bangladeshi infants. A significant finding was the lower rates of sudden infant death in all the groups of Asian origin.

• Toward the effective surveillance of hypospadias

  Authors: MC Addor, B Botting, E Calzolari, VC de, WH De, H Dolk, S Garcia-Minaur, E Garne, M Loane, N Physick, A Pierini, JES Scott, D Stone, R Tenconi, M Vrijheid, A Wiesel