Published online March 22, 2010
PEDIATRICS Vol. 125 No. 4 April 2010, pp. e836-e843 (doi:10.1542/peds.2009-2219)
ARTICLES
Malformations in a Chornobyl-Impacted Region
Wladimir Wertelecki, MD
Medical Genetics and Pediatrics, University of South Alabama, Mobile, Alabama
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.
