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KATHLEEN A. LEPPIG, MD; MARTHA M. WERLER, MPH; CRISTINA I. CANN; CATHERINE A. COOK; LEWIS B. HOLMES, MD

Am J Dis Child. 1988;142(12):1274.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Sir.—Dr Hoyme¹ in his editorial published in the September issue of AJDC failed to recognize our² recent work regarding the value of minor malformations for predicting the presence of a major malformation. In our study, 4305 newborn infants were examined for the presence of minor anomalies and major malformations. There were 158 infants identified as having three or more minor anomalies, among whom 31 (19.6%) had a concomitant major malformation. Our observed predictive value of 19.6% differs substantially from the 90% reported by Marden et al³ and cited by Hoyme. A similar predictive value of 26% was noted in a similar study by Mehes et al.⁴ In reviewing these studies, the most likely cause for this difference is the use of a checklist of minor anomalies in our study. This checklist helped remind our examiners to look for the presence or absence of each specific . . . [Full Text PDF of this Article]

Author Affiliations
Embryology-Teratology Unit Children's Service Massachusetts General Hospital Boston, MA 02114

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