Is There Evidence for Aetiologically Distinct Subgroups of Idiopathic Congenital Talipes Equinovarus? A Case- Only Study and Pedigree Analysis

• Main Authors: A H. Cardy, Linda Sharp, Nicola Torrance, Raoul C. Hennekam, Zosia Miedzybrodzka
• Other Authors: The Pennsylvania State University CiteSeerX Archives
• Format: Text
• Language: English
• Subjects: Orca
• Online Access: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.291.6012

Background: Idiopathic congenital talipes equinovarus (CTEV) is a common developmental foot disorder, the aetiology of which remains largely unknown. Some aspects of the epidemiology suggest the possibility of aetiologically distinct subgroups. Previous studies consider CTEV as a homogenous entity which may conceal risk factors in particular subgroups. We investigate evidence for aetiologically distinct subgroups of CTEV. Methods: Parents of 785 probands completed a postal questionnaire. Family pedigrees were compiled by telephone. Caseonly analysis was used to investigate interactions between risk factors and sex of the proband, CTEV laterality and CTEV family history. Results: The male:female ratio was 2.3:1, 58 % of probands were affected bilaterally and 11 % had a first-second degree family history. There were modest interactions between family history and twin births (multivariate case- only odds ratio [ORca] = 3.87, 95%CI 1.19–12.62) and family history and maternal use of folic acid supplements in early pregnancy (ORca = 0.62, 95%CI 0.38–1.01); and between sex of the proband and maternal alcohol consumption during pregnancy (female, positive history and alcohol consumed: ORca = 0.33, 95%CI 0.12–0.89). Previous reports of an interaction between maternal smoking and family history were not confirmed. Relatives of female probands were affected more often than relatives of male probands.