The case of babies without arms remains a mystery for France

Although this congenital disability seems to disproportionately affect children from three distinct rural areas in France (Ain, Morbihan and Loire-Atlantique), the report could not conclusively list the causes of this curious 'epidemic'. Parents of these children may have to get used to not knowing the causes. [Robert Scoble/Flickr]

On Friday (12 July), French authorities published their first report on children born without arms in rural areas of three specific French departments. Although this congenital disability, termed transverse agenesis of the upper limb, is well described, its causes remain unknown. EURACTIV’s partner le Journal de l’environnement reports.

France’s health ministry, the public health agency and food safety agency (ANSES) launched a nationwide joint investigation in November 2018 and published their first joint report on the case of thirteen babies born without arms on 12 July.

Although this congenital disability seems to disproportionately affect children from three rural areas in the French departments of Ain, Morbihan and Loire-Atlantique, the report could not conclusively list the causes of this curious ‘epidemic’. Parents of these children may have to get used to not knowing the causes.

For the report, researchers were tasked with answering two separate questions: What does this transverse birth agenesis of the upper limb entail, and what are the environmental causes for its emergence?

Difficult diagnosis

In sum, this congenital disability is a transverse anomaly affecting only one limb, which is isolated, i.e. no other tissues or organs are affected.

However, the report states that “its diagnosis may be difficult because it may be confused with other anomalies of a different nature and known origins (genetic or mechanical)”.

After re-examining the medical records of children with the congenital disability in Brittany and Ain, the scientists validated three cases in Brittany and six in Ain.

In the first region, the committee recommended “additional investigations”, particularly on pesticides applied in trials during the pregnancy of the mothers concerned.

However, the obligation to keep records on these products only runs for five years, making the information that may be collected uncertain. Scientists also recommended verifying the analyses of environmental quality near families’ homes (water, air, soil).

For the Loire-Atlantique, which does not have a register of malformations, the report stated that the collection and examination of files are still in progress.

What about the causes of the congenital disability?

So far, no one knows about the disability’s causes.

The second committee has started the analysis of 20,000 scientific articles and a review of controlled chemicals in an attempt to reveal possible cause-and-effect relationships. This review will be the subject of a forthcoming report, indicated France’s food safety agency, ANSES.

In the meantime, scientists do not recommend “the conduct of a large-scale epidemiological investigation, which would require several decades of observations”. This would be too expensive, for too few cases identified.

“The probability of finding a common cause for these cases exists, but it remains tiny,” Alexandra Benachi, head of the gynaecology and obstetrics department at Antoine-Beclère Hospital in Clamart near Paris, told AFP.

The mystery of children born without arms may never be solved.

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