“Evidence for a cluster of rare birth defects in the Ain department (France)”: Reply to letters to the editors

Abstract

To the editor, We read with interest the comments sent to the journal on our article “Evidence for a Cluster of Rare Birth Defects in the Ain Department (France).” Lewis Holmes, a recognized specialist in teratology, describes in detail what is known about transverse terminal limb agenesis: clinical forms, prevalence at birth, laterality, etiological elements (inclusion in a multiple malformation syndrome, known risk factors). Finally, he presents an embryopathological explanation of these malformations based on studies conducted in amphibians. We have no comment to this statement, with which we agree. Then Peter Langlois, a professor of epidemiology whose expertise is recognized in the field of congenital malformations, raises several questions, which we answer below: