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The effect of congenital anomalies on mortality risk in white and black infants

L H Malcoe1, G M Shaw, E J Lammer

  • 1California Birth Defects Monitoring Program, Emeryville, USA. lorraine-malcoe@ouhsc.edu

American Journal of Public Health
|June 8, 1999
PubMed

Insights

Congenital anomalies significantly increase infant mortality for White and Black infants, contributing substantially to deaths, especially in normal birth weight neonates. This highlights a major public health issue requiring further attention.

Area of Science:

  • Pediatric Health
  • Public Health
  • Genetics and Genomics

Background:

  • Congenital anomalies are a significant concern in infant mortality.
  • Previous estimates of anomaly contribution to infant death may be underestimated.
  • Understanding racial disparities in anomaly impact is crucial.

Purpose of the Study:

  • To investigate the impact of congenital anomalies on infant mortality across different racial groups (White and Black).
  • To analyze how infant sex, birth weight, gestational age, and anomaly lethality modify this impact.
  • To determine the overall contribution of anomalies to infant mortality.

Main Methods:

  • Utilized California Birth Defects Monitoring Program data linked with birth-death records.
  • Included 278,646 singleton non-Hispanic White and Black infants born between 1983-1986.
  • Compared mortality rates of malformed infants versus non-malformed infants.

Main Results:

  • Any congenital anomaly increased mortality 9.0-fold in Black infants and 17.8-fold in White infants.
  • Even "non-lethal" anomalies elevated mortality significantly (up to 8.9-fold).
  • Anomalies accounted for 33% of White and 19% of Black infant deaths, over 60% in neonates >1499g.

Conclusions:

  • Congenital anomalies represent a substantial public health problem for both White and Black infants.
  • The impact on mortality is significantly higher than previously estimated, particularly for normal birth weight infants.
  • Findings underscore the need for improved interventions and public health strategies.
Abstract

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