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Role of structural birth defects in preterm delivery
G M Shaw1, D A Savitz, V Nelson
1March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Oakland 94606, USA. gsh@cbdmp.org
Insights
Structural birth defects are linked to preterm births, with higher prevalence in earlier gestations. This study quantifies the association, finding over 8% of very preterm infants have defects, decreasing with gestational age.
Area of Science:
- Perinatal epidemiology
- Birth defect surveillance
- Neonatal health
Background:
- The association between preterm birth and structural birth defects requires precise quantification.
- Understanding the specific phenotypes of birth defects in preterm infants is crucial for targeted interventions.
Purpose of the Study:
- To determine the proportion of preterm infants diagnosed with structural birth defects within their first year of life.
- To identify specific birth defect phenotypes prevalent among preterm infants.
Main Methods:
- Utilized data from the California Birth Defects Monitoring Program, a population-based registry.
- Incorporated California vital records for births and fetal deaths from 1984-1996.
- Analyzed prevalence of structural birth defects across different gestational age groups.
Main Results:
- Prevalence of structural birth defects was over 8% for infants born at or before 30 weeks gestation.
- Prevalence decreased to 2% for infants born at or after 37 weeks gestation.
- This decreasing prevalence pattern was consistent across various birth defect groups, maternal demographics, and study years.
Conclusions:
- Structural birth defects significantly contribute to the incidence of preterm births.
- The prevalence of birth defects in preterm infants demonstrates a clear inverse relationship with increasing gestational age.
- These findings underscore the importance of considering birth defects in the management and understanding of preterm delivery.
Abstract:
The proportion of preterm births associated with structural birth defects has not been adequately quantified. We explored the proportion of preterm infants with structural birth defects diagnosed in the first year of life, as well as the specific phenotypes of birth defects occurring among preterm infants. The data used were from the California Birth Defects Monitoring Program, a population-based registry, as well as data from California vital records corresponding to births and fetal deaths in the period 1984-96. The prevalence of structural birth defects exceeded 8% among deliveries with gestational ages < or = 30 weeks, and prevalence decreased to 2% as gestational age increased to > or = 37 weeks gestation. The decreasing prevalence pattern with increasing gestational age was observed for a variety of anatomically defined birth defect groups suggesting that certain birth defects were not the sole contributors to the elevated prevalences among preterm births. Decreasing prevalence with increasing gestational age was also observed across strata of maternal race/ethnicities, ages, infant's sex and each year studied. These data indicate that structural birth defects may contribute significantly to the proportion of infants who are delivered before 37 weeks gestation.