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Patterns of first-year survival among infants with selected congenital anomalies in Texas, 1995-1997
W N Nembhard1, D K Waller, L E Sever
1University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas 77030, USA. wnem@msm.edu
Insights
Infants with congenital anomalies had an 80.8% first-year survival rate, with variations based on specific conditions. Survival decreased with more life-threatening anomalies, highlighting the need for ongoing population-based studies.
Area of Science:
- Pediatric Health
- Medical Research
- Public Health
Background:
- Limited registry-based studies exist on infant survival with congenital anomalies.
- This study addresses the need for data on survival patterns in infants with birth defects.
Purpose of the Study:
- To examine survival rates and patterns during the first year of life for infants with selected congenital anomalies.
- To assess survival probabilities based on specific anomalies and the number of life-threatening co-occurring conditions.
Main Methods:
- Utilized Texas Birth Defects Monitoring Division data linked with birth-infant death files.
- Analyzed data for 2,774 infants born between 1995-1997 with at least one of 23 common anomalies.
- Employed Kaplan-Meier survival analysis to estimate first-year survival rates.
Main Results:
- Overall first-year survival was 80.8% for infants with the studied congenital anomalies.
- Highest survival rates observed for gastroschisis (92.9%), trisomy 21 (92.3%), and cleft lip (87.6%).
- Survival rates varied significantly, with anencephaly, trisomy 13, and trisomy 18 associated with near-universal mortality; survival decreased with increased numbers of life-threatening anomalies.
Conclusions:
- First-year survival for infants with congenital anomalies is generally high.
- Further population-based research is necessary to track and understand improvements in infant survival rates for congenital anomalies.
Background:
Few registry-based studies have investigated survival among infants with congenital anomalies. We conducted a registry-based study to examine patterns and probability of survival during the first year of life among infants with selected congenital anomalies.
Methods:
Data from the Texas Birth Defects Monitoring Division were merged with linked birth-infant death files for 2,774 infants born January 1, 1995 to December 31, 1997, with at least 1 of 23 common anomalies. Deaths before the first birthday were assessed from infant death files. Kaplan-Meier was used to estimate first-year survival; first-year survival was assessed for specific anomalies and by the number of life-threatening anomalies.
Results:
Overall, 80.8% of infants with these 23 anomalies survived the first year of life. We observed the highest survival rates for infants with gastroschisis (92.9%, 95% CI = 86.8, 96.3), trisomy 21 (92.3%, 95% CI = 89.5, 94.4) or cleft lip with or without cleft palate (87.6%, 95% CI = 84.0, 90.5). Infants with intermediate survival rates included those with microcephaly (79.7%; 95% CI = 73.6, 84.6), tetralogy of Fallot (75.0%; 95% CI = 65.5, 82.2), or with diaphragmatic hernia (72.8%; 95% CI = 61.8, 81.2). As expected, all infants with anencephaly and almost all infants with trisomy 13 or trisomy 18 died during the first year of life. First-year survival declined as the number of co-occurring life-threatening anomalies increased.
Conclusions:
Overall, first-year survival for infants with congenital anomalies was high. Additional population-based studies are needed to quantify improvements in first-year survival.
