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The decline of postnatal mortality from gastrointestinal anomalies with age

Dolejs Josef1

  • 1National Radiation Protection Institute, Pileticka 57, Hradec Kralove 500 03, Czech Republic. djosef@post.cz

Mechanisms of Ageing and Development
|September 1, 2004
PubMed

Insights

Mortality from gastrointestinal anomalies, unlike other congenital issues, declines with the square of age. This suggests significant risk selection occurs during pregnancy, not before.

Area of Science:

  • Pediatrics
  • Medical Statistics
  • Developmental Biology

Background:

  • Mortality from congenital anomalies typically decreases with age.
  • Gastrointestinal anomalies and perinatal conditions show distinct age-related mortality decline patterns.
  • The theory of congenital individual risks posits that mortality decline is due to the elimination of more severely affected individuals.

Purpose of the Study:

  • To investigate the age-dependent mortality patterns of gastrointestinal anomalies.
  • To compare the mortality decline of gastrointestinal anomalies with other congenital conditions and perinatal issues.
  • To elucidate the timing of risk selection for congenital gastrointestinal anomalies.

Main Methods:

  • Analysis of mortality data for gastrointestinal anomalies (ICD9 codes 750, 751) across five countries.
  • Examination of age-specific mortality decline, specifically focusing on the power of age.
  • Comparison of observed mortality patterns with theoretical models of risk selection.

Main Results:

  • Mortality from gastrointestinal anomalies consistently decreases with the second power of age between 1-10 years in all studied countries.
  • This pattern contrasts with the first power of age decline seen in most congenital anomalies.
  • The findings indicate that gastrointestinal defects do not significantly impact vital functions during pregnancy, leading to minimal prenatal selection.

Conclusions:

  • The second power of age decline in mortality from gastrointestinal anomalies suggests minimal prenatal selection.
  • Risk selection for these conditions predominantly occurs after birth, not during gestation.
  • This challenges previous assumptions about the timing of selection for congenital anomalies, highlighting pregnancy as a critical period for other conditions.

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