Related Experiment Video
Updated: Aug 22, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Case fatality among infants with congenital malformations by lethality
Kirk A Bol1, Russel S Rickard, Russell S Kirby
1Colorado Responds to Children With Special Needs, Colorado Department of Public Health and Environment Denver 80246, USA. kirk.bol@state.co.us
Insights
Black/non-Hispanic mothers experienced higher infant mortality risk with less severe birth defects. This highlights disparities in infant mortality linked to maternal race and birth defect severity, warranting targeted prevention.
Area of Science:
- Public Health
- Perinatal Epidemiology
- Reproductive Health
Background:
- Congenital anomalies are the leading cause of infant death in the U.S.
- Limited research exists on factors influencing mortality across different congenital anomaly types.
- Understanding disparities in infant mortality is crucial for targeted interventions.
Purpose of the Study:
- To investigate if maternal race and ethnicity influence infant mortality risk.
- To assess this risk in relation to the severity of congenital malformations.
- To identify potential disparities in infant mortality outcomes.
Main Methods:
- Retrospective cohort analysis using Colorado's birth defects surveillance data (1995-2000).
- Inclusion of infants with major congenital malformations, stratified by lethality.
- Logistic regression analysis considering maternal race/ethnicity, birth weight, gestational age, maternal education, maternal age, and infant sex.
Main Results:
- For low/very low lethality congenital anomalies, Black/non-Hispanic maternal race/ethnicity was linked to increased infant mortality risk (OR 2.81).
- Low and very low birth weight were also significant risk factors in the low lethality group.
- Maternal race/ethnicity was not a significant factor in high/very high lethality groups; however, birth weight and gestational age interaction increased mortality risk.
Conclusions:
- Statewide birth defects surveillance data revealed a significant infant mortality disparity.
- This disparity was identified in a specific population subset, suggesting a need for further investigation.
- Findings support targeted prevention activities to address identified health inequities.
Objective:
Infant mortality rates continue to show that congenital anomalies are the leading cause of infant death in the United States. However, studies of factors contributing to increased mortality across different types of congenital anomalies have been limited. The objective of this study was to assess whether the likelihood of infant mortality varied by maternal race and ethnic group while considering the severity of the birth defect.
Methods:
A retrospective cohort analysis was conducted using data from Colorado's statewide, population-based birth defects surveillance system (CRCSN). The cohort included infants, born between 1995 and 2000 to Colorado resident mothers, who were diagnosed with major congenital malformations stratified by degree of lethality. Multiple logistic regression was performed for each level of lethality, and included the following potential explanatory variables: maternal race/ethnicity, clinical gestation, birth weight, maternal education level, maternal age, and sex of child.
Results:
Within the low/very low lethality cohort, maternal race/ethnicity of Black/non-Hispanic was associated with increased risk of infant mortality, OR 2.81 (1.41-5.19), as were low and very low birth weight, OR 2.21 (1.12-4.04) and 19.31 (11.84-31.01), respectively. Maternal race/ethnicity was not a significant risk factor in either high or very high lethality groups; however, the interaction between birth weight and gestational age significantly increased the risk of mortality.
Conclusions:
Through the use of statewide, population-based birth defects surveillance data, a disparity in infant mortality has been identified in a specific subset of the population that could be investigated further and targeted for prevention activities.
Related Concept Videos
01:07Teratogenicity
02:41Lethal Alleles
Lucien Cuénot discovered lethal alleles in 1905 while studying the inheritance of coat color in mice. The agouti gene is responsible for the color of the coat in mice. This gene codes for an agouti-signaling protein, which is responsible for melanin distribution in mammals. The wild-type allele gives rise to gray-brown coat color in mice, while the mutant allele gives rise to yellow coat color. In addition to coat color, the agouti gene is associated with the yellow...
01:30Neurulation