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Mortality among infants with birth defects: Joint effects of size at birth, gestational age, and maternal

Wendy N Nembhard1, Jason L Salemi, Mary K Ethen

  • 1Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida 33612-3805, USA. wnembha@health.usf.edu

Birth Defects Research. Part A, Clinical and Molecular Teratology
|July 31, 2010
PubMed

Insights

Infants with major birth defects face higher mortality risks. Preterm birth and being small for gestational age (SGA) significantly increase this risk, especially for Hispanic and Black infants.

Area of Science:

  • Pediatric Health
  • Perinatal Epidemiology
  • Birth Defect Research

Background:

  • Examined effects of gestational age, size at birth, and maternal race/ethnicity on early childhood survival.
  • Studied 48,391 singleton infants with major birth defects.

Purpose of the Study:

  • To determine the separate and joint effects of key infant and maternal factors on mortality.
  • To identify risk factors for early childhood survival in infants with major birth defects.

Main Methods:

  • Utilized Texas Birth Defects Registry data linked to death records and the National Death Index.
  • Employed Kaplan-Meier survival estimates and Cox-proportional hazards models to analyze mortality risk.

Main Results:

  • Non-Hispanic Blacks and Hispanics had higher mortality risks (51% and 10% greater, respectively) compared to non-Hispanic Whites.
  • Hispanic infants born small for gestational age (SGA) and preterm had the highest mortality risk (HR(a)=6.1) and lowest survival (76%).
  • Infants born large for gestational age (LGA) at term showed no increased mortality risk across racial/ethnic groups.

Conclusions:

  • Joint effects of gestational age and size at birth significantly impact childhood mortality in infants with birth defects.
  • Further research is needed to understand racial/ethnic disparities in mortality among this vulnerable population.
Abstract

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