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The association between race/ethnicity and major birth defects in the United States, 1999-2007
Mark A Canfield1, Cara T Mai, Ying Wang
1Mark A. Canfield and Lisa K. Marengo are with the Texas Department of State Health Services, Austin. Cara T. Mai, Alissa O'Halloran, Richard S. Olney, and C. J. Alverson are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Ying Wang is with the New York State Department of Health, Albany. Christopher L. Borger is with the Massachusetts Department of Public Health, Boston. Rachel Rutkowski is with the Florida Department of Health, Tallahassee. Jane Fornoff is with the Illinois Department of Public Health, Springfield. Nila Irwin is with the Nebraska Department of Health and Human Services, Lincoln. Glenn Copeland is with the Michigan Birth Defects Registry, Michigan Department of Community Health, Lansing. Timothy J. Flood is with the Arizona Department of Health Services, Phoenix. Robert E. Meyer is with the North Carolina Birth Defects Monitoring Program, Raleigh. Russel Rickard is with the Colorado Department of Public Health and Environment, Denver. Joseph Sweatlock is with the New Jersey Department of Health, Trenton. Russell S. Kirby is with the Department of Community and Family Health, University of South Florida, Tampa.
Insights
American Indian/Alaska Native populations show higher birth defect prevalence. Other racial/ethnic groups, including Asian and Hispanic subgroups, had lower or similar rates, warranting further investigation into these disparities.
Area of Science:
- Epidemiology
- Public Health
- Genetics
Background:
- Birth defects represent a significant public health concern.
- Understanding racial/ethnic variations in birth defect prevalence is crucial for targeted interventions.
- Existing data on birth defect prevalence across diverse racial/ethnic groups, particularly Asian and Hispanic subgroups, is limited.
Purpose of the Study:
- To investigate the relationship between race/ethnicity and the prevalence of 27 major birth defects.
- To systematically examine birth defect prevalence across a wide range of racial/ethnic groups in the United States.
Main Methods:
- Utilized pooled data from 12 population-based birth defects surveillance systems in the U.S. (1999-2007).
- Included over 13.5 million live births, representing approximately one-third of all U.S. births during the study period.
- Employed Poisson regression to calculate prevalence estimates and prevalence ratios, with non-Hispanic Whites as the referent group.
Main Results:
- American Indians/Alaska Natives exhibited significantly higher prevalence for 7 major birth defects, with adjusted prevalence ratios (aPRs) up to 3.97 for anotia/microtia.
- Cubans and Asians generally showed lower or similar birth defect prevalences compared to non-Hispanic Whites.
- Specific exceptions included higher prevalence of anotia/microtia in Chinese and Filipino infants, and tetralogy of Fallot in Vietnamese infants.
Conclusions:
- This study represents the largest population-based examination of major birth defects across diverse racial/ethnic groups to date.
- The elevated prevalence of birth defects among American Indians/Alaska Natives requires further focused research and attention.
- Findings highlight the need for culturally sensitive public health strategies to address observed racial/ethnic disparities in birth defect occurrence.
Objectives:
We investigated the relationship between race/ethnicity and 27 major birth defects.
Methods:
We pooled data from 12 population-based birth defects surveillance systems in the United States that included 13.5 million live births (1 of 3 of US births) from 1999 to 2007. Using Poisson regression, we calculated prevalence estimates for each birth defect and 13 racial/ethnic groupings, along with crude and adjusted prevalence ratios (aPRs). Non-Hispanic Whites served as the referent group.
Results:
American Indians/Alaska Natives had a significantly higher and 50% or greater prevalence for 7 conditions (aPR = 3.97; 95% confidence interval [CI] = 2.89, 5.44 for anotia or microtia); aPRs of 1.5 to 2.1 for cleft lip, trisomy 18, and encephalocele, and lower, upper, and any limb deficiency). Cubans and Asians, especially Chinese and Asian Indians, had either significantly lower or similar prevalences of these defects compared with non-Hispanic Whites, with the exception of anotia or microtia among Chinese (aPR = 2.08; 95% CI = 1.30, 3.33) and Filipinos (aPR = 1.90; 95% CI = 1.10, 3.30) and tetralogy of Fallot among Vietnamese (aPR = 1.60; 95% CI = 1.11, 2.32).
Conclusions:
This is the largest population-based study to our knowledge to systematically examine the prevalence of a range of major birth defects across many racial/ethnic groups, including Asian and Hispanic subgroups. The relatively high prevalence of birth defects in American Indians/Alaska Natives warrants further attention.
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