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Study of selected birth defects among American Indian/Alaska Native population: A multi-state population-based

Lisa K Marengo1, Timothy J Flood2, Mary K Ethen1

  • 1Texas Department of State Health Services, Austin, Texas.

Birth Defects Research
|November 8, 2018
PubMed

Insights

Birth defects like anotia/microtia and cleft lip +/- cleft palate remain significantly higher in American Indian/Alaska Native (AI/AN) newborns compared to non-Hispanic whites. Further research is needed to identify modifiable risk factors for these AI/AN birth defects.

Area of Science:

  • Public Health
  • Epidemiology
  • Genetics

Background:

  • American Indian/Alaska Native (AI/AN) newborns exhibit a higher prevalence of certain birth defects.
  • Investigating known risk factors is crucial to understand these disparities.

Purpose of the Study:

  • To determine if known risk factors explain the elevated prevalence of specific birth defects in AI/AN newborns.
  • To analyze birth defect prevalence among AI/AN populations compared to non-Hispanic whites (NHWs).

Main Methods:

  • Utilized data from 12 population-based birth defect surveillance systems (1999-2007).
  • Calculated prevalence ratios (PRs) for AI/ANs, adjusting for maternal age, education, diabetes, smoking, and surveillance system type.
  • Compared prevalence between non-Hispanic AI/ANs and NHWs, also analyzing any AI/ANs regardless of Hispanic ethnicity.

Main Results:

  • Anotia/microtia prevalence was nearly threefold higher, and cleft lip +/- cleft palate was approximately 70% higher in AI/ANs compared to NHWs, even after adjustments.
  • Excluding Hispanic individuals from the AI/AN group had minimal impact on the adjusted prevalence ratios.
  • Maternal factors accounted for some, but not all, of the elevated birth defect rates.

Conclusions:

  • Despite accounting for known risk factors, anotia/microtia and cleft lip +/- cleft palate remain significantly elevated in AI/AN newborns.
  • Hispanic ethnicity did not significantly alter the observed birth defect prevalences in AI/AN populations.
  • Further investigation is necessary to identify modifiable risk and protective factors for birth defects in AI/AN communities.
Abstract

Keywords:
Alaska NativesAmerican Indiansbirth defects surveillancecongenital abnormalitiespopulation health

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