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Selected acculturation factors and birth defects in the National Birth Defects Prevention Study, 1997-2011
Adrienne T Hoyt1, Charlie J Shumate1, Mark A Canfield1
1Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
Insights
Parental nativity impacts birth defect risks, with foreign-born parents showing varied associations with specific defects. Living in the U.S. for 5 years or less appeared protective for some conditions.
Area of Science:
- Reproductive Health
- Epidemiology
- Genetics
Background:
- Acculturation and its impact on adverse pregnancy outcomes, particularly birth defects, remain incompletely understood.
- Previous research on parental nativity and birth defect associations yields mixed and limited findings.
- Further investigation is needed to clarify the relationship between parental origin and the occurrence of specific birth defects.
Purpose of the Study:
- To explore the association between parental nativity (foreign-born vs. U.S.-born) and the risk of major isolated birth defects.
- To examine the influence of duration of residence in the U.S. on the relationship between parental nativity and birth defects.
- To analyze these associations across a spectrum of 46 major isolated birth defects.
Main Methods:
- Utilized data from the National Birth Defects Prevention Study (1997-2011).
- Included infants with 46 major isolated birth defects and healthy controls.
- Employed logistic regression to analyze parental nativity and years lived in the U.S. (≤5 or 6+ years), calculating adjusted odds ratios (aORs).
Main Results:
- Foreign-born mothers were often older, of Hispanic/Other ethnicity, and less likely to report unhealthy behaviors or folic acid use.
- Adjusted analyses revealed significant associations between both parents being foreign-born and increased risks for spina bifida, anotia/microtia, and diaphragmatic hernia (aORs 1.3-1.7).
- Conversely, foreign-born parental nativity was associated with reduced risks for craniosynostosis and gastroschisis (aORs=0.7), with a protective effect noted for those residing in the U.S. ≤5 years.
Conclusions:
- Parental nativity is associated with specific isolated birth defects.
- The direction and magnitude of this association vary depending on the birth defect's phenotype.
- Duration of residence in the U.S. modifies the relationship between parental nativity and birth defect risk.
Background:
Acculturation has been examined with respect to various pregnancy adverse outcomes, including birth defects. Given the mixed and limited findings on the association between nativity and birth defects, we sought to further explore parental nativity and years lived in the U.S. across a range of defects.
Methods:
Data from the National Birth Defects Prevention Study were used for this analysis. Infants with one of 46 major isolated birth defects (30 noncardiac/16 cardiac conditions) and infants without birth defects (controls) born during 1997-2011 were included. We examined parental nativity (foreign-born mothers, fathers, and both parents combined compared to a referent of both U.S.-born parents) and the number of years lived in the U.S. (≤5/6+ years). Descriptive statistics and logistic regression analyses were performed to estimate crude/adjusted odds ratios and 95% confidence intervals.
Results:
Compared to U.S.-born mothers, foreign-born mothers tended to be older (25+ years), of Hispanic or Other race/ethnicity and were less likely to have reported drinking, smoking, illicit drug use, or having taken folic acid. In the adjusted analysis, seven findings among both parents reporting a foreign-birth were significant, including an increased association with spina bifida, anotia/microtia, and diaphragmatic hernia (aORs range: 1.3-1.7), and a reduced association with craniosynostosis and gastroschisis (aORs = 0.7). A generally protective effect was observed among foreign-born subjects living in the U.S. ≤5 years.
Conclusions:
We found that nativity was associated with some selected isolated defects, although the direction of effect varied by phenotype and by a number of years residing in the U.S.
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