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Birth weight-specific infant mortality due to congenital anomalies, 1960 and 1980
Insights
Mortality from congenital anomalies decreased significantly between 1960 and 1980, yet their proportion of all infant deaths increased. Cardiovascular and central nervous system anomalies remained leading causes.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Congenital anomalies are a significant cause of infant mortality.
- Understanding trends in mortality due to congenital anomalies is crucial for public health interventions.
- Previous studies have highlighted disparities in infant mortality rates.
Purpose of the Study:
- To compare mortality impact of congenital anomalies in single-delivery births between 1960 and 1980 birth cohorts.
- To analyze changes in infant mortality risk (IMR) due to congenital anomalies across different racial groups and periods (neonatal vs. postneonatal).
- To examine the contribution of specific anomaly types to overall infant deaths due to congenital anomalies.
Main Methods:
- Utilized data from the 1960 National Center for Health Statistics national linkage of birth and death certificates.
- Employed data from the 1980 National Infant Mortality Surveillance project.
- Compared mortality rates and risks for congenital anomalies between the 1960 and 1980 birth cohorts, analyzing by race and birth period.
Main Results:
- Deaths due to congenital anomalies decreased by 41% from 1960 to 1980, with a 31% reduction in IMR for these anomalies.
- The absolute percentage of all infant deaths attributed to congenital anomalies increased from 15.8% to 24.1%.
- Cardiovascular and central nervous system anomalies were the primary contributors, accounting for 59% of deaths in 1980.
- While overall IMR showed a 2:1 black to white ratio, mortality risks for congenital anomalies were nearly equal between races in both years.
- For low birth weight infants (500-2,499 g), black infants had less than half the neonatal mortality risk of white infants.
Conclusions:
- Despite significant reductions in absolute numbers and relative risk, congenital anomalies became a more prominent cause of infant mortality by 1980.
- Improvements in reducing mortality from congenital anomalies were observed across racial groups, particularly in the postneonatal period.
- Cardiovascular anomalies represent a persistent major cause of infant mortality due to congenital anomalies.
- The study highlights complex trends in infant mortality, with specific improvements in congenital anomaly-related deaths but an increasing relative burden.
Abstract:
The impact of mortality due to congenital anomalies in single-delivery births was compared in 1960 and 1980 birth cohorts; data were used from the 1960 National Center for Health Statistics national linkage of birth and death certificates and the 1980 National Infant Mortality Surveillance project. In 1960 there were 14,714 deaths due to congenital anomalies, compared with 8,674 in 1980, a 41 percent reduction. The infant mortality risk (IMR) due to congenital anomalies fell 31 percent. This is in contrast with the observed 54 percent decline in IMR due to all causes. This reduction in mortality due to congenital anomalies occurred for both whites and blacks in the postneonatal period and for whites only in the neonatal period. Changes ranged from a 1.8 percent increase for the black neonatal mortality risk to a 46.6 percent decrease for the white postneonatal mortality risk. In spite of these relative reductions, the absolute percentage of all infant deaths due to congenital anomalies had increased from 15.8 percent in 1960 to 24.1 percent in 1980. Two categories, cardiovascular and central nervous system anomalies, accounted for 72 percent of infant deaths due to congenital anomalies in 1960 and for 59 percent in 1980; cardiovascular anomalies accounted for 48 percent of all deaths due to congenital anomalies in 1960 and 40 percent in 1980. Infant mortality risks in the United States showed a 2:1 black to white ratio in both 1960 and 1980. However, for infant mortality due to congenital anomalies, the black and white mortality risks were approximately equal in both 1960 and 1980. For infants with birth weights of 500-2,499 g, the risk of neonatal mortality for blacks was less than half the risk for whites.