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Epidemiology of the early amnion rupture spectrum of defects
A Garza1, J F Cordero, J Mulinare
1Division of Birth Defects and Developmental Disabilities, Centers for Disease Control, Atlanta.
Insights
The early amnion rupture spectrum of defects is more common in female infants and Black infants. Young Black mothers have a significantly higher risk of having infants with these defects compared to older Black mothers.
Area of Science:
- Epidemiology
- Medical Genetics
- Public Health
Background:
- The early amnion rupture spectrum of defects is a group of congenital anomalies.
- Understanding the epidemiological factors associated with these defects is crucial for public health initiatives.
Purpose of the Study:
- To investigate the birth prevalence and epidemiological characteristics of the early amnion rupture spectrum of defects.
- To identify potential risk factors, including race and maternal age, associated with these defects.
Main Methods:
- Utilized data from the population-based Metropolitan Atlanta Congenital Defects Program (MACDP).
- Analyzed live birth data from 1968 to 1982 to identify cases of early amnion rupture spectrum defects.
- Calculated birth prevalence rates stratified by infant sex, race, and maternal age and parity.
Main Results:
- Identified 45 cases among 388,325 live births, yielding a prevalence of 1.16 per 10,000.
- Observed higher prevalence in female (1.44) versus male (0.91) infants.
- Found a 1.76 times higher occurrence in Black infants compared to White infants.
- Documented a significantly higher rate (6.2 per 10,000) in infants of young Black multigravidas (<20 years) compared to older Black multigravidas (0.5 per 10,000).
Conclusions:
- Young Black multigravidas are at substantially higher risk for having infants with the early amnion rupture spectrum of defects.
- While diagnostic differences may influence racial prevalence, maternal age effects in Black multigravidas are distinct.
- The true birth prevalence may be closer to 3 per 10,000 live births, suggesting underdiagnosis in some populations.
Abstract:
We used data from the population-based Metropolitan Atlanta Congenital Defects Program to study the epidemiology of the early amnion rupture spectrum of defects. For the period 1968 through 1982, we identified 45 patients among 388,325 live births, for a birth prevalence rate of 1.16 per 10,000. The prevalence for male infants was 0.91 and for female infants, 1.44. The defects occurred 1.76 times more often in blacks than in whites (95% confidence interval 0.98, 3.13). Infants of young, black multigravidas (less than 20 years, more than one pregnancy) showed the highest rate (6.2), and infants of older, black multigravidas showed the lowest rate (0.5) (rate ratio = 12.4, 95% confidence interval 4.2, 36.4). These findings suggest that young, black multigravidas are at much higher risk than are older, black multigravidas of having infants with this spectrum of defects. Ascertainment (diagnostic) differences between hospitals probably account for some of the racial discrepancy in birth prevalence, but they do not explain the maternal age effects in black multigravidas. Because the higher rates for blacks probably reflect more accurate diagnoses, the findings also suggest that a closer estimate of the true birth prevalence may be about 3 per 10,000 live births.