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Descriptive epidemiology of small intestinal atresia, Atlanta, Georgia
J D Cragan1, M L Martin, C A Moore
1Birth Defects and Genetic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333.
Insights
Small intestinal atresia (SIA) affects 2.8 in 10,000 infants, with higher prevalence in Black infants and twins. Isolated jejunal atresia is significantly more common in Black infants.
Area of Science:
- Pediatric Surgery
- Medical Epidemiology
- Congenital Anomalies
Background:
- Small intestinal atresia (SIA) is a rare congenital malformation requiring surgical intervention.
- Understanding the epidemiological patterns of SIA is crucial for public health initiatives and resource allocation.
Purpose of the Study:
- To describe the epidemiology of small intestinal atresia (SIA) in Atlanta, Georgia, from 1968 to 1989.
- To investigate variations in SIA prevalence by race, twin status, and anatomical location.
Main Methods:
- Utilized the Metropolitan Atlanta Congenital Defects Program, a population-based surveillance system.
- Identified 176 infants diagnosed with SIA within their first year of life.
- Analyzed data for prevalence, relative risks, and associations with demographic and clinical factors.
Main Results:
- Overall SIA prevalence was 2.8 per 10,000 livebirths.
- Higher prevalence observed in Black infants (3.7/10,000) and twin infants (7.3/10,000) compared to White infants and singletons, respectively.
- Duodenal atresia was most common (49%), followed by jejunal (36%) and ileal (14%).
- Isolated jejunal atresia showed a significantly higher prevalence in Black infants compared to White infants.
Conclusions:
- SIA exhibits distinct epidemiological characteristics, with increased risk noted in Black infants and twins.
- Anatomical location and racial disparities are significant factors in SIA occurrence.
- Further research into the etiology of these disparities is warranted.
Abstract:
To describe the epidemiology of small intestinal atresia (SIA) in Atlanta, Georgia, from 1968 through 1989, we used the Metropolitan Atlanta Congenital Defects Program, an active, population-based surveillance system for birth defects diagnosed during the first year of life. We identified 176 infants with SIA, a prevalence of 2.8 per 10,000 livebirths. Among black infants, the prevalence was 3.7 per 10,000 livebirths, significantly higher than the prevalence of 2.4 per 10,000 among white infants [relative risk (RR) = 1.6, 95% confidence interval (CI) = 1.1,2.1]. Nine infants were each one member of a unique pair of twins. The prevalence among twin infants was 7.3 per 10,000, significantly higher than the prevalence of 2.8 per 10,000 among singletons (RR = 2.7, 95% CI = 1.4,5.2). Forty-nine percent of the infants had duodenal atresia, 36% had jejunal atresia, and 14% had ileal atresia. Two infants (1%) had atresia at an unspecified site in the small intestine. We grouped the infants by anatomic location of SIA into four categories: isolated SIA (53%), SIA with multiple unrelated defects (21%), sequences (16%), and syndromes (10%). We then compared the isolated and multiple unrelated defects groups by gender, race, maternal age, birth weight and one-year mortality for each location of SIA. Among black infants the prevalence of isolated jejunal atresia was 1.4 per 10,000, significantly higher than the prevalence of 0.2 per 10,000 among white infants (RR = 6.3, 95% CI = 2.9, 13.5). The increased prevalence of these defects among twins was a particularly interesting finding.