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Mortality among infants with congenital malformations, New York State, 1983 to 1988
C Druschel1, J P Hughes, C Olsen
1Congenital Malformations Registry, New York State Department of Health, Albany 12203, USA. cmd05@health.state.ny.us
Insights
Infants with major congenital malformations face a significantly higher risk of first-year mortality. Birth weight and the number of malformations are key risk factors influencing survival rates.
Area of Science:
- Pediatrics
- Public Health
- Genetics
Background:
- Major congenital malformations represent a significant public health concern.
- Understanding infant mortality risk factors is crucial for targeted interventions.
Purpose of the Study:
- To investigate first-year mortality rates in infants with major congenital malformations.
- To identify significant risk factors associated with mortality in this vulnerable population.
Main Methods:
- A statewide population-based registry identified infants with major congenital malformations born between 1983 and 1988.
- Analysis included birth weight, gestational age, sex, number of malformations, organ system involvement, hospital level of care, and maternal demographics.
Main Results:
- Infants with major malformations had a 6.3-fold higher mortality risk compared to the general live birth population.
- Birth weight and the number of malformations were the most potent risk factors for mortality.
- Mortality risk showed a slight decline from 1983 to 1988.
Conclusions:
- Congenital malformations are a primary determinant of infant mortality, overshadowing other risk factors.
- Higher cause-specific mortality was observed for all causes except injury in infants with congenital malformations.
Objective:
The authors examined first-year mortality and risk factors for mortality among infants with major congenital malformations.
Methods:
Infants with major congenital malformations born from 1983 to 1988 were identified from a statewide population-based congenital malformations registry. Variables analyzed included year of birth, birth weight, gestational age, infant sex, number of malformations, number of organ systems involved, level of care of the birth hospital, maternal age, maternal education, and maternal ethnicity.
Results:
Infants with major malformations had a risk of death 6.3 times higher than the general population of live births. The risk declined from 6.5 in 1983 to 5.9 in 1988. Birth weight and number of malformations were the strongest risk factors. The likelihood of survival was similar for white and black infants.
Conclusions:
Being born with a malformation outweighs most of the other risks for infant mortality. Children with congenital malformations had higher cause-specific mortality for all causes except injury.