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Taritsa IC, Ledwon JK, Bajaj A, Gosain AK. 12-Year Trends of Orofacial Clefts in the United States: Highlighting Racial/Ethnic Differences in Prevalence of Cleft Lip and Cleft Palate. Cleft Palate Craniofac J 2024:10556656241227033. [PMID: 38291621 DOI: 10.1177/10556656241227033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE Discrepancies in prevalence among infants with orofacial clefts are public health research priorities. Our objective was to calculate updated estimated prevalence of orofacial clefts in the United States, with sub-analyses by racial/ethnic group. DESIGN The National Birth Defect Prevention Network database was used to evaluate trends in cases with orofacial cleft in the United States from 2006 to 2018. Cases with cleft lip with and without cleft palate (CL ± P) and cleft palate (CP) alone were sub-stratified by racial/ethnic category. Estimated prevalence was calculated using the total live births reported in each maternal racial/ethnic group. The odds ratio (OR) was calculated to measure the strength of association between racial/ethnic group and risk of orofacial clefts. RESULTS Estimated prevalence rates show that maternally-reported Native American/Alaskan Native individuals were 43.8% (p < 0.0001) and 36.0% (p < 0.0001) more likely to have CL ± P and CP alone, respectively, compared to maternally-reported non-Hispanic White individuals. Estimated prevalence of CL ± P in maternally-reported non-Hispanic Black individuals (OR = 0.64) and maternally-reported Asians/Pacific Islander individuals were significantly lower than in maternally-reported non-Hispanic White individuals (OR = 0.63, p < 0.0001). Estimated prevalence of CP alone was significantly lower in maternally-reported non-Hispanic Black individuals (OR = 0.64, p < 0.0001), maternally-reported Asians/Pacific Islander individuals (OR = 0.69, p < 0.0001), and maternally-reported Hispanic individuals (OR = 0.81, p < 0.0001). CONCLUSIONS Across the total population, there was no significant change in estimated orofacial cleft prevalence. However, there were significant disproportions in estimated orofacial cleft prevalence across racial/ethnic groups, which may guide further discussion among craniofacial health care providers and centers and their patients regarding differences in cleft risk factors.
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Affiliation(s)
- Iulianna C Taritsa
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joanna K Ledwon
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anitesh Bajaj
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arun K Gosain
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Huang RS, Mihalache A, Wong Riff KWY. Cleft lip and/or palate mortality trends in the USA: a retrospective population-based study. BMJ Paediatr Open 2024; 8:e002305. [PMID: 38242631 PMCID: PMC10806517 DOI: 10.1136/bmjpo-2023-002305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Cleft lip and/or palate (CL/P) is one of the most common congenital anomalies worldwide. Although CL/P management may require a series of interventions, mortality resulting from CL/P alone is rare. This study aims to examine recent trends of CL/P mortality rates in the USA. METHODS A retrospective population-based study was conducted using official US birth and death certificate data from the Centers for Disease Control and Prevention from 2000 to 2019. Annual mortality rates per 1000 births with CL/P were calculated across sex and racial groups. Multivariable logistic regression models estimated the effects of sex and race on the risk of mortality with CL/P, and linear regression models were used to examine temporal changes in mortality rate across sex and race. RESULTS From 2000 to 2019, 1119 deaths occurred in patients with documented CL/P, for an overall incidence of 20.3 deaths per 1000 births with CL/P (95% CI 18.9 to 22.8). Of these, Patau syndrome was the listed cause of death in 167 cases (14.9%). Black individuals (OR 1.93, 95% CI 1.85 to 2.01), Hispanic (1.54, 1.49 to 1.58) and American Indian individuals (1.28, 1.20 to 1.35) were at a greater risk of CL/P mortality compared with white individuals. Additionally, females were also at a greater risk (1.35, 1.21 to 1.49). A significant upward trend in CL/P mortality was observed in Hispanic (r2=0.70, p<0.01) and American Indian individuals (r2=0.81, p<0.01) from 2000 to 2019. CONCLUSIONS Cleft birth and mortality surveillance is essential in healthcare and prevention planning. Future studies are required to understand the differences in CL/P mortality rates across various sociodemographic groups.
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Affiliation(s)
- Ryan S Huang
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Mihalache
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen W Y Wong Riff
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
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Bascom JT, Stephens SB, Lupo PJ, Canfield MA, Kirby RS, Nestoridi E, Salemi JL, Mai CT, Nembhard WN, Forestieri NE, Romitti PA, St. Louis AM, Agopian AJ. Scientific impact of the National Birth Defects Prevention Network multistate collaborative publications. Birth Defects Res 2024; 116:e2225. [PMID: 37492989 PMCID: PMC10910332 DOI: 10.1002/bdr2.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/16/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Given the lack of a national, population-based birth defects surveillance program in the United States, the National Birth Defects Prevention Network (NBDPN) has facilitated important studies on surveillance, research, and prevention of major birth defects. We sought to summarize NBDPN peer-reviewed publications and their impact. METHODS We obtained and reviewed a curated list of 49 NBDPN multistate collaborative publications during 2000-2022, as of December 31, 2022. Each publication was reviewed and classified by type (e.g., risk factor association analysis). Key characteristics of study populations and analytic approaches used, along with publication impact (e.g., number of citations), were tabulated. RESULTS NBDPN publications focused on prevalence estimates (N = 17), surveillance methods (N = 11), risk factor associations (N = 10), mortality and other outcomes among affected individuals (N = 6), and descriptive epidemiology of various birth defects (N = 5). The most cited publications were those that reported on prevalence estimates for a spectrum of defects and those that assessed changes in neural tube defects (NTD) prevalence following mandatory folic acid fortification in the United States. CONCLUSIONS Results from multistate NBDPN publications have provided critical information not available through other sources, including US prevalence estimates of major birth defects, folic acid fortification and NTD prevention, and improved understanding of defect trends and surveillance efforts. Until a national birth defects surveillance program is established in the United States, NBDPN collaborative publications remain an important resource for investigating birth defects and informing decisions related to health services planning of secondary disabilities prevention and care.
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Affiliation(s)
- Jacqueline T. Bascom
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - Sara B. Stephens
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - Philip J. Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Russell S. Kirby
- Chiles Center, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Eirini Nestoridi
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Jason L. Salemi
- Chiles Center, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Cara T. Mai
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wendy N. Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nina E. Forestieri
- Birth Defects Monitoring Program, State Center for Health Statistics, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - Paul A. Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa, USA
| | - Amanda M. St. Louis
- Birth Defects Registry, Center for Environmental Health, New York State Department of Health, New York, USA
| | - A. J. Agopian
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
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Ingram MC, Becker S, Olson SL, Tsai S, Sarkar A, Rothstein DH, Skarsgard ED, Raval MV. Disparities in surgical health service delivery and outcomes for indigenous children. J Pediatr Surg 2023; 58:375-383. [PMID: 36241445 DOI: 10.1016/j.jpedsurg.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Evidence of health disparities for Indigenous children requiring surgical care is lacking. We present a systematic review of the literature examining possible disparities in surgical care and outcomes for pediatric patients of Indigenous ethnicity. DATA SOURCES PubMed, Cochrane, MEDLINE, gray literature. METHODS Literature review, using PubMed, Cochrane, MEDLINE, and gray literature was conducted to identify articles published more than 2010-2020 examining children's surgical health service delivery (epidemiology, access, operations provided) and outcomes for pediatric patients of Indigenous ethnicity compared with others. Extracted data included study design, setting, participant race/ethnicity, operations examined, and surgical outcomes. Article quality was assessed using the Newcastle-Ottawa Scales. RESULTS From 411 abstracts, 125 articles were reviewed and 33 included for data abstraction. These were cohort and cross-sectional studies investigating a wide range of patient populations and procedures across the United States, Canada, Australia, and New Zealand. Articles were organized naturally by theme into birth malformations (15 articles), trauma (6 articles), pediatric general surgery/appendicitis (5 articles), pediatric otolaryngology (6 articles), and renal transplant (1 article) surgery. Four articles also described access and resource utilization related to inpatient care. Notable disparities observed included apparent increased prevalence of gastroschisis, rates of traumatic fatality, non accidental injury, and self harm among North American Indigenous children. CONCLUSIONS Indigenous children appear to be vulnerable to a number of health and treatment outcome disparities related to conditions treated by surgeons. Surgeons are thus uniquely poised to act in identifying and eliminating Indigenous ethnicity-based pediatric health disparities.
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Affiliation(s)
- Martha-Conley Ingram
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
| | - Sasha Becker
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sydney L Olson
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Stacy Tsai
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Arjun Sarkar
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David H Rothstein
- Division of Pediatric Surgery, Department of Surgery, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA, United States
| | - Erik D Skarsgard
- Division of Pediatric Surgery, Department of Surgery, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Mehul V Raval
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
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Stallings EB, Isenburg JL, Aggarwal D, Lupo PJ, Oster ME, Shephard H, Liberman RF, Kirby RS, Nestoridi E, Hansen B, Shan X, Navarro Sanchez ML, Boyce A, Heinke D. Prevalence of critical congenital heart defects and select co-occurring congenital anomalies, 2014-2018: A U.S. population-based study. Birth Defects Res 2022; 114:45-56. [PMID: 35048540 DOI: 10.1002/bdr2.1980] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Critical congenital heart defects (CCHDs) are one of the most common types of birth defects and can lead to significant morbidity and mortality along with surgical or catheter interventions within the first year of life. This report updates previously published estimates of CCHD prevalence with the latest population-based surveillance data from 19 birth defect surveillance programs. METHODS The U.S. population-based surveillance programs submitted data on identified cases of 12 CCHDs and co-occurring cardiovascular and chromosomal birth defects from 2014 to 2018. We estimated prevalence by program type and maternal and infant characteristics. Among nine programs with active case ascertainment that collect more than live births, we estimated the percentage of co-occurring cardiovascular and chromosomal birth defects for the 12 CCHDs. RESULTS We identified 18,587 cases of CCHD among all participating programs. Overall CCHD prevalence was 19.6 per 10,000 live births among all 19 programs and 20.2 per 10,000 live births among active programs. Among maternal racial/ethnic groups, infants/fetuses born to American Indian/Alaska Native mothers showed the highest overall prevalence for all CCHDs (28.3 per 10,000) along with eight of the 12 individual CCHDs. Among 7,726 infants/fetuses with CCHD from active case ascertainment programs, 15.8% had at least one co-occurring chromosomal birth defect. CONCLUSION Our study provides prevalence estimates for CCHDs by maternal and infant characteristics along with co-occurrence with cardiovascular and chromosomal birth defects among infants/fetuses with CCHD using one of the largest and most recent cohorts since the implementation of widespread CCHD screening. These data can provide a basis for future research to better understand risk factors for these defects.
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Affiliation(s)
- Erin Bugenske Stallings
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer L Isenburg
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Deepa Aggarwal
- California Birth Defects Monitoring Program, Genetic Disease Screening Program, California Department of Public Health, California, USA
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew E Oster
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hanna Shephard
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA.,Council of State and Territorial Epidemiologists, Atlanta, Georgia, USA
| | - Rebecca F Liberman
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Eirini Nestoridi
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Brenda Hansen
- California Birth Defects Monitoring Program, Genetic Disease Screening Program, California Department of Public Health, California, USA
| | - Xiaoyi Shan
- Arkansas Reproductive Health Monitoring System, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | | | - Aubree Boyce
- Utah Birth Defect Network, Utah Department of Health, Salt Lake City, Utah, USA
| | - Dominique Heinke
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
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Leung J, Kennedy JL, Haberling DL, Apostolou A, Lanzieri TM. Congenital CMV-Coded Diagnosis Among American Indian and Alaska Native Infants in the United States, 2000-2017. J Immigr Minor Health 2020; 22:1101-1104. [PMID: 32424641 PMCID: PMC8829881 DOI: 10.1007/s10903-020-01024-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To assess prevalence of congenital cytomegalovirus (CMV)-coded diagnosis among American Indian/Alaska Native (AI/AN) infants who received Indian Health Service (IHS)-funded care during 2000-2017. Using data from the Indian Health Service National Data Warehouse, we identified AI/AN infants with congenital CMV-coded diagnosis, defined as presence of a diagnostic code for congenital CMV disease or CMV infection (International Classification of Diseases, Ninth Revision or Tenth Revision, Clinical Modification 771.1, 078.5, P35.1, B25.xx) within 90 days of life. We calculated prevalence of congenital CMV-coded diagnosis overall, by age at first CMV-coded diagnosis, and by geographical region. During 2000-2017, 54 (1.5/10,000) of 354,923 AI/AN infants had a congenital CMV-coded diagnosis; 32 (0.9/10,000) had their first CMV-coded diagnosis within 45 days of life, and 22 (0.6/10,000) between 46 and 90 days of life. Prevalence of congenital CMV-coded diagnosis varied by region (range 0.9/10,000 in Southern Plains to 3.7/10,000 in Alaska, P = 0.0038). Among the 54 infants with a congenital CMV-coded diagnosis, 48% had clinical signs such as jaundice, petechiae, or microcephaly, compared to 25% of 354,869 infants without a CMV-coded diagnosis (P < 0.01); and 1 (2%) vs. 277 (0.1%), respectively, died (P < 0.05). The prevalence of congenital CMV-coded diagnosis among AI/AN infants who received care at IHS facilities was slightly lower than in other studies based on health claims data and varied by geographical region.
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Affiliation(s)
- Jessica Leung
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS H24-5, Atlanta, GA, 30333, USA.
| | - Jordan L Kennedy
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana L Haberling
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andria Apostolou
- Division of Epidemiology and Disease Prevention, Indian Health Service, Rockville, MD, USA
- SciMetrika, LLC, McLean, VA, USA
| | - Tatiana M Lanzieri
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS H24-5, Atlanta, GA, 30333, USA
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Thompson JA, Suter MA. Estimating racial health disparities among adverse birth outcomes as deviations from the population rates. BMC Pregnancy Childbirth 2020; 20:155. [PMID: 32164616 PMCID: PMC7069047 DOI: 10.1186/s12884-020-2847-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Despite significant research, the reasons for racial health disparities among adverse birth outcomes (ABO) remain largely unknown. The bulk of research into racial health disparities among ABO in the United States has concentrated on the risk of race and ethnic groups relative to the specific sub-population of non-Hispanic white women and their children. The objective of this study was to estimate the racial and ethnic risks among a set of neonatal and maternal health disparities while minimizing bias attributable to how the baseline risk was established. Methods All birth records were obtained from the United States Natality database for the years 2014 to 2017. A Bayesian modeling approach was used to estimate the risk disparity for disorders by race. The estimation of the race-specific risks used a sum-to-zero constraint for the race regression coefficients. Results Estimating racial health disparities relative to the overall population rate yielded novel results and identified perinatal health disparities for all the race groups studied. Conclusions Unbiased risk estimates for racial disparities among ABO are now available for stimulating and initiating more complex causal modeling that can lead to understanding how racial health disparities for ABO are mediated and how they can be prevented.
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Affiliation(s)
- James A Thompson
- College of Veterinary Medicine and Biomedical Science, Texas A&M University, College Station, TX, 77843-4475, USA.
| | - Melissa A Suter
- Department of Obstetrics and Gynecology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
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Janitz AE, Dao HD, Campbell JE, Stoner JA, Peck JD. Distribution of congenital anomalies by race/ethnicity and geospatial location in Oklahoma, 1997-2009. Birth Defects Res 2020; 112:262-269. [PMID: 31820848 PMCID: PMC7057226 DOI: 10.1002/bdr2.1631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Congenital anomalies were the leading cause of infant mortality, responsible for 23 and 21% of deaths in Oklahoma and the USA, respectively, in 2016. We aimed to determine the prevalence by race/ethnicity and spatial distribution of congenital anomalies to identify geographic and racial/ethnic disparities, particularly among American Indian/Alaska Natives (AI/AN). METHODS We evaluated the prevalence of anomalies by type and race/ethnicity among 648,074 live births in Oklahoma from 1997 to 2009. Prevalence proportion ratios (PPRs) and 95% confidence intervals (CIs) were calculated using Poisson regression. We used Moran's I and Getis-Ord Gi* to evaluate spatial clustering for neural tube defects, critical congenital heart defects (CCHDs), and oral clefts among births whose residence geocoded to the ZIP code or finer level. RESULTS Overall prevalence of anomalies among live births was 3.9%. Non-Hispanic (NH) African American (PPR: 0.87, 95% CI: 0.83, 0.91), Asian/Pacific Islander (PPR: 0.70, 95% CI: 0.63, 0.78), and Hispanic (PPR: 0.87, 95% CI: 0.83, 0.91) children had a lower prevalence of anomalies compared to NH whites. The prevalence in NH AI/AN children was similar to NH whites (PPR: 1.01, 95% CI: 0.97, 1.05). However, differences in specific types of anomalies were observed by race/ethnicity. We observed no spatial autocorrelation for CCHD and oral clefts. Neural tube defects demonstrated spatial autocorrelation (p < .0001). Local hot spots varied by anomaly. DISCUSSION The prevalence of anomalies by race/ethnicity and geography differed by race/ethnicity and region, though this varied by anomaly. Additional research is needed to identify behavioral or environmental factors to target for prevention.
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Affiliation(s)
- Amanda E Janitz
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Hanh Dung Dao
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Julie A Stoner
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jennifer D Peck
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Le MT, Shumate CJ, Hoyt AT, Wilkinson AV, Canfield MA. The prevalence of birth defects among non-Hispanic Asian/Pacific Islanders and American Indians/Alaska Natives in Texas, 1999-2015. Birth Defects Res 2019; 111:1380-1388. [PMID: 31264390 DOI: 10.1002/bdr2.1543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is considerable variability in the prevalence of birth defects among racial/ethnic groups. This study estimated birth defect prevalence among the less studied non-Hispanic (NH) Asian/Pacific Islander (PI) and American Indian/Alaska Native (AI/AN) populations in Texas relative to NH Whites. METHODS Data were obtained from the Texas Birth Defect Registry from 1999 to 2015 for deliveries to Texas-resident women who were NH White, NH Asian/PI, or AI/AN. This covers a live birth population of 2.6 million. Prevalence ratios and 95% confidence intervals (95% CIs) were calculated for NH Asian/PIs and AI/ANs (relative to NH Whites) for 44 birth defects using Poisson regression adjusting for maternal age. RESULTS After adjustment there were 33 statistically significant prevalence ratios (aPRs). Among NH Asian/PIs, 23 defects had a lower aPR (0.38-0.86) and three defects had a higher aPR (1.19-2.50). AI/ANs had one defect with a significantly lower aPR (0.64) and six with a higher aPR (1.36-4.63). CONCLUSIONS Non-Hispanic Asian/PIs generally have a lower prevalence ratio for many birth defects while AI/ANs have a higher prevalence ratio compared to NH Whites. These findings update the limited literature on this topic and warrant additional research to identify the true associations across a range of birth defects among these understudied racial/ethnic groups.
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Affiliation(s)
- Mimi T Le
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Charlie J Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Adrienne T Hoyt
- Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Anna V Wilkinson
- Department of Epidemiology, Human Genetics and Environmental Science, University of Texas School of Public Health, Austin, Texas
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
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Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ, Lupo PJ, Riehle-Colarusso T, Cho SJ, Aggarwal D, Kirby RS. National population-based estimates for major birth defects, 2010-2014. Birth Defects Res 2019; 111:1420-1435. [PMID: 31580536 PMCID: PMC7203968 DOI: 10.1002/bdr2.1589] [Citation(s) in RCA: 422] [Impact Index Per Article: 84.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Using the National Birth Defects Prevention Network (NBDPN) annual data report, U.S. national prevalence estimates for major birth defects are developed based on birth cohort 2010-2014. METHODS Data from 39 U.S. population-based birth defects surveillance programs (16 active case-finding, 10 passive case-finding with case confirmation, and 13 passive without case confirmation) were used to calculate pooled prevalence estimates for major defects by case-finding approach. Fourteen active case-finding programs including at least live birth and stillbirth pregnancy outcomes monitoring approximately one million births annually were used to develop national prevalence estimates, adjusted for maternal race/ethnicity (for all conditions examined) and maternal age (trisomies and gastroschisis). These calculations used a similar methodology to the previous estimates to examine changes over time. RESULTS The adjusted national birth prevalence estimates per 10,000 live births ranged from 0.62 for interrupted aortic arch to 16.87 for clubfoot, and 19.93 for the 12 critical congenital heart defects combined. While the birth prevalence of most birth defects studied remained relatively stable over 15 years, an increasing prevalence was observed for gastroschisis and Down syndrome. Additionally, the prevalence for atrioventricular septal defect, tetralogy of Fallot, omphalocele, and trisomy 18 increased in this period compared to the previous periods. Active case-finding programs generally had higher prevalence rates for most defects examined, most notably for anencephaly, anophthalmia/microphthalmia, trisomy 13, and trisomy 18. CONCLUSION National estimates of birth defects prevalence provide data for monitoring trends and understanding the impact of these conditions. Increasing prevalence rates observed for selected conditions warrant further examination.
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Affiliation(s)
- Cara T. Mai
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L. Isenburg
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Robert E. Meyer
- North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, Raleigh, North Carolina
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Adolfo Correa
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Clinton J. Alverson
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Tiffany Riehle-Colarusso
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sook Ja Cho
- Birth Defects Monitoring & Analysis Unit, Minnesota Department of Health, St. Paul, Minnesota
| | - Deepa Aggarwal
- California Birth Defects Monitoring Program, California Department of Public Health, Richmond, California
| | - Russell S. Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
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11
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Weaver TL. Diversity in Plastic Surgery: Trends in Minority Representation among Applicants and Residents. Plast Reconstr Surg 2019; 145:220e-224e. [PMID: 31625986 DOI: 10.1097/prs.0000000000006359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Kirby RS, Mai CT, Wingate MS, Janevic T, Copeland GE, Flood TJ, Isenburg J, Canfield MA. Prevalence of selected birth defects by maternal nativity status, United States, 1999-2007. Birth Defects Res 2019; 111:630-639. [PMID: 30920179 DOI: 10.1002/bdr2.1489] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/10/2019] [Accepted: 02/21/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES We investigated differences in prevalence of major birth defects by maternal nativity within racial/ethnic groups for 27 major birth defects. METHODS Data from 11 population-based birth defects surveillance systems in the United States including almost 13 million live births (approximately a third of U.S. births) during 1999-2007 were pooled. We calculated prevalence estimates for each birth defect for five racial/ethnic groups. Using Poisson regression, crude and adjusted prevalence ratios (aPRs) were also calculated using births to US-born mothers as the referent group in each racial/ethnic group. RESULTS Approximately 20% of case mothers and 26% of all mothers were foreign-born. Elevated aPRs for infants with foreign-born mothers were found for spina bifida and trisomy 13, 18, and 21, while lower prevalence patterns were found for pyloric stenosis, gastroschisis, and hypospadias. CONCLUSIONS This study demonstrates that birth defects prevalence varies by nativity within race/ethnic groups, with elevated prevalence ratios for some specific conditions and lower prevalence for others. More detailed analyses focusing on a broader range of maternal behaviors and characteristics are required to fully understand the implications of our findings.
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Affiliation(s)
- Russell S Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - Cara T Mai
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Martha S Wingate
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Teresa Janevic
- Department of Obstetrics, Gynecology and Reproductive Science, Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Population Health Science and Policy, Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Glenn E Copeland
- Michigan Birth Defects Surveillance Program, Michigan Department of Health and Human Services, Lansing, Michigan
| | - Timothy J Flood
- Arizona Birth Defects Monitoring Program, Arizona Department of Health Services, Phoenix, Arizona
| | - Jennifer Isenburg
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
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