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J Pediatr. 2015 Apr;166(4):819-26.e1-2. doi: 10.1016/j.jpeds.2014.12.025. Epub 2015 Jan 29.

Racial/ethnic differences in survival of United States children with birth defects: a population-based study.

Author information

1
Division of Data Analysis and Research, Office of Primary Care and Health System Management, New York State Department of Health, Albany, NY. Electronic address: ying.wang@health.ny.gov.
2
Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY.
3
Texas Department of State Health Services, Austin, TX.
4
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
5
North Carolina Birth Defects Monitoring Program, Raleigh, NC.
6
Massachusetts Department of Public Health, Boston, MA.
7
Michigan Birth Defects Registry, Michigan Department of Community Health, Lansing, MI.
8
Arkansas Reproductive Health Monitoring System, Arkansas Children's Hospital Research Institute & University of Arkansas for Medical Sciences, Little Rock, AR.
9
Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL.

Abstract

OBJECTIVES:

To examine racial/ethnic-specific survival of children with major birth defects in the US.

STUDY DESIGN:

We pooled data on live births delivered during 1999-2007 with any of 21 birth defects from 12 population-based birth defects surveillance programs. We used the Kaplan-Meier method to calculate cumulative survival probabilities and Cox proportional hazards models to estimate mortality risk.

RESULTS:

For most birth defects, there were small-to-moderate differences in neonatal (<28 days) survival among racial/ethnic groups. However, compared with children born to non-Hispanic white mothers, postneonatal infant (28 days to <1 year) mortality risk was significantly greater among children born to non-Hispanic black mothers for 13 of 21 defects (hazard ratios [HRs] 1.3-2.8) and among children born to Hispanic mothers for 10 of 21 defects (HRs 1.3-1.7). Compared with children born to non-Hispanic white mothers, a significantly increased childhood (≤ 8 years) mortality risk was found among children born to Asian/Pacific Islander mothers for encephalocele (HR 2.6), tetralogy of Fallot, and atrioventricular septal defect (HRs 1.6-1.8) and among children born to American Indian/Alaska Native mothers for encephalocele (HR 2.8), whereas a significantly decreased childhood mortality risk was found among children born to Asian/Pacific Islander mothers for cleft lip with or without cleft palate (HR 0.6).

CONCLUSION:

Children with birth defects born to non-Hispanic black and Hispanic mothers carry a greater risk of mortality well into childhood, especially children with congenital heart defect. Understanding survival differences among racial/ethnic groups provides important information for policy development and service planning.

PMID:
25641238
PMCID:
PMC4696483
DOI:
10.1016/j.jpeds.2014.12.025
[Indexed for MEDLINE]
Free PMC Article

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