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Birth Defects Res. 2018 Nov 15;110(19):1412-1418. doi: 10.1002/bdr2.1397. Epub 2018 Nov 6.

Study of selected birth defects among American Indian/Alaska Native population: A multi-state population-based retrospective study, 1999-2007.

Author information

1
Texas Department of State Health Services, Austin, Texas.
2
Arizona Department of Health Services, Phoeniz, Arizona.
3
Department of Community and Family Health, University of South Florida, Tampa, Florida.
4
New York State Department of Health, Albany, New York.
5
Michigan Birth Defects Registry, Michigan Department of Community Health, Lansing, Michigan.
6
North Carolina Birth Defects Monitoring Program, Raleigh, North Carolina.
7
Massachusetts Department of Public Health, Boston, Massachusetts.
8
Association of American Indian Physicians, Formerly Oklahoma Area Tribal Epidemiology Center and Southern Plains Tribal Health Board, Oklahoma City, Oklahoma.
9
Navajo Epidemiology Center, Navajo Nation Department of Health, Window Rock, Arizona.
10
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.

Abstract

BACKGROUND:

Higher prevalence of selected birth defects has been reported among American Indian/Alaska Native (AI/AN) newborns. We examine whether known risk factors for birth defects explain the higher prevalence observed for selected birth defects among this population.

METHODS:

Data from 12 population-based birth defects surveillance systems, covering a birth population of 11 million from 1999 to 2007, were used to examine prevalence of birth defects that have previously been reported to have elevated prevalence among AI/ANs. Prevalence ratios (PRs) were calculated for non-Hispanic AI/ANs and any AI/ANs (regardless of Hispanic ethnicity), adjusting for maternal age, education, diabetes, and smoking, as well as type of case-finding ascertainment surveillance system.

RESULTS:

After adjustment, the birth prevalence of two of seven birth defects remained significantly elevated among AI/ANs compared to non-Hispanic whites (NHWs): anotia/microtia was almost threefold higher, and cleft lip +/- cleft palate was almost 70% higher compared to NHWs. Excluding AI/AN subjects who were also Hispanic had only a negligible impact on adjusted PRs.

CONCLUSIONS:

Additional covariates accounted for some of the elevated birth defect prevalences among AI/ANs compared to NHWs. Exclusion of Hispanic ethnicity from the AI/AN category had little impact on birth defects prevalences in AI/ANs. NHWs serve as a viable comparison group for analysis. Birth defects among AI/ANs require additional scrutiny to identify modifiable risk and protective factors.

KEYWORDS:

Alaska Natives; American Indians; birth defects surveillance; congenital abnormalities; population health

PMID:
30403007
DOI:
10.1002/bdr2.1397

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