Mortality among infants with birth defects: Joint effects of size at birth, gestational age, and maternal race/ethnicity

Nembhard, Wendy N.; Salemi, Jason L.; Ethen, Mary K.; Fixler, David E; Canfield, Mark A.

doi:10.1002/bdra.20696

Cited by 21 publications

(25 citation statements)

References 45 publications

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“…Some of the disparities (compared with white children) in eight-year outcomes were striking: an encephalocele mortality rate of 70% for AIAN children vs. 27% for white children; triple the adjusted hazards of death for AIAN and API children with encephalocele; and double the adjusted hazards of death for AA children with esophageal atresia/tracheoesophageal fistula, Latino children with common truncus, and API children with atrioventricular septal defects. These findings complement the results of several recent studies of single state registries which documented significantly higher adjusted hazards (compared with white children) of early childhood death for AAs and Latinos with major birth defects overall 19 and with several specific congenital heart defects. 20,21,22 …”

supporting

confidence: 87%

Dead Wrong: The Growing List of Racial/Ethnic Disparities in Childhood Mortality

Flores

Escala

Hall

2015

The Journal of Pediatrics

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supporting

confidence: 87%

Dead Wrong: The Growing List of Racial/Ethnic Disparities in Childhood Mortality

Flores

Escala

Hall

2015

The Journal of Pediatrics

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“…22-24 Previous literature suggests that the mortality and survival experience of children with birth defects differs by specific birth defect phenotype and by demographic factors such as maternal race/ethnicity. 12-14,25-28 Racial/ethnic disparities in infant and child mortality were found among Florida 29 and Texas infants with birth defects 25,27,28 but not among New York children (up to 25 years) with birth defects. 12 …”

mentioning

confidence: 93%

Racial/Ethnic Differences in Survival of United States Children with Birth Defects: A Population-Based Study

Wang¹,

Liu

Canfield

et al. 2015

The Journal of Pediatrics

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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.

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“…15 We identified non-white maternal race as an independent risk factor associated with increased hospital mortality in our population of infants with selected severe CHDs. This finding deserves further evaluation.…”

Section: (33%)mentioning

confidence: 89%

The effect of late preterm birth on mortality of infants with major congenital heart defects

et al. 2011

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Objective: We evaluated the effect of late preterm delivery (34 to 36 weeks) on hospital mortality of infants with congenital heart defects (CHDs).Study Design: Retrospective record review of infants with major CHD born at or after to 34 weeks, cared for in a single tertiary perinatal center between 2002 and 2009. Factors associated with death before discharge from the hospital were ascertained using univariate and multivariate analyses.Result: Of the 753 infants with CHD, 117 were born at late preterm. Using logistic regression analysis, white race (OR; 95% CI) (0.60; 0.39 to 0.95), late preterm delivery (2.70; 1.69 to 4.33), and need for intubation in the delivery room (3.15; 1.92 to 5.17) were independently associated with hospital death. Conclusion:Late preterm birth of infants with major CHDs was independently associated with increased risk of hospital death compared with delivery at more mature gestational ages.

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Mortality among infants with birth defects: Joint effects of size at birth, gestational age, and maternal race/ethnicity

Abstract: The joint effect of gestational age and size at birth had greatest impact on childhood mortality. Additional population based studies are needed to better understand causes of racial/ethnic disparities in mortality among children with birth defects.

Cited by 21 publications

References 45 publications

Dead Wrong: The Growing List of Racial/Ethnic Disparities in Childhood Mortality

Dead Wrong: The Growing List of Racial/Ethnic Disparities in Childhood Mortality

Racial/Ethnic Differences in Survival of United States Children with Birth Defects: A Population-Based Study

The effect of late preterm birth on mortality of infants with major congenital heart defects

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