Objective: We examined differences in the prevalence of TEF and rectal atresia among three racial groups, Non-Hispanic Whites (NHW), African Americans (AA), and Mexicans (MX). Method: The study population was derived from the U.S. Birth Cohort of 1990. The study population consisted of three groups, NHW (N=2,630,513), AA (N=661,934), and MX(N=389,578).Approximately 10% of NHW, 12% of AA, and 6% of MX births did not have information on the congenital anomalies in this study. Crude and maternal age-adjusted odds ratios for TEF and rectal atresia were estimated for these three racial groups using logistic regression. Results: Prevalence of TEF was 17.8 [95% CI, 16.2-19.6) in NHW, 10.7 [95% CI, 8.2-13.7] in AA and 11.7 [95% CI, 8.5-15.8] in MX per 100,000 live births. Prevalence of rectal atresia was 12.3 [95% CI, 10.9-13.8] in NHW, 6.7 [95% CI, 4.8-9.2] in AA, and 7.6 [95% CI, 5.0-11.0) in MX per 100,000 live births. Age-adjusted odds ratio of TEF was 36% lower in MX and 42% lower in AA as compared to NHW (Table). Age-adjusted odds ratio of rectal atresia was 40% lower in MX and 48% lower in AA as compared to NHW. The effect of maternal age on the risk of TEF was curvilinear with increased risks for mothers who were <25 years of age and particularly for mothers who were >40 years of age, as compared with mothers 25-29 years of age [Odds Ratio,3.29, 95% CI, 1.93-5.63]. For rectal atresia, the only significant increase with age occurred in mothers ≥45 years of age [Odds Ratio: 8.1, 95% CI, 1.1-58.4]. Conclusion: The age-adjusted birth prevalence of TEF and rectal atresia is lower in AA and MX infants as compared to NHW.

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