Abstract
Objective:
Birth defects are number one cause of death among infants below 1 year of age. The objective is to examine the interaction of sex, race/ethnicity and place of birth on the prevalence of major congenital birth anomalies.
Study Design:
We analyzed the data sets produced by the Healthcare Cost and Utilization Project (HCUP) for the years 1997–2004. We identified the malformations: congenital diaphragmatic hernia (CDH), abdominal wall defects (AWD) and neural tube defects (NTD) using their respective International Classification of Disease 9 diagnostic codes. Newborns were classified according to their birth region into four groups; Northeast, South, Midwest and West. We calculated prevalence of each disease for the overall sample then for every sex, race and birth region. Using stratified analysis and χ2 test, we calculated the odds ratio (OR) risk for each disease comparing females with males, different races/ethnicity to Caucasians and different US regions to Northeast.
Result:
There were 1291 newborns with CDH representing 0.031% of the sample. (AWD: 2184 (0.052%) and NTD: 979 (0.024%)). West region had the highest prevalence of CDH (OR=1.62 (confidence intervals (CI): 1.4–1.9, P<0.001)). Female-to-male risk disparities were most observed among Caucasians in the South (OR=1.44 (CI: 1.1–1.8, P=0.003)). African Americans had the least prevalence of CDH but only in the South (OR=0.67 (CI: 0.5–0.8, P=0.001)). Native Americans had higher risk for AWD in the Midwest and West regions compared with Caucasians.
Conclusion:
This study links the birth region as a detrimental factor like sex and race in the prevalence of CDH, AWD and NTD. These findings implicate a possible role for environmental factors in the pathogenesis of these diseases.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Heron M, Hoyert D, Murphy S, Xu J, Kochanek K, Tejada-Vera B . Deaths: final data for 2006. National Vital Statistics Report, Vol 57 (14). Division of Vital Statistics: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf.
March of Dimes: Global Report on Birth Defects. http://www.marchofdimes.com/downloads/Birth_Defects_Report-PF.pdf.
Lobo I, Zhaurova K . Birth Defects: causes and Statistics: 2008. http://www.nature.com/scitable/topicpage/birth-defects-causes-and-statistics-86.
Birth Defect Statistics. Physician Committee for Responsible Medicine. http://www.pcrm.org/resch/humres/birthdefects.html.
Sola J, Bronson S, Cheung M, Ordonez B, Neville H, Koniaris L . Survival disparities in newborns with congenital diaphragmatic hernia: a national perspective. J Pediatr Surg 2010; 45: 1336–1342.
Stege G, Fenton A, Jaffray B . Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia. Pediatrics 2003; 113 (3): 532–535.
Holder A, Klaassens M, Tibboel D, de Klein A, Lee B, Scott DA . Genetic factors in congenital diaphragmatic hernia. Am J Hum Genet 2007; 80 (5): 825–845.
Greer J, Allan D, Babiuk R, Lemke R . Recent advances in understanding the pathogenesis of nitrofen-induced-congenital diaphragmatic hernia. Pediatr Pulmonol 2000; 29 (5): 394–399.
Yang W, Carmichael S, Harris J, Shaw G . Epidemiologic characteristics of congenital diaphragmatic hernia among 2.5 million California births, 1989–1997. Birth Defects Res (Part A) 2006; 76: 170–174.
Colvin J, Bower C, Dickinson JE, Sokol J . Outcomes of congenital diaphragmatic hernia: a population-based study in Western Australia. Pediatrics 2005; 116 (3): 356–363.
Glasser J . Omphalocele and gastroschisis. eMedicine 2009. http://emedicine.medscape.com/article/975583-overview#showall.
Bird T, Robbins J, Druschel C . Demographic and environmental risk factors for gastroschisis and omphalocele in the National Birth Defects Prevention Study. Pediatr Surg 2009; 44: 1546–1551.
Mathew L, Robert M, Carl B, Alison W, Eduardo O, Ann H et al. Rising birth prevalence of gastroschisis. J Perinatol 2003; 23: 291–293.
Castilla EE, Mastrojacovo P, Orioli IM . Gastroschisis: international epidemiology and public health perspectives. Am J Med Genet C Semin Med Genet 2008; 148C: 162–179.
Hougland KT, Hanna AM, Meyers R, Null D . Increasing prevalence of gastroschisis in Utah. J Pediatric Surg 2005; 40: 535–540.
Vu L, Nobuhara K, Laurent C, Shaw GM . Increasing prevalence of gastroschisis: population-based study in California. J Pediatr 2008; 152: 807–811.
Root E, Meyer R, Emch M . Evidence of localized clustering of gastroschisis births in North Carolina, 1999–2004. Soc Sci Med 2009; 68 (8): 1361–1367.
Loane M, Dolk H, Bradbury I . Increasing prevalence of gastroschisis in Europe 1980–2002: a phenomenon restricted to younger mothers? Pediatr Perinat Epidemiol 2007; 21 (4): 363–369.
Marcia F, Micheal F, John C . Decreasing prevalence of neural tube defects in Utah: 1985–2000. Teratology 2002; 66: S23–S28.
Amanda M, Sean F . Neural tube defects: is a decreasing prevalence associated with a decrease in severity. Eur J Obstet Gynecol Reprod Biol 2005; 119: 161–163.
Boulet S, Gambrell D, Shin M, Mathews T, Honein, M . Racial/ethnic differences in the birth prevalence of spina bifida—United States, 1995–2005. JAMA 2009; 301 (21): 2203–2204.
Grech V, Agius-Muscat H, Savona-Ventura C, Pace J . Regional differences in the birth prevalence of congenital heart disease in Malta. Cardiol Young 1999; 9: 150–154.
Samánek M, Slavík Z, Balatka J, Bartáková H, Goetzová J, Homola J et al. Regional differences in the prevalence of congenital heart defects. Cesk Pediatr 1991; 46 (2): 65–70.
NIS Data from HCUP. http://www.hcup-us.ahrq.gov/nisoverview.jsp, accessed 1 January 2011.
KID Data from HCUP. http://www.hcup-us.ahrq.gov/kidoverview.jsp, accessed 1 January 2011.
US Census Bureau. http://www.census.gov/geo/www/us_regdiv.pdf, accessed 3 January 2011.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Additional information
Supplementary Information accompanies the paper on the Journal of Perinatology website
Supplementary information
Rights and permissions
About this article
Cite this article
Mohamed, M., Aly, H. Birth region, race and sex may affect the prevalence of congenital diaphragmatic hernia, abdominal wall and neural tube defects among US newborns. J Perinatol 32, 861–868 (2012). https://doi.org/10.1038/jp.2011.184
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2011.184
Keywords
This article is cited by
-
Epidemiology of congenital diaphragmatic hernia among 24 million Chinese births: a hospital-based surveillance study
World Journal of Pediatrics (2023)
-
Transamniotic stem cell therapy: a novel strategy for the prenatal management of congenital anomalies
Pediatric Research (2018)
-
Clinical features and practice patterns of gastroschisis: a retrospective analysis using a Japanese national inpatient database
Pediatric Surgery International (2018)
-
Association between ALDH1L1 gene polymorphism and neural tube defects in the Chinese Han population
Neurological Sciences (2016)