Risk for birth defects among premature infants: a population-based study.
OBJECTIVE
To investigate the relationship between prematurity and birth defects.


METHODS
In a population-based cohort study, infants with birth defects were ascertained through the Metropolitan Atlanta Congenital Defects Program, a surveillance system with active methods of ascertainment. Gestational age data were obtained from birth certificates of liveborn, singleton infants with and without birth defects born in the 5-county metropolitan Atlanta area.


RESULTS
Among 264,392 infants with known gestational ages born between 1989 and 1995, 7738 were identified as having birth defects (2.93%). Premature infants (<37 weeks' gestation) were more than two times as likely to have birth defects than term infants (37-41 weeks) (risk ratio = 2.43; 95% CI 2.30-2.56). This relationship was evident for several categories of birth defects. The rate of birth defects varied by gestational age categories, with the highest risk in the 29- to 32-week gestational age category (risk ratio = 3.37).


CONCLUSIONS
The risk for birth defects is increased in premature infants. Awareness of this relationship is important for clinicians caring for premature infants. The morbidity and mortality associated with a particular defect may be significantly altered by the presence of prematurity. Further study of this association may provide insight into the etiology of these relatively common problems.
Rasmussen
S A
SA
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Moore
C A
CA
Paulozzi
L J
LJ
Rhodenhiser
E P
EP
D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000145:classification / Q000453:epidemiology*; D005845:Georgia / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016017:Odds Ratio; D012307:Risk Factors; D014481:United States / Q000453:epidemiology