Patterns of first-year survival among infants with selected congenital anomalies in Texas, 1995-1997.
BACKGROUND
Few registry-based studies have investigated survival among infants with congenital anomalies. We conducted a registry-based study to examine patterns and probability of survival during the first year of life among infants with selected congenital anomalies.


METHODS
Data from the Texas Birth Defects Monitoring Division were merged with linked birth-infant death files for 2,774 infants born January 1, 1995 to December 31, 1997, with at least 1 of 23 common anomalies. Deaths before the first birthday were assessed from infant death files. Kaplan-Meier was used to estimate first-year survival; first-year survival was assessed for specific anomalies and by the number of life-threatening anomalies.


RESULTS
Overall, 80.8% of infants with these 23 anomalies survived the first year of life. We observed the highest survival rates for infants with gastroschisis (92.9%, 95% CI = 86.8, 96.3), trisomy 21 (92.3%, 95% CI = 89.5, 94.4) or cleft lip with or without cleft palate (87.6%, 95% CI = 84.0, 90.5). Infants with intermediate survival rates included those with microcephaly (79.7%; 95% CI = 73.6, 84.6), tetralogy of Fallot (75.0%; 95% CI = 65.5, 82.2), or with diaphragmatic hernia (72.8%; 95% CI = 61.8, 81.2). As expected, all infants with anencephaly and almost all infants with trisomy 13 or trisomy 18 died during the first year of life. First-year survival declined as the number of co-occurring life-threatening anomalies increased.


CONCLUSIONS
Overall, first-year survival for infants with congenital anomalies was high. Additional population-based studies are needed to quantify improvements in first-year survival.
Nembhard
W N
WN
University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas 77030, USA. wnem@msm.edu
Waller
D K
DK
Sever
L E
LE
Canfield
M A
MA
D000015:Abnormalities, Multiple / Q000453:epidemiology / Q000401:mortality*; D002971:Cleft Lip / Q000401:mortality; D002972:Cleft Palate / Q000401:mortality; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000401:mortality*; D004314:Down Syndrome / Q000401:mortality; D020139:Gastroschisis / Q000401:mortality; D006548:Hernia, Diaphragmatic / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008831:Microcephaly / Q000401:mortality; D012042:Registries; D013771:Tetralogy of Fallot / Q000401:mortality; D013781:Texas; D013997:Time Factors