Mortality throughout early childhood for Michigan children born with congenital anomalies, 1992-1998.
BACKGROUND
Congenital anomalies are a leading cause of infant deaths, accounting for almost a fifth of all infant deaths. Few studies have researched the survival experience of infants born with congenital anomalies past the infant stage.


METHODS
Using birth and death files routinely linked to the Michigan Birth Defects Registry, we identified all singleton infants during calendar years 1992 through 1998 with reportable congenital anomalies for our study. A comparative file of children born without congenital anomalies during the same time period was developed using linked birth and death files. The mortality data were assessed by age at death (through age six) and race to determine mortality rates, relative risks, hazard ratios, and survival trends.


RESULTS
Throughout early childhood, children born with congenital anomalies had a high risk of mortality compared with all other children. The overall 7-year hazard ratio comparing children with congenital anomalies with all other children was 7.2. Overall mortality rates for black children were significantly higher than white children through the age of seven, irrespective of whether they had congenital anomalies. Among children with congenital anomalies, this disparity disappeared after adjusting for birth weight, sex, mother's age, mother's education, and number of organ systems affected.


CONCLUSIONS
Compared with children without congenital anomalies, children born with congenital anomalies had a higher risk of mortality well beyond the infant period. Racial disparities in mortality rates among children with congenital anomalies were due to confounding factors.
Berger
Katherine H
KH
Epidemiology Services Division, Bureau of Epidemiology, Michigan Department of Community Health, Lansing, Michigan 48909, USA.
Zhu
Bao-Ping
BP
Copeland
Glenn
G
D017677:Age Distribution; D001719:Birth Certificates; D001724:Birth Weight; D044383:Black People; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality*; D003644:Death Certificates; D005260:Female; D006801:Humans; D007223:Infant; D008423:Maternal Age; D008498:Medical Record Linkage; D008824:Michigan / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D017678:Sex Distribution; D044465:White People; D001741:Black or African American