title: Racial differences in infant mortality attributable to birth defects in the United States, 1989-2002.
abstract: BACKGROUND
  The objective is to study racial differences in infant mortality attributable to birth defects (IMBD) in the United States.
  
  
  METHODS
  We analyzed 1989-1991 and 1995-2002 linked birth/death files for trends and racial differences in IMBD by selected categories of birth defects for infants of non-Hispanic white, non-Hispanic black, and Hispanic mothers.
  
  
  RESULTS
  In 1989-2002, the IMBD rates declined. However, the decline in postneonatal mortality attributable to birth defects (PMBD) rate was significantly slower than that of overall postneonatal mortality. The adjusted rate ratio for non-Hispanic black and Hispanic versus non-Hispanic white for neonatal mortality attributable to birth defects (NMBD) remained unchanged from 1989-1991 through 2000-2002. For PMBD, it increased from 0.97 (95% confidence interval [CI], 0.90-1.13) in 1989-1991 to 1.12 (95% CI, 1.04-1.21) in 2001-2002 and from 1.08 (95% CI, 1.00-1.16) to 1.18 (95% CI, 1.10-1.27) for non-Hispanic black and Hispanic, respectively. Infant mortality due to cardiovascular and central nervous system defects were the main contributors to the increased racial disparities in PMBD rates.
  
  
  CONCLUSIONS
  The disparity in PMBD between infants of non-Hispanic black and Hispanic mothers and infants of non-Hispanic white mothers increased significantly from 1989-1991 to 2000-2002. Further studies are needed to assess the extent to which delays in care or lack of access to care for infants with birth defects might be contributing to the disparity in IMBD.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333, USA. qay0@cdc.gov
authors.forename: Quanhe
authors.initials: Q
authors.lastname: Yang
authors.forename: Huichao
authors.initials: H
authors.lastname: Chen
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
authors.forename: Owen
authors.initials: O
authors.lastname: Devine
authors.forename: T J
authors.initials: TJ
authors.lastname: Mathews
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Honein
mesh_terms: D018376:Cardiovascular Abnormalities / Q000208:ethnology* / Q000401:mortality*; D002423:Cause of Death; D005006:Ethnicity; D006297:Health Services Accessibility; D006801:Humans; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008297:Male; D009421:Nervous System Malformations / Q000208:ethnology* / Q000401:mortality*; D044469:Racial Groups; D012189:Retrospective Studies; D014481:United States