Racial/ethnic variations in the prevalence of selected major birth defects, metropolitan Atlanta, 1994-2005.
OBJECTIVE
Birth defects are the leading cause of infant mortality and are responsible for substantial child and adult morbidity. Documenting the variation in prevalence of birth defects among racial/ethnic subpopulations is critical for assessing possible variations in diagnosis, case ascertainment, or risk factors among such groups.


METHODS
We used data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects registry with active case ascertainment. We estimated the racial/ethnic variation in prevalence of 46 selected major birth defects among live births, stillbirths, and pregnancy terminations at >20 weeks gestation among mothers residing in the five central counties of metropolitan Atlanta between 1994 and 2005, adjusting for infant sex, maternal age, gravidity, and socioeconomic status (SES). We also explored SES as a potential effect measure modifier.


RESULTS
Compared with births to non-Hispanic white women, births to non-Hispanic black women had a significantly higher prevalence of five birth defects and a significantly lower prevalence of 10 birth defects, while births to Hispanic women had a significantly higher prevalence of four birth defects and a significantly lower prevalence of six birth defects. The racial/ethnic disparities in the prevalence of some defects varied by SES, but no clear pattern emerged.


CONCLUSIONS
Racial/ethnic disparities were suggested in 57% of included birth defects. Disparities in the prevalence of birth defects may result from different underlying genetic susceptibilities; exposure to risk factors; or variability in case diagnosis, ascertainment, or reporting among the subpopulations examined. Policies that improve early diagnosis of birth defects could reduce associated morbidity and mortality.
Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA 30333, USA. jkucik@cdc.gov
James E
JE
Kucik
Clinton J
CJ
Alverson
Suzanne M
SM
Gilboa
Adolfo
A
Correa
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000013:Congenital Abnormalities / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D005845:Georgia / Q000453:epidemiology; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D011247:Pregnancy; D015995:Prevalence; D012042:Registries; D012923:Social Class; D014505:Urban Population; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult