title: Sickle cell disease incidence among newborns in New York State by maternal race/ethnicity and nativity.
abstract: OBJECTIVE
  Sickle cell disease is estimated to occur in 1:300-400 African-American births, with higher rates among immigrants from Africa and the Caribbean, and is less common among Hispanic births. This study determined sickle cell disease incidence among New York State newborns stratified by maternal race/ethnicity and nativity.
  
  
  METHODS
  Newborns with confirmed sickle cell disease born to New York State residents were identified by the New York State newborn screening program for the years 2000-2008 and matched to birth records to obtain birth and maternal information. Annual incidence rates were computed and bivariate analyses were conducted to examine associations with maternal race/ethnicity and nativity.
  
  
  RESULTS
  From 2000 to 2008, 1,911 New York State newborns were diagnosed with sickle cell disease and matched to the birth certificate files. One in every 1,146 live births was diagnosed with sickle cell disease. Newborns of non-Hispanic black mothers accounted for 86% of sickle cell disease cases whereas newborns of Hispanic mothers accounted for 12% of cases. The estimated incidence was 1:230 live births for non-Hispanic black mothers, 1:2,320 births for Hispanic mothers, and 1:41,647 births for non-Hispanic white mothers. Newborns of foreign-born non-Hispanic black mothers had a twofold higher incidence of sickle cell disease than those born to US-born non-Hispanic black mothers (P < 0.001).
  
  
  CONCLUSIONS
  This study provides the first US estimates of sickle cell disease incidence by maternal nativity. Women born outside the United States account for the majority of children with sickle cell disease born in New York State. Such findings identify at-risk populations and inform outreach activities that promote ongoing, high-quality medical management to affected children.
authors.affiliation: The Congenital Malformations Registry, Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, New York, USA. wxy01@health.state.ny.us
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Joseph
authors.initials: J
authors.lastname: Kennedy
authors.forename: Michele
authors.initials: M
authors.lastname: Caggana
authors.forename: Regina
authors.initials: R
authors.lastname: Zimmerman
authors.forename: Sanil
authors.initials: S
authors.lastname: Thomas
authors.forename: John
authors.initials: J
authors.lastname: Berninger
authors.forename: Katharine
authors.initials: K
authors.lastname: Harris
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Green
authors.forename: Suzette
authors.initials: S
authors.lastname: Oyeku
authors.forename: Mary
authors.initials: M
authors.lastname: Hulihan
authors.forename: Althea M
authors.initials: AM
authors.lastname: Grant
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology / Q000208:ethnology; D012111:Residence Characteristics; D055815:Young Adult