title: Population-based study to determine mortality in spina bifida: New York State Congenital Malformations Registry, 1983 to 2006.
abstract: BACKGROUND
  The lifetime risk of death among individuals with spina bifida is 10-times higher compared with the general population. A population-based analysis on cause-specific mortality among individuals spina bifida is lacking.
  
  
  METHODS
  Using statewide, population-based New York Congenital Malformations Registry, we examined all births between years 1983 and 2006, and identified 1988 births with spina bifida and 10,951 births with congenital hypertrophic pyloric stenosis (CHPS). We linked registry records to birth and death files from vital records, and determined age- and cause-specific mortality for isolated and multiple spina bifida, and compared the findings with the less fatal CHPS.
  
  
  RESULTS
  Mortality in spina bifida is significantly high compared with CHPS (16.9% vs. 0.96%, respectively). The probability of survival in spina bifida was lower compared with CHPS. A majority of the deaths in spina bifida occurred in infants within the first year of birth; however, an increased risk of death persisted in young adulthood for both isolated and multiple cases of spina bifida. The common causes of death in children with spina bifida were hydrocephalus, infections, cardiac anomalies, pneumonia, and pulmonary embolism; while infections, heart or kidney failure, injuries and neoplasms contributed to deaths in adults.
  
  
  CONCLUSIONS
  We conclude that mortality in spina bifida is a large concern, and individuals living with the defect require improved clinical care for lethal medical complications. Primary prevention of spina bifida through mandatory folic acid fortification remains as the best strategy to reduce both disability and mortality associated with this defect across the world.
authors: Center for Spina Bifida Research, Prevention and Policy, Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.
authors: Vijaya
authors: V
authors: Kancherla
authors: Charlotte M
authors: CM
authors: Druschel
authors: Godfrey P
authors: GP
authors: Oakley
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009518:New York / Q000453:epidemiology; D011159:Population Surveillance; D046248:Pyloric Stenosis, Hypertrophic / Q000453:epidemiology* / Q000401:mortality*; D012042:Registries; D016135:Spinal Dysraphism / Q000453:epidemiology* / Q000401:mortality*; D055815:Young Adult
keywords: birth defects; cause of death; congenital malformations registry; hypertrophic pyloric stenosis; long-term follow-up; mortality; spina bifida