title: The association between race/ethnicity and major birth defects in the United States, 1999-2007.
abstract: OBJECTIVE
  We investigated the relationship between race/ethnicity and 27 major birth defects.
  
  
  METHODS
  We pooled data from 12 population-based birth defects surveillance systems in the United States that included 13.5 million live births (1 of 3 of US births) from 1999 to 2007. Using Poisson regression, we calculated prevalence estimates for each birth defect and 13 racial/ethnic groupings, along with crude and adjusted prevalence ratios (aPRs). Non-Hispanic Whites served as the referent group.
  
  
  RESULTS
  American Indians/Alaska Natives had a significantly higher and 50% or greater prevalence for 7 conditions (aPR = 3.97; 95% confidence interval [CI] = 2.89, 5.44 for anotia or microtia); aPRs of 1.5 to 2.1 for cleft lip, trisomy 18, and encephalocele, and lower, upper, and any limb deficiency). Cubans and Asians, especially Chinese and Asian Indians, had either significantly lower or similar prevalences of these defects compared with non-Hispanic Whites, with the exception of anotia or microtia among Chinese (aPR = 2.08; 95% CI = 1.30, 3.33) and Filipinos (aPR = 1.90; 95% CI = 1.10, 3.30) and tetralogy of Fallot among Vietnamese (aPR = 1.60; 95% CI = 1.11, 2.32).
  
  
  CONCLUSIONS
  This is the largest population-based study to our knowledge to systematically examine the prevalence of a range of major birth defects across many racial/ethnic groups, including Asian and Hispanic subgroups. The relatively high prevalence of birth defects in American Indians/Alaska Natives warrants further attention.
authors.affiliation: Mark A. Canfield and Lisa K. Marengo are with the Texas Department of State Health Services, Austin. Cara T. Mai, Alissa O'Halloran, Richard S. Olney, and C. J. Alverson are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Ying Wang is with the New York State Department of Health, Albany. Christopher L. Borger is with the Massachusetts Department of Public Health, Boston. Rachel Rutkowski is with the Florida Department of Health, Tallahassee. Jane Fornoff is with the Illinois Department of Public Health, Springfield. Nila Irwin is with the Nebraska Department of Health and Human Services, Lincoln. Glenn Copeland is with the Michigan Birth Defects Registry, Michigan Department of Community Health, Lansing. Timothy J. Flood is with the Arizona Department of Health Services, Phoenix. Robert E. Meyer is with the North Carolina Birth Defects Monitoring Program, Raleigh. Russel Rickard is with the Colorado Department of Public Health and Environment, Denver. Joseph Sweatlock is with the New Jersey Department of Health, Trenton. Russell S. Kirby is with the Department of Community and Family Health, University of South Florida, Tampa.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Canfield
authors.forename: Cara T
authors.initials: CT
authors.lastname: Mai
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Alissa
authors.initials: A
authors.lastname: O'Halloran
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Marengo
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Borger
authors.forename: Rachel
authors.initials: R
authors.lastname: Rutkowski
authors.forename: Jane
authors.initials: J
authors.lastname: Fornoff
authors.forename: Nila
authors.initials: N
authors.lastname: Irwin
authors.forename: Glenn
authors.initials: G
authors.lastname: Copeland
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Flood
authors.forename: Robert E
authors.initials: RE
authors.lastname: Meyer
authors.forename: Russel
authors.initials: R
authors.lastname: Rickard
authors.forename: C J
authors.initials: CJ
authors.lastname: Alverson
authors.forename: Joseph
authors.initials: J
authors.lastname: Sweatlock
authors.forename: Russell S
authors.initials: RS
authors.lastname: Kirby
mesh_terms: D001719:Birth Certificates; D000013:Congenital Abnormalities / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D006801:Humans; D011159:Population Surveillance; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology