title: Racial/ethnic differences in survival of United States children with birth defects: a population-based study.
abstract: OBJECTIVE
  To examine racial/ethnic-specific survival of children with major birth defects in the US.
  
  
  METHODS
  We pooled data on live births delivered during 1999-2007 with any of 21 birth defects from 12 population-based birth defects surveillance programs. We used the Kaplan-Meier method to calculate cumulative survival probabilities and Cox proportional hazards models to estimate mortality risk.
  
  
  RESULTS
  For most birth defects, there were small-to-moderate differences in neonatal (<28 days) survival among racial/ethnic groups. However, compared with children born to non-Hispanic white mothers, postneonatal infant (28 days to <1 year) mortality risk was significantly greater among children born to non-Hispanic black mothers for 13 of 21 defects (hazard ratios [HRs] 1.3-2.8) and among children born to Hispanic mothers for 10 of 21 defects (HRs 1.3-1.7). Compared with children born to non-Hispanic white mothers, a significantly increased childhood (≤ 8 years) mortality risk was found among children born to Asian/Pacific Islander mothers for encephalocele (HR 2.6), tetralogy of Fallot, and atrioventricular septal defect (HRs 1.6-1.8) and among children born to American Indian/Alaska Native mothers for encephalocele (HR 2.8), whereas a significantly decreased childhood mortality risk was found among children born to Asian/Pacific Islander mothers for cleft lip with or without cleft palate (HR 0.6).
  
  
  CONCLUSIONS
  Children with birth defects born to non-Hispanic black and Hispanic mothers carry a greater risk of mortality well into childhood, especially children with congenital heart defect. Understanding survival differences among racial/ethnic groups provides important information for policy development and service planning.
authors: Division of Data Analysis and Research, Office of Primary Care and Health System Management, New York State Department of Health, Albany, NY. Electronic address: ying.wang@health.ny.gov.
authors: Ying
authors: Y
authors: Wang
authors: Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY.
authors: Gang
authors: G
authors: Liu
authors: Texas Department of State Health Services, Austin, TX.
authors: Mark A
authors: MA
authors: Canfield
authors: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Cara T
authors: CT
authors: Mai
authors: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Suzanne M
authors: SM
authors: Gilboa
authors: North Carolina Birth Defects Monitoring Program, Raleigh, NC.
authors: Robert E
authors: RE
authors: Meyer
authors: Massachusetts Department of Public Health, Boston, MA.
authors: Marlene
authors: M
authors: Anderka
authors: Michigan Birth Defects Registry, Michigan Department of Community Health, Lansing, MI.
authors: Glenn E
authors: GE
authors: Copeland
authors: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors: James E
authors: JE
authors: Kucik
authors: Arkansas Reproductive Health Monitoring System, Arkansas Children's Hospital Research Institute & University of Arkansas for Medical Sciences, Little Rock, AR.
authors: Wendy N
authors: WN
authors: Nembhard
authors: Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL.
authors: Russell S
authors: RS
authors: Kirby
mesh_terms: D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
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