Distribution of congenital anomalies by race/ethnicity and geospatial location in Oklahoma, 1997-2009.

Birth Defects Res

Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Published: February 2020

AI Article Synopsis

  • Congenital anomalies were the leading cause of infant mortality in 2016, accounting for 23% of deaths in Oklahoma and 21% in the USA, prompting a study on their prevalence by race/ethnicity and geography.
  • The research analyzed 648,074 live births in Oklahoma from 1997 to 2009, calculating prevalence ratios and assessing spatial clustering of specific anomalies like neural tube defects and congenital heart defects.
  • Findings revealed lower prevalence rates of anomalies in Non-Hispanic African American, Asian/Pacific Islander, and Hispanic children compared to Non-Hispanic white children, while American Indian/Alaska Native children had similar rates; however, differences existed among specific anomaly types

Article Abstract

Introduction: Congenital anomalies were the leading cause of infant mortality, responsible for 23 and 21% of deaths in Oklahoma and the USA, respectively, in 2016. We aimed to determine the prevalence by race/ethnicity and spatial distribution of congenital anomalies to identify geographic and racial/ethnic disparities, particularly among American Indian/Alaska Natives (AI/AN).

Methods: We evaluated the prevalence of anomalies by type and race/ethnicity among 648,074 live births in Oklahoma from 1997 to 2009. Prevalence proportion ratios (PPRs) and 95% confidence intervals (CIs) were calculated using Poisson regression. We used Moran's I and Getis-Ord Gi* to evaluate spatial clustering for neural tube defects, critical congenital heart defects (CCHDs), and oral clefts among births whose residence geocoded to the ZIP code or finer level.

Results: Overall prevalence of anomalies among live births was 3.9%. Non-Hispanic (NH) African American (PPR: 0.87, 95% CI: 0.83, 0.91), Asian/Pacific Islander (PPR: 0.70, 95% CI: 0.63, 0.78), and Hispanic (PPR: 0.87, 95% CI: 0.83, 0.91) children had a lower prevalence of anomalies compared to NH whites. The prevalence in NH AI/AN children was similar to NH whites (PPR: 1.01, 95% CI: 0.97, 1.05). However, differences in specific types of anomalies were observed by race/ethnicity. We observed no spatial autocorrelation for CCHD and oral clefts. Neural tube defects demonstrated spatial autocorrelation (p < .0001). Local hot spots varied by anomaly.

Discussion: The prevalence of anomalies by race/ethnicity and geography differed by race/ethnicity and region, though this varied by anomaly. Additional research is needed to identify behavioral or environmental factors to target for prevention.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057226PMC
http://dx.doi.org/10.1002/bdr2.1631DOI Listing

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