Birth defect mortality in India 1990-2017: estimates from the Global Burden of Disease data.

India is yet to establish a national surveillance for birth defects (congenital disorders). The objective of this study was to describe the epidemiology of birth defects in the neonatal, post-neonatal, and 1-4-year age groups, using modelled estimates from the Global Burden of Disease (GBD) database. We extracted age- and condition-specific birth defect mortality data and analysed the magnitude and trends of these conditions in India, and across Indian states. We compared these trends with other neonatal causes of mortality for the period 1990-2017. The results indicate that birth defects caused 37,104 (95%UI 31,825-43,134) deaths in the early neonatal period and 27,120 (95%UI 23,490-30,777) deaths in the post-neonatal period in 2017 in India. These rates were double and five times higher when compared with the whole group of middle- and high-income countries respectively. There was a small decline in birth defect mortality between 1990 and 2017. However, with the exception of orofacial clefts, the proportion of deaths caused by selected birth defects increased between 1990 and 2017, relative to other causes of child mortality. In 70% of states ranked in the high and middle Socio-demographic Index (SDI) category, birth defects were the third leading cause of neonatal mortality. The analysis identifies the need for establishing birth defects services in the country. It demonstrates that modelled estimates of the GBD could be used as the best available data for understanding the epidemiology of birth defects in low- and middle-income countries till surveillance systems are put in place.