Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Birth Defects Res. 2019 Jul 1;111(11):630-639. doi: 10.1002/bdr2.1489. Epub 2019 Mar 28.
We investigated differences in prevalence of major birth defects by maternal nativity within racial/ethnic groups for 27 major birth defects.
Data from 11 population-based birth defects surveillance systems in the United States including almost 13 million live births (approximately a third of U.S. births) during 1999-2007 were pooled. We calculated prevalence estimates for each birth defect for five racial/ethnic groups. Using Poisson regression, crude and adjusted prevalence ratios (aPRs) were also calculated using births to US-born mothers as the referent group in each racial/ethnic group.
Approximately 20% of case mothers and 26% of all mothers were foreign-born. Elevated aPRs for infants with foreign-born mothers were found for spina bifida and trisomy 13, 18, and 21, while lower prevalence patterns were found for pyloric stenosis, gastroschisis, and hypospadias.
This study demonstrates that birth defects prevalence varies by nativity within race/ethnic groups, with elevated prevalence ratios for some specific conditions and lower prevalence for others. More detailed analyses focusing on a broader range of maternal behaviors and characteristics are required to fully understand the implications of our findings.
我们调查了美国 11 个基于人群的出生缺陷监测系统的数据,这些系统包括了 1999 年至 2007 年期间近 1300 万活产儿(约占美国出生总数的三分之一),以研究在五个种族/族裔群体中,母亲出生地不同与主要出生缺陷患病率之间的差异。
我们计算了每个缺陷的患病率估计值,并针对每个种族/族裔群体,使用出生于美国的母亲所生的婴儿作为参照组,计算了粗患病率比(crude prevalence ratio,CPR)和调整后的患病率比(adjusted prevalence ratio,aPR)。
大约 20%的病例母亲和 26%的所有母亲是外国出生的。在五个种族/族裔群体中,外国出生母亲所生婴儿的神经管缺陷和三体 13、18 和 21 的 aPR 较高,而幽门狭窄、腹裂和尿道下裂的患病率则较低。
本研究表明,出生缺陷的患病率在不同种族/族裔群体的出生地之间存在差异,某些特定疾病的患病率比值较高,而其他疾病的患病率则较低。需要更详细地分析更广泛的母婴行为和特征,以充分理解我们研究结果的意义。