Causes of neonatal and postneonatal death among infants with birth defects in Texas

Abstract

Background: The proportion of deaths attributed to various causes has not been quantified among infants with birth defects. We sought to describe the causes of neonatal and postneonatal death among infants in the Texas Birth Defects Registry. Methods: We calculated frequencies and percentages for both underlying causes and all causes (underlying or contributing) of neonatal (0-27 days) and postneonatal (28-364 days) death listed on death certificates among infants born alive with birth defects and delivered in Texas during 1999-2013 (n = 8,389 deaths). Analyses were repeated separately for infants with isolated, multiple, and syndromic defects.Results: After birth defects, the most frequently listed causes of neonatal death were preterm/low birth weight (10%), circulatory system diseases (8%), and sepsis (5%). The leading postneonatal causes of death beyond birth defects were circulatory system diseases (32%), sepsis (11%), and renal failure (7%). Conclusions: Improved understanding of the causes of mortality among infants with birth defects may help identify priorities for postnatal care. Our results suggest that potentially modifiable causes of death (e.g., circulatory system diseases, sepsis) contribute substantially to mortality in this population.Prioritizing continued improvements in prevention, diagnosis, and management of preventable conditions may reduce mortality among infants born with birth defects.

Survival of infants and children born with severe microcephaly, Texas, 1999–2015

“…We found the lowest infant survival was among infants with severe microcephaly and with co‐occurring chromosomal/syndromic associations (66.1%), followed by infants with co‐occurring multiple defects (85.8%). Benjamin et al (2021) also observed lower infant survival (83.8%) among infants with syndromic birth defects relative to infants with isolated birth defects. Sattolo et al (2022) described a correlation between multiple birth defects and higher mortality.…”

Association of Birth Defects With Child Mortality Before Age 14 Years

“…In Texas, a study of 8000 infants with birth defects found that deaths owing to circulatory, respiratory, and digestive causes were frequent before 1 year of age. 19 In another study of children with birth defects, circulatory disorders ranked as an important cause of death before age 10 years. 6 Circulatory disorders are common in children with heart defects, diaphragmatic hernia, and lung hypoplasia.…”

“…6 Circulatory disorders are common in children with heart defects, diaphragmatic hernia, and lung hypoplasia. 19 Infections such as respiratory syncytial virus can be common in children with spina bifida, lung malformations, cleft palate, and biliary atresia. 20 Prematurity can also exacerbate risks of mortality because of circulatory, respiratory, and digestive complications, 17,19,21 although birth defects were associated with these causes even when we excluded preterm births.…”

“…Compared with no defect, birth defects were associated with more than 23 times the risk of mortality from these causes. In Texas, a study of 8000 infants with birth defects found that deaths owing to circulatory, respiratory, and digestive causes were frequent before 1 year of age . In another study of children with birth defects, circulatory disorders ranked as an important cause of death before age 10 years .…”

“…In another study of children with birth defects, circulatory disorders ranked as an important cause of death before age 10 years . Circulatory disorders are common in children with heart defects, diaphragmatic hernia, and lung hypoplasia . Infections such as respiratory syncytial virus can be common in children with spina bifida, lung malformations, cleft palate, and biliary atresia .…”