Contribution of birth defects to infant mortality in the United States

Petrini, Joann; Damus, Karla; Russell, Rebecca; Poschman, Karalee; Davidoff, Michael J.; Mattison, Donald R.

doi:10.1002/tera.90002

Cited by 136 publications

(97 citation statements)

References 2 publications

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“…9 In this study most patients admitted with congenital heart defects were infants, followed by toddlers and preschoolers. Only 7.8% children were enrolled who reached puberty and adolescent in >10 years age group.…”

Section: Discussionmentioning

confidence: 72%

Comorbidities with Congenital Heart Disease among Hospitalized Children in a Specialized Cardiac Hospital in Bangladesh

Mita¹,

Salim

Haque

et al. 2017

Cardiovasc. j.

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Background: Congenital heart diseases (CHD) when associated with any comorbid condition may complicate the outcome of management. So to find out and treat comorbidities before definite treatment is essential for better outcome. Methods: This observational cross sectional study was conducted in the inpatient Department of Paediatric Cardiology at National Institute of Cardiovascular Diseases, Dhaka, during the period of January 2014 to January 2015 to identify the comorbid conditions of congenital heart disease.Results: A total of 794 children with different types of congenital heart disease were enrolled during the study period. Among them, 48.6% were simple CHD and 51.4% were complex CHD. Among simple CHD, ventricular septal defect (VSD) was commonest (27.2%), Tetralogy of Fallot (TOF) occupied the second position (20.5%). One child presented with Ectopia cardis. Among complex CHD most common anomalies were VSD with either atrial septal defect (ASD) or patent ductus arteriosus (PDA) or valvular lesion. Next common anomalies were TOF with PDA or ASD &/or pulmonary valvular abnormalities. Double outlet of right ventricle (DORV) with shunt and transposition of great arteries (TGA) with shunt also occur frequently. AV canal defect with or without valvular lesion presented in significant number. Among them 616 (77.6%) had different types of comorbid conditions. Among comorbidities, respiratory and acquired cardiac comorbidities were common (37.9% & 34.1% respectively). Other congenital or genetic comorbidities were in 11.2%. Multisystem involvement was in 9.8% cases.Conclusion: Pneumonia and heart failure were the most frequent comorbid condition among both simple and complex congenital heart disease. They were common among acyanotic heart disease. But cyanotic spell, acute stroke syndrome and brain abscess were common among cyanotic heart disease. Among genetic comorbidities Downs syndrome occupied the major part.Cardiovasc. j. 2017; 9(2): 83-89

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Section: Discussionmentioning

confidence: 72%

Comorbidities with Congenital Heart Disease among Hospitalized Children in a Specialized Cardiac Hospital in Bangladesh

Mita¹,

Salim

Haque

et al. 2017

Cardiovasc. j.

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“…10 Major birth defects also continue to be the leading cause of infant mortality in the United States, 11 and costs for care and treatment of children with major birth defects annually totals millions of dollars. 12 Canfield et al 10 used pooled data from 11 states with active case finding to calculate national birth prevalence estimates for 18 selected defects.…”

Section: Substantial Public Health Burdenmentioning

confidence: 99%

Utility of Family History Reports of Major Birth Defects as a Public Health Strategy

Romitti

2007

Pediatrics

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A major birth defect is an abnormality that can affect the structure or function of an organ. In the United States, major birth defects are the leading cause of infant mortality and contribute substantially to childhood disability and morbidity. Globally, these conditions lead to the death of millions of infants and children annually. Patients with 1 or more affected family members may be at increased risk for having a child with a major birth defect; thus, accurate knowledge of these conditions among family members of their patients gives the clinician the ability to provide improved risk assessment and reproductive planning. Such knowledge can also serve as motivation for patients to adhere to healthy behaviors such as folic acid use or smoking cessation. To evaluate the utility of collecting family history reports of major birth defects as a public health strategy, 6 key criteria were examined by reviewing the relevant published literature. Overall, the review showed that major birth defects satisfied several of the criteria. Additional research is needed, however, regarding the awareness of parent reports of the occurrence of these conditions among relatives and how knowledge of birth defect diagnoses and related risk factors are transmitted among relatives. Such research needs to encompass not only immediate family members but also other first-degree and second-degree relatives. In summary, routine collection of family history reports of birth defects in pediatric practice holds promise as a public health strategy to reduce the burden of morbidity, mortality, and disability associated with major birth defects. 2 To date, gene discovery using such information has accounted for a small proportion of the total burden of a particular disease (eg, BRCA1 mutations for breast cancer prevention). 3 Less well understood is the contribution of a positive family history as a predictor of common chronic diseases that encompass both genetic and partial genetic origins (ie, multifactorial conditions). 4 For the pediatric patient, birth defects exemplify such multifactorial conditions. Birth defects can be grouped into 2 broad categories: major and minor defects. A major defect is an abnormality of an organ structure or function that results in physical disability, mental disability, or death, 5 whereas a minor defect does not produce significant health consequences. 6 Both major and minor defects can occur as isolated entities, affecting 1 organ system, or as multiple defects, affecting 1 or several organ systems. Alone, minor defects are not considered to have significant health consequences, although their presentation with 1 or more major defects can provide clues to an underlying genetic or teratogenic etiology. Conservatively, estimates suggest that a causal gene or teratogen accounts for Ͻ30% of defects that occur. For the remainder, the most likely explanation is a confluence of genetic and teratogenic exposures and, to a lesser degree, factors such as intrauterine constraint and amniotic bands that can l...

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“…Accepted for publication Mar 28, 2014 Congenital heart disease (CHD) is one of thecommoncausesofdeathininfancy. [1][2][3][4] Although the outcome has improved over the past decades, morbidity and mortality remain high, especially in infants with critical congenital heart disease (CCHD) in which circulation is dependent on ductal or interatrial shunting. [5][6][7] A large Swedish populationbased study reported that the risk of being discharged with undiagnosed duct-dependent CCHD was 28%.…”

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confidence: 99%

Age at Referral and Mortality From Critical Congenital Heart Disease

Fixler

Nembhard

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Newborn pulse oximetry screening is recommended to promote early referral of neonates with critical congenital heart disease (CCHD) and reduce mortality; however, the impact of late referral on mortality is not well defined. The purpose of this population-based study was to describe the association between timing of referral to a cardiac center and mortality in 2360 liveborn neonates with CCHD. METHODS: Neonates with CCHD born before pulse oximetry screening (1996–2007) were selected from the Texas Birth Defects Registry and linked to state birth and death records. Age at referral was ascertained from date of first cardiac procedure at a cardiac center. Logistic and Cox proportional hazards regression models were used to estimate factors associated with late referral and mortality; the Kaplan-Meier method was used to estimate 3-month survival. RESULTS: Median age at referral was 1 day (25th–75th percentile: 0–6 days). Overall, 27.5% (649 of 2360) were referred after age 4 days and 7.5% (178 of 2360) had no record of referral. Neonatal mortality was 18.1% (277 of 1533) for those referred at 0 to 4 days of age, 9.0% (34 of 379) for those referred at 5 to 27 days of age, and 38.8% (69 of 178) for those with no referral. No improvement in age at referral was found across the 2 eras within 1996–2007. CONCLUSIONS: A significant proportion of neonates with CCHD experienced late or no referral to cardiac specialty centers, accounting for a significant number of the deaths. Future population-based studies are needed to determine the benefit of pulse oximetry screening on mortality and morbidity.

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Contribution of birth defects to infant mortality in the United States

Cited by 136 publications

References 2 publications

Comorbidities with Congenital Heart Disease among Hospitalized Children in a Specialized Cardiac Hospital in Bangladesh

Comorbidities with Congenital Heart Disease among Hospitalized Children in a Specialized Cardiac Hospital in Bangladesh

Utility of Family History Reports of Major Birth Defects as a Public Health Strategy

Age at Referral and Mortality From Critical Congenital Heart Disease

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