Infant mortality and congenital anomalies from 1950 to 1994: an international perspective

Abstract

Study objective-To provide an international perspective on the impact of congenital anomalies on infant mortality from 1950 to 1994. Design-Population-based study based on data obtained from vital statistics reported to the World Health Organisation. Settings-36 countries from Europe, the Middle East, the Americas, Asia, and the South Pacific. Results-On average, infant mortality declined 68.8 per cent from 1950 to 1994. In the countries studied, infant mortality attributable to congenital anomalies decreased by 33.4 per cent, although it recently increased in some countries in Central and Latin America and in Eastern Europe. Anomalies of the heart and of the central nervous system accounted for 48.9 per cent of infant deaths attributable to congenital anomalies. During 1990-1994, infant mortality attributable to congenital anomalies was inversely correlated to the per capita gross domestic product in the countries studied. At the same time, the proportion of infant deaths attributable to congenital malformations was directly correlated with the per capita gross domestic product. Conclusions-Congenital malformations account for an increasing proportion of infant deaths in both developed and developing countries. Infant mortality attributable to congenital anomalies is higher in poorer countries although as a proportion of infant deaths it is greater in wealthier countries. Conditions such as spina bifida, whose occurrence can be reduced through preventive strategies, still cause many infant deaths. The apparent increase of infant mortality because of congenital anomalies in some countries should be investigated to confirm the finding, find the causes, and provide prevention opportunities.

Infant mortality due to congenital malformation in Argentina (1998–2009): temporal and spatial analysis of neonatal and postneonatal components

“…Particularly, the recent pattern (2002)(2003)(2004)(2005)(2006) of IM by CM in Argentina is characterized by a decrease in the rate of IM by CM (RIMCM) and concomitant increase in the percentage of deaths from CM (DCM%) (Bronberg et al 2009). This pattern is similar to that observed in developed countries (Rosano et al 2000). However, although the spatial distribution is practically uniform RIMCM, especially at the regional and provincial levels, the DCM% displayed wide geographical variation indicative of socio-economic, educational, and cultural interprovincial and interregional inequalities (Bronberg et al 2012).…”

“…Both indicators provide complementary information on the risk of infant death by CM, comparable over time and across countries, regions, provinces, etc., and also represent a useful measure of the burden of child deaths by CM of interest to public health, the formulation of health policies, and an understanding of the scope of CM as a risk factor of (Penchszadeh 1993;Copeland and Kirby, 2007). While the validity of death certificates as a source of information for epidemiological analysis of deaths has been questioned due to underreporting of CM (Copeland et al 2007;Northam and Knapp 2006;Rosano et al 2000) on account of deficiencies in the capability and quality of diagnosis (description, classification, and coding), this is the only population-level information collected from multiple countries which, supported or promoted by international agencies such as WHO (1998), is useful for comparative purposes. However, the validity of these certificates has been confirmed for the identification of neural tube defects (Tairou et al 2006).…”

Confiabilidade das informações das declarações de nascido vivo com registro de defeitos congênitos no Município do Rio de Janeiro, Brasil, 2004

“…Os defeitos congênitos ocorrem em cerca de 2% a 3% dos recém-nascidos e são os principais responsáveis pela mortalidade infantil em nações desenvolvidas 1 . Também na América Latina, essas patologias têm contribuído significativamente para a mortalidade de menores de um ano 1,2,3 e no Brasil, embora nos últimos anos o número de óbitos nesta faixa etária decorrentes de grande parte das doenças tenha declinado, o mesmo não se verifica com aqueles relacionados aos defeitos congênitos, hoje a segunda causa de mortalidade infantil no país 4 .…”

Primary prevention of neural tube defects in Brazil: insights into anencephaly

“…While the validity of death certificates is in question due to deficiencies in the competence and quality of diagnosis, it is the only information available in Brazil at the population level on the epidemiological behavior of this lethal malformation (Rosano et al 2000;Copeland and Russell 2007;Northam and Knapp 2006;Bronberg et al 2009). Data from the SIM had an average quality with completeness of 84 % and 79 % coverage.…”