Analysis of the Burden of Infant Mortality due to Birth Defects by Race/Ethnicity in the United States from 2010-2014 公开

Joseph, Avinash Sebastian (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/m326m258s?locale=zh
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Abstract

Congenital anomalies, also known as birth defects, are among the leading contributors to infant mortality each year in the United States. The proportion of infant mortality due to birth defects has been shown to vary by race and/or ethnicity, with Hispanics and Asians having the highest risk. The purpose of this analysis was to determine the current burden of infant mortality due to birth defects, and racial and ethnic disparities associated with it among all infant deaths in the United States. We examined the National Vital Statistics System Linked Birth/Death data files for the most recent 5 years, 2010 through 2014. Proportional mortality due to birth defects was then calculated for five racial/ethnic groups: Non-Hispanic White, Non-Hispanic Black, Hispanic, American Indian, and Asian, further stratified by birth weight and age at death. Differences in characteristics between deaths due to birth defects and all other causes were compared using the Chi-square test. Cochran-Armitage test was used to examine trends in birth defects associated infant mortality across the 5-year period. We observed that significant differences exist in mortality due to birth defects by race and ethnicity (Chi-square=1591.71, p<0.0001), with proportional mortalities of 25.86% for Hispanics, 22.99% for Non-Hispanic Whites, 22.09% for Asians, 20.40% for American Indians, and 13.32% for Non-Hispanic Blacks. The test for trend showed a significant decrease in proportional mortality for Non-Hispanic Blacks (P value=0.0300) and Hispanics (P value=0.0407) over the 5-year period. Proportional mortalities across birth weight and age at death categories also showed racial/ethnic differences with a few aberrations, such as Hispanics having a relatively low proportion of birth defects associated mortality at extremely low birth weights and Asians having a relatively high proportion when age at death was between 28 and 365 days. In summary, our analysis demonstrates that racial/ethnic disparities are persistent in infant mortality due to birth defects across birth weight and age at death categories and have not changed in the recent years compared to previous years. We recommend further research into understanding infant mortality associated with birth defects and addressing preventable mortality.

Table of Contents

Literature Review...............................................................................................................................1

Methods............................................................................................................................................9

Results............................................................................................................................................11

Discussion........................................................................................................................................14

Strengths and Limitations....................................................................................................................17

Future Directions...............................................................................................................................18

References.......................................................................................................................................20

Tables..............................................................................................................................................23

Figures.............................................................................................................................................35

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