The 130th Annual Meeting of APHA

Abstract #49186

Joann Petrini, MPH¹, Rebecca Russell, MSPH¹, Michael Davidoff, MPH¹, Karalee Poschman², and Karla Damus, RN, PhD¹. (1) Perinatal Data Center, March of Dimes Birth Defects Foundation, 1275 Mamaroneck Ave, White Plains, NY 10605, 914-997-4515, jpetrini@modimes.org, (2) March of Dimes Birth Defects Foundation, Yale University, 1275 Mamaroneck Avenue, White Plains, NY 10605

Birth defects are the leading cause of infant death in the US, and the 1996-8 average birth defects-specific infant mortality rate (IMR) was 1.6 per 1,000 live births. In 1996-8, rates of low birthweight (LBW, <2500 grams) and preterm birth (<37 weeks) were 7.5% and 11.3%, respectively. To understand the correlation of LBW and preterm birth with deaths due to birth defects, birth defects-specific IMRs by birthweight and gestational age for the US were examined. Analysis of linked birth-infant death data from the National Center for Health Statistics revealed that in 1996-8, about 60% of infant deaths due to birth defects occurred to LBW infants, while about half occurred to preterm infants. Stratification by plurality revealed that birth defects-specific IMRs increased with increasing plurality. However, among LBW and preterm infants, these rates decreased with increasing plurality, possibly reflecting greater medical management among multiple births. Birth defects-specific IMRs by race and plurality indicate that among singletons, non-Hispanic black infants (1.8 per 1,000 live births) were more likely than non-Hispanic white (1.5) or Hispanic (1.6) infants to die due to a birth defect. However, when these rates were stratified by birthweight and gestation, non-Hispanic black LBW or preterm infants were less likely than corresponding non-Hispanic white or Hispanic infants to die due to a birth defect. Additional findings by maternal age and type of birth defect will be presented. The relevance of these findings for public health initiatives, medical management and enhancement of data systems will be discussed.

Learning Objectives: At the conclusion of this session, the participant will be able to

• Identify the leading cause of infant death in the United States.
• Understand how plurality, race/ethnicity, and maternal age influence rates of infant death due to birth defects.
• Describe the impact of birthweight and gestational age on rates of birth defects-specific infant mortality.

Keywords: Birth Defects, Low Birthweight

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.