Vijaya Kancherla1, Charlotte M Druschel, Godfrey P Oakley. 1. Center for Spina Bifida Research, Prevention and Policy, Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.
Abstract
BACKGROUND: The lifetime risk of death among individuals with spina bifida is 10-times higher compared with the general population. A population-based analysis on cause-specific mortality among individuals spina bifida is lacking. METHODS: Using statewide, population-based New York Congenital Malformations Registry, we examined all births between years 1983 and 2006, and identified 1988 births with spina bifida and 10,951 births with congenital hypertrophic pyloric stenosis (CHPS). We linked registry records to birth and death files from vital records, and determined age- and cause-specific mortality for isolated and multiple spina bifida, and compared the findings with the less fatal CHPS. RESULTS: Mortality in spina bifida is significantly high compared with CHPS (16.9% vs. 0.96%, respectively). The probability of survival in spina bifida was lower compared with CHPS. A majority of the deaths in spina bifida occurred in infants within the first year of birth; however, an increased risk of death persisted in young adulthood for both isolated and multiple cases of spina bifida. The common causes of death in children with spina bifida were hydrocephalus, infections, cardiac anomalies, pneumonia, and pulmonary embolism; while infections, heart or kidney failure, injuries and neoplasms contributed to deaths in adults. CONCLUSION: We conclude that mortality in spina bifida is a large concern, and individuals living with the defect require improved clinical care for lethal medical complications. Primary prevention of spina bifida through mandatory folic acid fortification remains as the best strategy to reduce both disability and mortality associated with this defect across the world.
BACKGROUND: The lifetime risk of death among individuals with spina bifida is 10-times higher compared with the general population. A population-based analysis on cause-specific mortality among individuals spina bifida is lacking. METHODS: Using statewide, population-based New York Congenital Malformations Registry, we examined all births between years 1983 and 2006, and identified 1988 births with spina bifida and 10,951 births with congenital hypertrophic pyloric stenosis (CHPS). We linked registry records to birth and death files from vital records, and determined age- and cause-specific mortality for isolated and multiple spina bifida, and compared the findings with the less fatal CHPS. RESULTS: Mortality in spina bifida is significantly high compared with CHPS (16.9% vs. 0.96%, respectively). The probability of survival in spina bifida was lower compared with CHPS. A majority of the deaths in spina bifida occurred in infants within the first year of birth; however, an increased risk of death persisted in young adulthood for both isolated and multiple cases of spina bifida. The common causes of death in children with spina bifida were hydrocephalus, infections, cardiac anomalies, pneumonia, and pulmonary embolism; while infections, heart or kidney failure, injuries and neoplasms contributed to deaths in adults. CONCLUSION: We conclude that mortality in spina bifida is a large concern, and individuals living with the defect require improved clinical care for lethal medical complications. Primary prevention of spina bifida through mandatory folic acid fortification remains as the best strategy to reduce both disability and mortality associated with this defect across the world.
Authors: Vijaya Kancherla; Chen Ma; Gerald Grant; Henry C Lee; Susan R Hintz; Suzan L Carmichael Journal: Am J Perinatol Date: 2020-05-30 Impact factor: 1.862
Authors: Marian K Bakker; Vijaya Kancherla; Mark A Canfield; Eva Bermejo-Sanchez; Janet D Cragan; Saeed Dastgiri; Hermien E K De Walle; Marcia L Feldkamp; Boris Groisman; Miriam Gatt; Paula Hurtado-Villa; Karin Kallen; Daniella Landau; Nathalie Lelong; Jorge S Lopez Camelo; Laura Martínez; Margery Morgan; Osvaldo M Mutchinick; Wendy N Nembhard; Anna Pierini; Anke Rissmann; Antonin Sipek; Elena Szabova; Giovanna Tagliabue; Wladimir Wertelecki; Ignacio Zarante; Pierpaolo Mastroiacovo Journal: Paediatr Perinat Epidemiol Date: 2019-10-21 Impact factor: 3.980
Authors: Samar Altoukhi; Clare L Whitehead; Greg Ryan; Jan Deprest; Luc Joyeux; Katie Gallagher; James Drake; Paige Church; Daphne Horn; Yenge Diambomba; Jose C A Carvalho; Tim Van Mieghem Journal: Trials Date: 2020-08-21 Impact factor: 2.279