Lisa K Marengo1, Timothy J Flood2, Mary K Ethen1, Russell S Kirby3, Sarah Fisher4, Glenn Copeland5, Robert E Meyer6, Julie Dunn7, Mark A Canfield1, Tom Anderson8, Del Yazzie9, Cara T Mai10. 1. Texas Department of State Health Services, Austin, Texas. 2. Arizona Department of Health Services, Phoeniz, Arizona. 3. Department of Community and Family Health, University of South Florida, Tampa, Florida. 4. New York State Department of Health, Albany, New York. 5. Michigan Birth Defects Registry, Michigan Department of Community Health, Lansing, Michigan. 6. North Carolina Birth Defects Monitoring Program, Raleigh, North Carolina. 7. Massachusetts Department of Public Health, Boston, Massachusetts. 8. Association of American Indian Physicians, Formerly Oklahoma Area Tribal Epidemiology Center and Southern Plains Tribal Health Board, Oklahoma City, Oklahoma. 9. Navajo Epidemiology Center, Navajo Nation Department of Health, Window Rock, Arizona. 10. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
BACKGROUND: Higher prevalence of selected birth defects has been reported among American Indian/Alaska Native (AI/AN) newborns. We examine whether known risk factors for birth defects explain the higher prevalence observed for selected birth defects among this population. METHODS: Data from 12 population-based birth defects surveillance systems, covering a birth population of 11 million from 1999 to 2007, were used to examine prevalence of birth defects that have previously been reported to have elevated prevalence among AI/ANs. Prevalence ratios (PRs) were calculated for non-Hispanic AI/ANs and any AI/ANs (regardless of Hispanic ethnicity), adjusting for maternal age, education, diabetes, and smoking, as well as type of case-finding ascertainment surveillance system. RESULTS: After adjustment, the birth prevalence of two of seven birth defects remained significantly elevated among AI/ANs compared to non-Hispanic whites (NHWs): anotia/microtia was almost threefold higher, and cleft lip +/- cleft palate was almost 70% higher compared to NHWs. Excluding AI/AN subjects who were also Hispanic had only a negligible impact on adjusted PRs. CONCLUSIONS: Additional covariates accounted for some of the elevated birth defect prevalences among AI/ANs compared to NHWs. Exclusion of Hispanic ethnicity from the AI/AN category had little impact on birth defects prevalences in AI/ANs. NHWs serve as a viable comparison group for analysis. Birth defects among AI/ANs require additional scrutiny to identify modifiable risk and protective factors.
BACKGROUND: Higher prevalence of selected birth defects has been reported among American Indian/Alaska Native (AI/AN) newborns. We examine whether known risk factors for birth defects explain the higher prevalence observed for selected birth defects among this population. METHODS: Data from 12 population-based birth defects surveillance systems, covering a birth population of 11 million from 1999 to 2007, were used to examine prevalence of birth defects that have previously been reported to have elevated prevalence among AI/ANs. Prevalence ratios (PRs) were calculated for non-Hispanic AI/ANs and any AI/ANs (regardless of Hispanic ethnicity), adjusting for maternal age, education, diabetes, and smoking, as well as type of case-finding ascertainment surveillance system. RESULTS: After adjustment, the birth prevalence of two of seven birth defects remained significantly elevated among AI/ANs compared to non-Hispanic whites (NHWs): anotia/microtia was almost threefold higher, and cleft lip +/- cleft palate was almost 70% higher compared to NHWs. Excluding AI/AN subjects who were also Hispanic had only a negligible impact on adjusted PRs. CONCLUSIONS: Additional covariates accounted for some of the elevated birth defect prevalences among AI/ANs compared to NHWs. Exclusion of Hispanic ethnicity from the AI/AN category had little impact on birth defects prevalences in AI/ANs. NHWs serve as a viable comparison group for analysis. Birth defects among AI/ANs require additional scrutiny to identify modifiable risk and protective factors.
Authors: Russell S Kirby; Cara T Mai; Martha S Wingate; Teresa Janevic; Glenn E Copeland; Timothy J Flood; Jennifer Isenburg; Mark A Canfield Journal: Birth Defects Res Date: 2019-03-28 Impact factor: 2.344
Authors: Amanda E Janitz; Hanh Dung Dao; Janis E Campbell; Julie A Stoner; Jennifer D Peck Journal: Birth Defects Res Date: 2019-12-10 Impact factor: 2.344
Authors: Erin Bugenske Stallings; Jennifer L Isenburg; Deepa Aggarwal; Philip J Lupo; Matthew E Oster; Hanna Shephard; Rebecca F Liberman; Russell S Kirby; Eirini Nestoridi; Brenda Hansen; Xiaoyi Shan; Maria Luisa Navarro Sanchez; Aubree Boyce; Dominique Heinke Journal: Birth Defects Res Date: 2022-01-19 Impact factor: 2.661
Authors: Cara T Mai; Jennifer L Isenburg; Mark A Canfield; Robert E Meyer; Adolfo Correa; Clinton J Alverson; Philip J Lupo; Tiffany Riehle-Colarusso; Sook Ja Cho; Deepa Aggarwal; Russell S Kirby Journal: Birth Defects Res Date: 2019-10-03 Impact factor: 2.661