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. Keywords: congenital anomalies; infant mortality; spina bifida
Full Text
The Full Text of this article is available as a PDF (150.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Edouard L., Alberman E. National trends in the certified causes of perinatal mortality, 1968 to 1978. Br J Obstet Gynaecol. 1980 Oct;87(10):833–838. doi: 10.1111/j.1471-0528.1980.tb04433.x. [DOI] [PubMed] [Google Scholar]
- Holmes L., Harris J., Oakley G. P., Jr, Friedman J. M. Teratology Society Consensus Statement on use of folic acid to reduce the risk of birth defects. Teratology. 1997 Jun;55(6):381–381. doi: 10.1002/(SICI)1096-9926(199706)55:6<381::AID-TERA4>3.0.CO;2-0. [DOI] [PubMed] [Google Scholar]
- Kalter H. Five-decade international trends in the relation of perinatal mortality and congenital malformations: stillbirth and neonatal death compared. Int J Epidemiol. 1991 Mar;20(1):173–179. doi: 10.1093/ije/20.1.173. [DOI] [PubMed] [Google Scholar]
- Manniello R. L., Farrell P. M. Analysis of United States neonatal mortality statistics from 1968 to 1974, with specific reference to changing trends in major causalities. Am J Obstet Gynecol. 1977 Nov 15;129(6):667–674. doi: 10.1016/0002-9378(77)90650-0. [DOI] [PubMed] [Google Scholar]
- Petrini J., Damus K., Johnston R. B., Jr An overview of infant mortality and birth defects in the United States. Teratology. 1997 Jul-Aug;56(1-2):8–10. doi: 10.1002/(SICI)1096-9926(199707/08)56:1/2<8::AID-TERA3>3.0.CO;2-U. [DOI] [PubMed] [Google Scholar]
- Sachs B. P., Fretts R. C., Gardner R., Hellerstein S., Wampler N. S., Wise P. H. The impact of extreme prematurity and congenital anomalies on the interpretation of international comparisons of infant mortality. Obstet Gynecol. 1995 Jun;85(6):941–946. doi: 10.1016/0029-7844(95)00056-W. [DOI] [PubMed] [Google Scholar]