Racial Disparity in Birth Defects: Who Has Higher Risk?

Abstract

Objectives: This study aimed to evaluate relationships between race/ethnicity and selected major birth defects using 2006-2008 Louisiana birth defects surveillance data. Introduction: Many studies have shown relationships between race/ethnicity and birth defects. Racial disparity in birth defects has never been evaluated using birth defects surveillance data in Louisiana. The Louisiana Birth Defects Monitoring Network (LBDMN) is a population-based surveillance system created in 2005 that actively collects information from multiple sources to track babies born with birth defects up to 3 years old. Findings from this study are expected to help LBDMN and Louisiana Children, Youth with Special Health Needs Program better understand variations in the prevalence of some birth defects among certain racial/ethnic groups. Methods: The 2006-2008 linked birth defects and birth records data were analyzed. Data included non- Hispanic white (NHW) and non-Hispanic black (NHB) live births whose deliveries occurred at 35 hospitals in 2007 and 2008, or at 25 hospitals during 2006. CDC coding system, based on the British Pediatric Association and Classification of Diseases and the ICD-9- CM, was used to classify birth defects. Poisson regression models were used to evaluate associations between race/ethnicity and birth defects while controlling for factors such as child's sex, gestational age, maternal demographics and geographic characteristics. SAS 9.3 was used and alpha was set at 0.05. Results: Of the total 113,696 live births included in the study, there were 3,661 cases with birth defects. Adjusted models showed the following birth defects higher in NHW: ventricular septal defects (prevalence ratio [PR]:1.59, CI95%[CI]: 1.33-1.91), atrial septal defects (PR: 1.24, CI: 1.05- 1.46), patent ductus teriosus (PR:1.31, CI: 1.07-1.61), cleft palate without cleft lip (PR: 2.20, CI: 1.35-3.59), pyloric stenosis (PR:2.77, CI: 1.80-4.26), obstructive genitourinary defect (PR: 1.31, CI: 1.03-1.68), gastrochisis (PR: 2.71, CI: 1.52-4.82), Down's syndrome (PR:1.49, CI:1.03-2.16), and hypospadias (PR:1.50, CI:1.21-1.86). Microcephalus (PR:1.53, CI:1.05-2.24) and atrioventricular septal defects (PR: 1.67, CI: 1.01-2.76) were found to be higher in NHB. Conclusions: Many defects were seen more prevalent in NHW than in NHB counterparts. This difference may be results of genetic susceptibility or environmental factors. Further in-depth studies seeking these risk factors will be beneficial to define reasons of racial disparity in birth defects in Louisiana.