The Association Between Race/Ethnicity and Major Birth Defects in the United States, 1999-2007
The Association Between Race/Ethnicity and Major Birth Defects in the United States, 1999-2007
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DOI：
10.2105/ajph.2014.302098
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发表时间：
2014-09-01
影响因子：
12.7
通讯作者：
Kirby, Russell S.
中科院分区：
文献类型：
--
作者：
Canfield, Mark A.;Mai, Cara T.;Kirby, Russell S.
目标.我们调查了种族/民族和27个主要出生缺陷之间的关系。我们汇总了1999年至2007年美国12个基于人群的出生缺陷监测系统的数据，其中包括1350万例活产婴儿（占美国出生婴儿的3分之1）。使用泊松回归，我们计算了每种出生缺陷和13个种族/民族的患病率估计值，沿着粗患病率和调整后的患病率（aPR）。非西班牙裔白人作为参照组。美洲印第安人/阿拉斯加原住民的7种疾病的患病率显著更高，为50%或更高（aPR = 3.97; 95%置信区间[CI] = 2.89，对于无耳症或小耳症为5.44）;唇裂、18三体和脑膨出以及下肢、上肢和任何肢体缺陷的aPR为1.5至2.1）。古巴人和亚洲人，特别是中国人和亚洲印第安人，与非西班牙裔白人相比，这些缺陷的患病率明显较低或相似，但中国人中的无耳症或小耳症除外（aPR = 2.08; 95% CI = 1.30，3.33）和菲律宾人（aPR = 1.90; 95%CI = 1.10，3.30）和法洛四联症（aPR = 1.60; 95%CI = 1.11，2.32）。据我们所知，这是最大规模的基于人群的研究，系统地检查了许多种族/族裔群体（包括亚裔和西班牙裔亚组）中一系列重大出生缺陷的患病率。美洲印第安人/阿拉斯加原住民出生缺陷发生率相对较高，值得进一步关注。
Objectives. We investigated the relationship between race/ethnicity and 27 major birth defects.Methods. We pooled data from 12 population-based birth defects surveillance systems in the United States that included 13.5million live births (1 of 3 of US births) from 1999 to 2007. Using Poisson regression, we calculated prevalence estimates for each birth defect and 13 racial/ethnic groupings, along with crude and adjusted prevalence ratios (aPRs). Non-Hispanic Whites served as the referent group.Results. American Indians/Alaska Natives had a significantly higher and 50% or greater prevalence for 7 conditions (aPR = 3.97; 95% confidence interval [CI] = 2.89, 5.44 for anotia or microtia); aPRs of 1.5 to 2.1 for cleft lip, trisomy 18, and encephalocele, and lower, upper, and any limb deficiency). Cubans and Asians, especially Chinese and Asian Indians, had either significantly lower or similar prevalences of these defects compared with non-Hispanic Whites, with the exception of anotia or microtia among Chinese (aPR = 2.08; 95% CI = 1.30, 3.33) and Filipinos (aPR = 1.90; 95% CI = 1.10, 3.30) and tetralogy of Fallot among Vietnamese (aPR = 1.60; 95% CI = 1.11, 2.32).Conclusions. This is the largest population-based study to our knowledge to systematically examine the prevalence of a range of major birth defects across many racial/ethnic groups, including Asian and Hispanic subgroups. The relatively high prevalence of birth defects in American Indians/Alaska Natives warrants further attention.