Current Trends
Contribution of Birth Defects to Infant
Mortality -- United States, 1986
As infant mortality in the United States has declined during the
20th
century, the proportion of infant deaths attributed to birth
defects
has increased steadily (1) (Figure 1). Birth defects also
contribute
substantially to years of potential life lost before age 65 (2).
To evaluate the contribution of birth defects to infant mortality
in
the United States, mortality data for 1986 from CDC's National
Center
for Health Statistics were analyzed. Birth defects were defined as
conditions coded within Congenital Anomalies (740.0-759.9) of the
International Classification of Diseases, Ninth Revision (ICD-9).
Excluded from this group were 460 babies with lung hypoplasia
(748.5),
patent ductus arteriosus (747.0), or hydrocephalus (742.3)
secondary to
intraventricular hemorrhage (772.1) who also had ICD-9 codes 764 or
765
(disorders relating to low birthweight and short gestation).
Of 38,957 reported infant deaths in 1986, 8005 (20.5%) had birth
defects listed as the underlying cause of death; birth defects were
the
leading cause of infant mortality (Figure 2). Birth defects were
listed
as a contributing cause of death for an additional 1088 infants.
Thus,
in 1986 birth defects were an underlying or contributing cause of
death
for 9093 (23.3%) infants.
Cardiovascular defects, the most frequent type of birth defect,
were
present in 3057 (38.2%) of the 8005 babies. Central nervous system
defects (including anencephalus and similar anomalies, spina
bifida,
and other congenital anomalies of the central nervous system and
eye)
were the second largest group, occurring in 1191 (14.9%). Birth
defects
of the respiratory system comprised the third largest group (870
(10.9%)).
Reported by: Birth Defects and Genetics Br, Div of Birth Defects
and
Developmental Disabilities, Center for Environmental Health and
Injury
Control, CDC.
Editorial Note
Editorial Note: The rapid decline of infant mortality rates in the
1970s has been attributed largely to the advent of medical
technology
in the care of premature and other critically ill newborns. In the
1980s, this decline has slowed considerably--partly because of a
lack
of progress in primary prevention of conditions which lead to
infant
death. As a consequence, the 1990 health objective of nine infant
deaths per 1000 live births is unlikely to be met (3).
Additionally, to
meet the year 2000 objectives, health agencies will have to make
substantial efforts to prevent the leading causes of infant
mortality.
Birth defects, prematurity, and sudden infant death syndrome
account
for 52% of all infant deaths. Epidemiologic and basic research are
integral to the development of prevention programs for infant
mortality. The federal government and 22 states maintain
surveillance
systems for birth defects. These systems can assist in assessing
the
effectiveness of intervention programs in preventing defects whose
etiology is known (e.g., fetal alcohol syndrome) and in serving as
a
basis for the epidemiologic research needed to understand the
causes of
birth defects.
References
Warkany J. Congenital malformations. Chicago: Year Book Medical
Publishers, 1971:41.
CDC. Premature mortality due to congenital anomalies--United
States.
MMWR 1988;37:505-6.
Public Health Service. The 1990 health objectives for the
nation: a
midcourse review. Washington, DC: US Department of Health and Human
Services, Public Health Service, 1986.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
