Document Detail


Omphalocele and gastroschisis: Black-White disparity in infant survival.
MedLine Citation:
PMID:  15368557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Racial/ethnic variations in the occurrence of abdominal wall defects have been previously noted but it remains poorly understood whether race/ethnicity is a determinant of survival among affected infants. METHODS: Study was conducted on cases of gastroschisis and omphalocele recorded for the years 1983-1999 at the New York Congenital Malformation Registry. Adjusted and unadjusted hazard ratios were generated from a Proportional Hazards Regression model to compare survival among affected Blacks, Hispanics and Whites. The major end point of analysis was differences in all cause mortality among infants with abdominal wall birth defects across different racial/ethnic groups. RESULTS: Among the three racial/ethnic groups, 1481 infants were diagnosed with either omphalocele (978 or 66%) or gastroschisis (503 or 34%). Overall infant mortality rate (IMR) was 182 per 1000, with 74% of the deaths occurring within the first 28 days of life. Omphalocele infants had significantly higher infant mortality (IMR = 215 per 1000) than infants with gastroschisis (IMR = 118 per 1000)[p < 0.0001]. Overall, Black infants with abdominal wall defects had lower mortality indices than Whites and Hispanics. However, when considered as separate disease entities, Black infants were twice as likely to survive as compared to Whites if they had omphalocele [Adjusted Hazard Ratio (AHR) = 0.52; 95% Confidence Interval (CI) = 0.37-0.74], and twice as likely to die as Whites if they had gastroschisis instead (AHR = 2.23; 95% CI = 1.16-4.28). For both defect subtypes, Hispanics have risks for infant mortality comparable to Whites. CONCLUSIONS: The natural history of omphalocele and gastroschisis co-varies with race. Black infants with gastroschisis have worse survival outcomes while those with omphalocele have better chances of survival than their White or Hispanic counterparts.
Authors:
Hamisu M Salihu; Zakari Y Aliyu; Bosny J Pierre-Louis; Francis A Obuseh; Charlotte M Druschel; Russell S Kirby
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Birth defects research. Part A, Clinical and molecular teratology     Volume:  70     ISSN:  1542-0752     ISO Abbreviation:  Birth Defects Res. Part A Clin. Mol. Teratol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-15     Completed Date:  2005-02-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101155107     Medline TA:  Birth Defects Res A Clin Mol Teratol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  586-91     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley-Liss, Inc.
Affiliation:
Department of Maternal and Child Health, University of Alabama at Birmingham, 35294, USA. hsalihu@uab.edu
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group / ethnology,  statistics & numerical data
Continental Population Groups / ethnology*,  statistics & numerical data
European Continental Ancestry Group / ethnology,  statistics & numerical data
Gastroschisis / ethnology*,  mortality*,  pathology
Hernia, Umbilical / ethnology*,  mortality*,  pathology
Hispanic Americans / ethnology,  statistics & numerical data
Humans
Infant, Newborn
New York / epidemiology
Proportional Hazards Models
Registries
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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