| Racial disparities in mortality among infants with Dandy-Walker syndrome. | |
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MedLine Citation:
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PMID: 19476199 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Congenital malformations are the major cause of infant mortality in the United States, but their contribution to overall racial disparity--a major public health concern--is poorly understood. We sought to estimate the contribution of a congenitally acquired central nervous system lesion, Dandy-Walker Syndrome (DWS), to black-white disparity in infant mortality. METHODS: Data were obtained from the New York State Congenital Malformations Registry, an ongoing population-based validated surveillance system. We compared black to white infants with respect to infant, neonatal, and postneonatal mortality using Cox proportional hazards regression models. RESULTS: A total of 196 live-born neonates were diagnosed with DWS in the state from 1992 to 2005 inclusive. Of these, 53 were non-Hispanic black and 76 were non-Hispanic white. Neonatal mortality was similar for non-Hispanic blacks and non-Hispanic whites (adjusted hazards ratio [AHR], 1.42; 95% CI, 0.52-3.82), but non-Hispanic blacks had an 8-fold increased risk for postneonatal mortality (AHR, 8.26; 95% CI, 2.08-32.72). Adjustment for fetal growth and other maternal and infant characteristics resulted in a 10-fold increased risk of mortality for non-Hispanic black infants as compared to non-Hispanic whites. By contrast, adjustment for preterm birth attenuated the risk, but non-Hispanic black infants were still more than 6 times as likely to die during the postneonatal period than non-Hispanic whites (AHR, 6.36, 95% CI, 1.52-26.60). CONCLUSION: DWS has one of the largest black-white disparities in postneonatal survival. This underscores the importance of evaluating racial disparities in infant mortality by specific conditions in order to formulate targeted interventions to reduce disparities. |
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Authors:
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Hamisu M Salihu; Jennifer L Kornosky; Amina P Alio; Charlotte M Druschel |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of the National Medical Association Volume: 101 ISSN: 0027-9684 ISO Abbreviation: J Natl Med Assoc Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-29 Completed Date: 2009-08-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503090 Medline TA: J Natl Med Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 456-61 Citation Subset: IM |
Affiliation:
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Department of Epidemiology, College of Public Health, University of South Florida, Tampa, FL 33613, USA. hamisu.salihu@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult African Americans / statistics & numerical data* Confidence Intervals Dandy-Walker Syndrome / epidemiology, ethnology*, mortality* European Continental Ancestry Group / statistics & numerical data* Female Health Status Disparities* Humans Infant Infant, Newborn Male New York / epidemiology Proportional Hazards Models Registries Risk |
| Grant Support | |
ID/Acronym/Agency:
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U50/CCU223184/CC/CDC HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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