Document Detail

Racial disparities in mortality among infants with Dandy-Walker syndrome.
MedLine Citation:
PMID:  19476199     Owner:  NLM     Status:  MEDLINE    
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.
Hamisu M Salihu; Jennifer L Kornosky; Amina P Alio; Charlotte M Druschel
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the National Medical Association     Volume:  101     ISSN:  0027-9684     ISO Abbreviation:  J Natl Med Assoc     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-29     Completed Date:  2009-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503090     Medline TA:  J Natl Med Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  456-61     Citation Subset:  IM    
Department of Epidemiology, College of Public Health, University of South Florida, Tampa, FL 33613, USA.
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MeSH Terms
African Americans / statistics & numerical data*
Confidence Intervals
Dandy-Walker Syndrome / epidemiology,  ethnology*,  mortality*
European Continental Ancestry Group / statistics & numerical data*
Health Status Disparities*
Infant, Newborn
New York / epidemiology
Proportional Hazards Models
Grant Support
U50/CCU223184/CC/CDC HHS

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