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González-Ramos L, Martínez-Sanz E, García-Serradilla M, García-de-Pereda M, Maldonado E. Frequency of gastroschisis and omphalocele and possible influence of maternal folic acid supplementation. A narrative review. Congenit Anom (Kyoto) 2024. [PMID: 38897927 DOI: 10.1111/cga.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/26/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
There is an increase in the worldwide prevalence of congenital abdominal wall defects (CAWD), with gastroschisis (GS) and omphalocele (OC) being the most common. It is widely accepted that folic acid supplementation (FAS) in the maternal diet decreases the incidence of anomalies such as neural tube defects, but there is controversy regarding the possible beneficial role for other congenital malformations. Several epidemiological studies raise controversy regarding a possible relationship between vitamin supplementation with the occurrence of abdominal wall malformations. The aim of the present study is to obtain an updated review of the global frequency of CAWD in neonates and the relationship with FAS in the mothers. For this we have carried out a systematic search of epidemiological studies in different article databases between 2011 and 2022. The analysis of 25 studies conducted in different countries where cases of OC and/or GS are registered directly or together with other congenital defects shows that 60% inquire into the relationship of FAS with the incidence of CAWD. Half of them proposes a beneficial effect of FAS and the other half find no association, concluding that there is no unanimous evidence that FAS in the maternal diet decreases the incidence of CAWD. However, it seems that an influential factor to take into account is the nutritional habits of the mothers.
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Affiliation(s)
- Laura González-Ramos
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
| | - Elena Martínez-Sanz
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
- Research Group UCM 920202, Ciudad Universitaria, Madrid, Spain
| | - Moisés García-Serradilla
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
- Research Group UCM 920202, Ciudad Universitaria, Madrid, Spain
| | - Miquel García-de-Pereda
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
| | - Estela Maldonado
- Department of Anatomy and Embriology, Medicine School, Universidad Complutense de Madrid (UCM), Ciudad Universitaria, Madrid, Spain
- Research Group UCM 920202, Ciudad Universitaria, Madrid, Spain
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Hibbs SD, Girod Salgado SI, Howland J, Najera C, Rankin KM, Collins JW. Mexican-American Women's Lifelong Residence in the United States Is Associated with an Increased Risk of Gastroschisis: A Population-Based Study. J Pediatr 2023; 261:113594. [PMID: 37399923 DOI: 10.1016/j.jpeds.2023.113594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To determine whether nativity is associated with abdominal wall defects among births to Mexican-American women. STUDY DESIGN Using a cross-sectional, population-based design, stratified and multivariable logistic regression analyses were performed on the 2014-2017 National Center for Health Statistics live-birth cohort dataset of infants of US-born (n = 1 398 719) and foreign-born (n = 1 221 411) Mexican-American women. RESULTS The incidence of gastroschisis was greater among births to US-born compared with Mexico-born Mexican-American women: 36.7/100 000 vs 15.5/100 000, RR = 2.4 (2.0, 2.9). US-born (compared with Mexico-born) Mexican-American mothers had a greater percentage of teens and cigarette smokers, P < .0001. In both subgroups, gastroschisis rates were greatest among teens and decreased with advancing maternal age. Adjusting for maternal age, parity, education, cigarette smoking, pre-pregnancy body mass index, prenatal care usage, and infant sex), OR of gastroschisis for US-born (compared with Mexico-born) Mexican-American women was 1.7 (95% CI 1.4-2.0). The population attributable risk of maternal birth in the US for gastroschisis equaled 43%. The incidence of omphalocele did not vary by maternal nativity. CONCLUSIONS Mexican-American women's birth in the US vs Mexico is an independent risk factor for gastroschisis but not omphalocele. Moreover, a substantial proportion of gastroschisis lesions among Mexican-American infants is attributable to factors closely related to their mother's nativity.
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Affiliation(s)
- Shayna D Hibbs
- Department of Pediatrics, Northwestern University, Chicago, IL.
| | | | - Julia Howland
- University of Illinois at Chicago, School of Public Health, Chicago, IL
| | - Clarissa Najera
- University of Illinois at Chicago, School of Public Health, Chicago, IL
| | - Kristin M Rankin
- University of Illinois at Chicago, School of Public Health, Chicago, IL
| | - James W Collins
- Department of Pediatrics, Northwestern University, Chicago, IL
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Miao Q, Dunn S, Wen SW, Lougheed J, Yang P, Davies M, Venegas CL, Walker M. Association between maternal marginalization and infants born with congenital heart disease in Ontario Canada. BMC Public Health 2023; 23:790. [PMID: 37118769 PMCID: PMC10142402 DOI: 10.1186/s12889-023-15660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND This study aims to evaluate the impact of socioeconomic status (SES) on the risk of congenital heart disease (CHD) since previous studies have yielded inconsistent results. METHODS We conducted a population-based retrospective cohort study, including all singleton live and still births in Ontario hospitals from April 1, 2012, to March 31, 2018. We used linked records from the Better Outcomes Registry & Network Information System, the Canadian Institute for Health Information databases, and the Ontario Marginalization Index (ON_Marg). ON_Marg was estimated at a dissemination area level using Canadian Census 2016 data and categorized into quintiles. Multivariable logistic regression models were performed to examine the relationships between four ON_Marg indices (material deprivation, dependency, ethnic concentration, residential instability), as proxies for maternal SES and the risk of infant CHD. We adjusted for maternal age at birth, assisted reproductive technology, obesity, pre-existing health conditions, substance use during pregnancy, mental health conditions before and during pregnancy, rural residence, and infant's sex in the analysis. RESULTS Among the cohort of 776,799 singletons, 9,359 infants had a diagnosis of CHD. Of those, 3,069 were severe CHD and 493 cases were single ventricle CHD. The prevalence of all infant CHD types was higher for males relative to females. Compared to mothers living in neighbourhoods with the lowest material deprivation, mothers with highest material deprivation had a 27% (adjusted OR = 1.27; 95% CI: 1.18-1.37) higher odds of having an infant diagnosed with CHD. Mothers living in neighbourhoods with the highest minority ethnic and immigrant concentration tend to have infants with 11% lower odds of CHD (adjusted OR = 0.89; 95% CI: 0.82-0.97) as compared to those living in the least ethnically diverse communities. Maternal dependency and residential stability quintiles were not significantly associated with the risk of CHD. CONCLUSION Higher maternal material deprivation was associated with increasing odds of infant CHD, whereas neighbourhood minority ethnic concentration was inversely associated with the odds of infant CHD. Our study further confirms that poverty is associated with CHD development. Future investigations might focus on the causal pathways between social deprivation, immigrant status, ethnicity, and the risk of infant CHD.
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Affiliation(s)
- Qun Miao
- Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
| | - Sandra Dunn
- Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Shi Wu Wen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, ON, Canada
| | - Jane Lougheed
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Phoebe Yang
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Michael Davies
- Adelaide Medical School, Faculty of Health and Medical Sciences, the Robinson Research Institute at the University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Carolina Lavin Venegas
- Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Mark Walker
- Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, ON, Canada
- International and Global Health Office, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics, The Ottawa Hospital, Gynecology & Newborn Care, Ottawa, ON, Canada
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Schraw JM, Woodhouse JP, Benjamin RH, Shumate CJ, Nguyen J, Canfield MA, Agopian AJ, Lupo PJ. Factors associated with nonsyndromic anotia and microtia, Texas, 1999-2014. Birth Defects Res 2023; 115:67-78. [PMID: 36398384 DOI: 10.1002/bdr2.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Few risk factors have been identified for nonsyndromic anotia/microtia (A/M). METHODS We obtained data on cases and a reference population of all livebirths in Texas for 1999-2014 from the Texas Birth Defects Registry (TBDR) and Texas vital records. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for A/M (any, isolated, nonisolated, unilateral, and bilateral) using Poisson regression. We evaluated trends in prevalence rates using Joinpoint regression. RESULTS We identified 1,322 cases, of whom 982 (74.3%) had isolated and 1,175 (88.9%) had unilateral A/M. Prevalence was increased among males (PR: 1.3, 95% CI: 1.2-1.4), offspring of women with less than high school education (PR: 1.3, 95% CI: 1.1-1.5), diabetes (PR: 2.0, 95% CI: 1.6-2.4), or age 30-39 versus 20-29 years (PR: 1.2, 95% CI: 1.0-1.3). The prevalence was decreased among offspring of non-Hispanic Black versus White women (PR: 0.6, 95% CI: 0.4-0.8) but increased among offspring of Hispanic women (PR: 2.9, 95% CI: 2.5-3.4) and non-Hispanic women of other races (PR: 1.7, 95% CI: 1.3-2.3). We observed similar results among cases with isolated and unilateral A/M. Sex disparities were not evident for nonisolated or bilateral phenotypes, nor did birth prevalence differ between offspring of non-Hispanic Black and non-Hispanic White women. Maternal diabetes was more strongly associated with nonisolated (PR: 4.5, 95% CI: 3.2-6.4) and bilateral A/M (PR: 5.0, 95% CI: 3.3-7.7). Crude prevalence rates increased throughout the study period (annual percent change: 1.82). CONCLUSION We identified differences in the prevalence of nonsyndromic A/M by maternal race/ethnicity, education, and age, which may be indicators of unidentified social/environmental risk factors.
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Affiliation(s)
- Jeremy M Schraw
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Houston, Texas, USA
| | - J P Woodhouse
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Houston, Texas, USA
| | - Renata H Benjamin
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - Charles J Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Joanne Nguyen
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
- Department of Genetics, Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - A J Agopian
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - Philip J Lupo
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Houston, Texas, USA
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Clinical Features of Bilambdoid and Sagittal Synostosis (BLSS): A Retrospective Multicenter Study in Japan. J Craniofac Surg 2021; 32:2134-2138. [PMID: 33534322 DOI: 10.1097/scs.0000000000007482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Bilambdoid and sagittal synostosis (BLSS), a rare form of multisutural craniosynostosis, is sometimes known as the Mercedes-Benz syndrome due to the appearance of the fused sagittal and bilateral lambdoid sutures. Although previous studies have described some of its clinical features, the pathology of this disease is not yet fully understood. Moreover, it has been pointed out that BLSS is more common among individuals of Hispanic ethnicity, but its incidence in Asia remains unclear. In the present study, BLSS cases in Japan were analyzed to determine the characteristics of the condition in Japan. Three hospitals in Tokyo participated in the present study. Patients with BLSS who underwent cranial remodeling were included. Data on patient demographics, clinical symptoms, status of the cranial sutures, morphological subclassification, surgical procedures, developmental status, and genetic mutations were analyzed. In total, 22 patients met the enrollment criteria and were included, indicating a higher incidence of BLSS in Japan than in other nations reported in previous studies. In terms of morphological subclassification, there were 15 brachycephalic, 4 dolichocephalic, and 3 normocephalic. For the initial cranial procedure, 7 patients underwent a single-stage cranioplasty, 13 underwent a posterior distraction, and 2 underwent lateral expansion. Patients with a normocephalic cranial morphology tended to undergo surgery at an older age than patients with the other two types. Appropriate timing for surgery is important for healthy development; hence, surgeons should remember that BLSS can lead to "balanced dysmorphism" that may have led to a delay in diagnosis due to its normal-looking morphology.
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Social determinants of health and outcomes for children and adults with congenital heart disease: a systematic review. Pediatr Res 2021; 89:275-294. [PMID: 33069160 DOI: 10.1038/s41390-020-01196-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Social determinants of health (SDH) can substantially impact health outcomes. A systematic review, however, has never been conducted on associations of SDH with congenital heart disease (CHD) outcomes. The aim, therefore, was to conduct such a systematic review. METHODS Seven databases were searched through May 2020 to identify articles on SDH associations with CHD. SDH examined included poverty, uninsurance, housing instability, parental educational attainment, immigration status, food insecurity, and transportation barriers. Studies were independently selected and coded by two researchers based on the PICO statement. RESULTS The search generated 3992 citations; 88 were included in the final database. SDH were significantly associated with a lower likelihood of fetal CHD diagnosis, higher CHD incidence and prevalence, increased infant mortality, adverse post-surgical outcomes (including hospital readmission and death), decreased healthcare access (including missed appointments, no shows, and loss to follow-up), impaired neurodevelopmental outcomes (including IQ and school performance) and quality of life, and adverse outcomes for adults with CHD (including endocarditis, hospitalization, and death). CONCLUSIONS SDH are associated with a wide range of adverse outcomes for fetuses, children, and adults with CHD. SDH screening and referral to appropriate services has the potential to improve outcomes for CHD patients across the lifespan. IMPACT Social determinants of health (SDH) are associated with a wide range of adverse outcomes for fetuses, children, and adults with congenital heart disease (CHD). This is the first systematic review (to our knowledge) on associations of SDH with congenital heart disease CHD outcomes. SDH screening and referral to appropriate services has the potential to improve outcomes for CHD patients across the lifespan.
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Mozooni M, Preen DB, Pennell CE. The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia. PLoS One 2020; 15:e0231106. [PMID: 32240255 PMCID: PMC7117748 DOI: 10.1371/journal.pone.0231106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/16/2020] [Indexed: 12/16/2022] Open
Abstract
Objective To investigate the influence of acculturation, demonstrated by age on arrival, length of residence, interpreter use and having an Australian-born partner, on disparities observed in the risk of stillbirth between migrant and Australian-born populations in Western Australia (WA). Methods A retrospective cohort study using linked administrative health data for all non-Indigenous births in WA from 2005–2013 was performed. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Adjusted odds ratios (aOR) for stillbirth in migrants from six ethnicities of white, Asian, Indian, African, Māori, and ‘other’, with different levels of acculturation, were compared with Australian-born women using multivariable logistic regression analysis and marital status, maternal age group, socioeconomic status, parity, plurality, previous stillbirth, any medical conditions, any pregnancy complications, sex of baby, and smoking during pregnancy as the covariates. Results From all births studied, 172,571 (66%) were to Australian-born women and 88,395 (34%) to migrant women. Women from African, Indian and Asian backgrounds who gave birth in the first two years after arrival in Australia experienced the highest risk of stillbirth (aOR 3.32; 95% CI 1.70–6.47, aOR 2.71; 95% CI 1.58–4.65, aOR 1.93; 95% CI 1.21–3.05 respectively) compared with Australian-born women. This association attenuated with an increase in the length of residence in Asian and Indian women, but the risk of stillbirth remained elevated in African women after five years of residence (aOR 1.96 [1.10–3.49]). Interpreter use and an Australian-born partner were associated with 56% and 20% lower odds of stillbirth in migrants (p<0.05), respectively. Conclusions Acculturation is a multidimensional process and may lower the risk of stillbirth through better communication and service utilisation and elevate such risk through increase in prevalence of smoking in pregnancy; the final outcome depends on how these factors are in play in a population. It is noteworthy that in women of African background risk of stillbirth remained elevated for longer periods after immigrating to Australia extending beyond five years. For migrants from Asian and Indian backgrounds, access to services, in the first two years of residence, may be more relevant. Enhanced understanding of barriers to accessing health services and factors influencing and influenced by acculturation may help developing interventions to reduce the burden of stillbirth in identified at-risk groups.
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Affiliation(s)
- Maryam Mozooni
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
- * E-mail:
| | - David Brian Preen
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Craig Edward Pennell
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
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Hoyt AT, Ramadhani T, Le MT, Shumate CJ, Canfield MA, Scheuerle AE. Acculturation and selected birth defects among non-Hispanic Blacks in a population-based case-control study. Birth Defects Res 2020; 112:535-554. [PMID: 32134219 DOI: 10.1002/bdr2.1665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND There are noted birth defects prevalence differences between race/ethnicity groups. For instance, non-Hispanic (NH) Black mothers are more likely to have an infant with encephalocele, although less likely to have an infant with anotia/microtia compared to NH Whites. When stratifying by nativity and years lived within the United States, additional variations become apparent. METHODS Data from the National Birth Defects Prevention Study were used to calculate descriptive statistics and estimate crude/adjusted odds ratios (aORs) and 95% confidence intervals (95%CIs) among NH Blacks with one of 30 major defects and non-malformed controls. Total case/controls were as follows: U.S.- (2,773/1101); Foreign- (343/151); African-born (161/64). Study participants were also examined by number of years lived in the U.S. (≤5 vs. 6+ years). RESULTS Compared to U.S.-born, foreign-born NH Black controls tended to be older, had more years of education, and were more likely to have a higher household income. They also had fewer previous livebirths and were less likely to be obese. In the adjusted analyses, two defect groups were significantly attenuated: limb deficiencies, aORs/95%CIs = (0.44 [0.20-0.97]) and septal defects (0.69 [0.48-0.99]). After stratifying by years lived in the United States, the risk for hydrocephaly (2.43 [1.03-5.74]) became apparent among those having lived 6+ years in the United States. When restricting to African-born mothers, none of the findings were statistically significant. CONCLUSIONS Foreign-born NH Blacks were at a reduced risk for a few selected defects. Results were consistent after restricting to African-born mothers and did not change considerably when stratifying by years lived in the United States.
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Affiliation(s)
- Adrienne T Hoyt
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA.,Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | | | - Mimi T Le
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Charlie J Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Angela E Scheuerle
- Department of Pediatrics, Division of Genetics and Metabolism, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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