Joann Petrini, PhD, MPH¹, Rebecca Russell, MSPH¹, Michael Davidoff, MPH¹, Karalee Poschman², Nancy Green, MD³, and Karla Damus, RN, PhD¹. (1) Perinatal Data Center, March of Dimes Birth Defects Foundation, 1275 Mamaroneck Ave, White Plains, NY 10605, 914-997-4515, jpetrini@marchofdimes.com, (2) March of Dimes Birth Defects Foundation, Yale University, 1275 Mamaroneck Avenue, White Plains, NY 10605, (3) March of Dimes, 1275 Mamaroneck Ave, White Plains, NY 10605

Despite significant declines in the birth defects-specific infant mortality rate (BDIMRs), birth defects continue to be the leading cause of infant death in the United States, with the 1999-2001 average being 1.4 per1,000 live births. It is well known that there is substantial overlap among adverse outcomes such as birth defects, low birthweight (LBW, <2500 grams) and preterm birth (PTB, <37 weeks), making it important for public health initiatives and medical management to delineate the impact of LBW and PTB on infant deaths due to birth defects. We conducted a study whereby BDIMRs were analyzed by birthweight and gestational age, stratified by plurality for the US. Analyses of linked birth/infant death data from the National Center for Health Statistics revealed that in 1999-2001 about 60% of birth defects infant deaths were also LBW and about half were also PTB. Although total BDIMRs increased with increasing plurality, the reverse was observed for LBW and PTB for which BDIMRs decreased with higher order multifetal births. Among singletons, non-Hispanic black infants (1.6 per 1,000 live births) were more likely than non-Hispanic white (1.3) or Hispanic (1.4) infants to die due to a birth defect. However, LBW or PTB non-Hispanic black infants were less likely than corresponding non-Hispanic white or Hispanic infants to die due to a birth defect. Additional findings by maternal age and type of birth defect will be presented. The implications of these findings for enhancement of data systems will be discussed.

Learning Objectives:

• To understand the correlation between birthweight and gestational age on infant deaths due to birth defects.
• To understand the impact of plurality, maternal race/ethnicity and maternal age on the correlation between gestational age/birthweight and birth defects-specific IMRs.
• To understand the implications that this analysis has on the enhancement of existing data systems in the US.

Keywords: Infant Mortality, Data/Surveillance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.