Research report
Infant mortality and congenital anomalies from 1950 to 1994: an
international perspective
Aldo Rosanoa, Lorenzo D Bottob, Beverley Bottingc, Pierpaolo Mastroiacovoa d
a International
Centre for Birth Defects, Rome, Italy, b Division of Birth Defects and
Pediatric Genetics, Centers for Disease Control and Prevention,
Atlanta, USA, c Office For
National Statistics, London, d Paediatric
Department of Catholic University, Rome, Italy
Correspondence to: Dr Mastroiacovo, International Centre for Birth Defects, Via Pilo Albertelli 9, 00195, Rome, Italy (a.rosano{at}mclink.it)
Accepted for publication 19 December 1999
STUDY OBJECTIVE
To
provide an international perspective on the impact of congenital
anomalies on infant mortality from 1950 to 1994.
DESIGNPopulation-based
study based on data obtained from vital statistics reported to the
World Health Organisation.
SETTINGS36 countries
from Europe, the Middle East, the Americas, Asia, and the South Pacific.
RESULTSOn average,
infant mortality declined 68.8 per cent from 1950 to 1994. In the
countries studied, infant mortality attributable to congenital
anomalies decreased by 33.4 per cent, although it recently increased in
some countries in Central and Latin America and in Eastern Europe.
Anomalies of the heart and of the central nervous system accounted for
48.9 per cent of infant deaths attributable to congenital anomalies.
During 1990-1994, infant mortality attributable to congenital
anomalies was inversely correlated to the per capita gross domestic
product in the countries studied. At the same time, the proportion of
infant deaths attributable to congenital malformations was directly
correlated with the per capita gross domestic product.
CONCLUSIONSCongenital
malformations account for an increasing proportion of infant deaths in
both developed and developing countries. Infant mortality attributable
to congenital anomalies is higher in poorer countries although as a
proportion of infant deaths it is greater in wealthier countries.
Conditions such as spina bifida, whose occurrence can be reduced
through preventive strategies, still cause many infant deaths. The
apparent increase of infant mortality because of congenital anomalies
in some countries should be investigated to confirm the finding, find
the causes, and provide prevention opportunities.
Keywords: congenital anomalies; infant mortality; spina bifida
© 2000 by Journal of Epidemiology and Community Health
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