Title: ARE BIRTH DEFECTS IN TEXAS HIGHER ALONG THE MEXICAN BORDER
1ARE BIRTH DEFECTS IN TEXAS HIGHER ALONG THE
MEXICAN BORDER?
- Peter Langlois PhD, Mark Canfield PhD, Lucina
Suarez PhD - Texas Dept of State Health Services
2BACKGROUND
3METHODS
- Cases from Texas Birth Defects Registry, 1999 -
2002 - Compared 14 border counties to remaining 240
counties
4Texas Border Counties
5METHODS (contd)
- 92.1 of live births in border counties Hispanic,
thus restricted all analyses to Hispanics - Examined 165 birth defects and any reportable
birth defect
6METHODS (contd)
- Chi-square tests to identify potential
confounders - Poisson regression to calculate prevalence ratio
for border Hispanic vs non-border Hispanic for
each defect
7METHODS (contd)
- 4 analyses
- Crude
- Adjusted for all covariates found to be
significantly different between border and
non-border - Isolated cases of birth defects (crude)
- Severe cases of birth defects (crude), criteria
- Had severe procedure (surgery, repair, autopsy)
- Fetal death
- If live birth, died in first year after birth
8RESULTS
- Border (vs non-border) Hispanics significantly
- Were delivered more in 1999-2000 vs later
- Had older moms
- Had moms with more previous live births
- Had more educated moms
- Had a greater of moms born in Mexico
- Had a lower of moms with diabetes
- Had slightly higher multiple births
- Infant sex was not significantly different
9Maternal Age Among Texas Hispanics by Border
Status
10Maternal Education Among Texas Hispanics by
Border Status
11Border vs Non-border Residence Any Monitored
Birth Defect Among Hispanics
12Examples of Defects Among Hispanics Higher in
Border Areas Based on Different Analyses
13Number of Cardiovascular Defects Among Hispanics
Higher in Border Areas Based on Different Criteria
14Number of All Defects Among Hispanics Higher in
Border Areas Based on Different Criteria
15Analyses Where Defects Met Both Criteria
16(No Transcript)
17Number of All Defects Among Hispanics Lower in
Border Areas Based on Different Criteria
18CONCLUSIONS
- Hispanic mothers on the border tend to be older,
better educated, and Mexican-born than Hispanic
mothers elsewhere - Overall, birth defects among Hispanics are lower
along the border since - Any birth defects were less prevalent
- Using either criterion to identify meaningful
associations, more defects were lower along the
border than higher
19CONCLUSIONS (cont)
- The defects with elevations among border
Hispanics did not show consistent patterns, and
are not etiologically related - Where possible, it is useful to
- adjust for confounders and
- examine clinical subsets of cases such as severe
cases.
20CONCLUSIONS (cont)
- It may be useful to combine criteria for
determining meaningful associations - Some other possible criteria
- Number of cases available
- Dose-response (distance)
- Biological plausibility / other Hill criteria
- Diagnostic practice considerations
21- Contact information
- Peter Langlois
- 512-458-7232
- peter.langlois_at_dshs.state.tx.us
- www.dshs.state.tx.us/birthdefects