Racial/ethnic differences in the birth prevalence of congenital anomalies in the United States

Objectives: This work aimed to analyze a single large representative population to determine racial/ethnic differences in the prevalence of congenital anomalies (CA). Design: This is a population-based comprehensive analysis of racial/ethnic differences in the prevalence of CA diagnoses. We reviewed all live births in the 2008 Nationwide Inpatient Sample (NIS) database and determined the birth prevalence of 55 selected CA diagnoses in Caucasians. We then calculated the relative risk of these CA diagnoses in African American, Hispanics, and Asians relative to Caucasians. Result: Overall CA prevalence was 29.2 per 1000 in a cohort of 1,048,252 live births, of which 51% were Caucasians. Compared with Caucasians, risk of overall CA was lower in African Americans (RR=0.9, CI: 0.8-0.9) and Hispanics (RR=0.9, CI: 0.8-0.9). Risk of overall CA was similar in Caucasians and Asians. Relative to the Caucasians, African Americans had lower risk of cardiac, genitourinary, and craniofacial CA but higher risk of musculoskeletal anomalies. Hispanics had lower risk of genitourinary and gastrointestinal CA. Asians had higher risk of craniofacial and musculoskeletal CA. Conclusions: Observed racial/ethnic differences in risk of CA may be related to genetic susceptibilities, cultural or social differences that could modify exposures, or many potential combinations between susceptibilities and exposures.