Adverse social determinats and risk for congenital anomalies

Introduction: Different studies have related familiar and regional adverse social conditions to perinatal outcome (neonatal mortality, low birth weight and prematurity); however, few studies have studied the effect of poverty on congenital anomalies. Objective:To assess the hazard ratio of 25 conge...

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Autores principales: Pawluk, Mariela Soledad, Campaña, Hebe, Gili, Juan Antonio, Comas, Belén, Giménez, Lucas Gabriel, Villalba, María Inés, Scala, Sandra C., Poletta, Fernando Adrián, López Camelo, Jorge Santiago
Formato: Articulo
Lenguaje:Inglés
Publicado: 2014
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Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/101463
https://ri.conicet.gov.ar/11336/35118
http://www.sap.org.ar/docs/publicaciones/archivosarg/2014/v112n3a04.pdf
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Sumario:Introduction: Different studies have related familiar and regional adverse social conditions to perinatal outcome (neonatal mortality, low birth weight and prematurity); however, few studies have studied the effect of poverty on congenital anomalies. Objective:To assess the hazard ratio of 25 congenital anomalies and adverse social determinants as per the socioeconomic level of families and regions. Population and methods: Exploratory, casecontrol study using data from the Latin-American Collaborative Study of Congenital Malformations (Estudio Colaborativo Latinoamericano de Malformaciones Congénitas, ECLAMC). The sample consisted of 3786 live newborn infants with a single malformation and 13 344 controls selected among 546 129 births occurred in 39 hospitals from Argentina in the 1992- 2001 period. Both direct and indirect (residence) risks (OR) were estimated, together with the interaction between the individual and residential socioeconomic levels for each of the 25 congenital anomalies. Results: Cleft lip with/without cleft palate (OR= 1.43) and ventricular septal defect (OR= 1.38) showed a significantly higher risk in the lower socioeconomic level. Low socioeconomic levels were significantly associated with a higher frequency of parental sibship (blood relationship), native descent, maternal age younger than 19 years old, more than four pregnancies, a low number of antenatal care visits, and residence in deprived regions. Conclusion: Cleft lip with/without cleft palate and ventricular septal defects were significantly associated with a lower socioeconomic level. Lack of family planning and antenatal care, and exposure to environmental or teratogenic agents may account for these findings.