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ARE BIRTH DEFECTS IN TEXAS HIGHER ALONG THE MEXICAN BORDER?

ARE BIRTH DEFECTS IN TEXAS HIGHER ALONG THE MEXICAN BORDER?. Peter Langlois PhD, Mark Canfield PhD, Lucina Suarez PhD Texas Dept of State Health Services. BACKGROUND. METHODS. Cases from Texas Birth Defects Registry, 1999 - 2002 Compared 14 border counties to remaining 240 counties.

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ARE BIRTH DEFECTS IN TEXAS HIGHER ALONG THE MEXICAN BORDER?

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  1. ARE BIRTH DEFECTS IN TEXAS HIGHER ALONG THE MEXICAN BORDER? Peter Langlois PhD, Mark Canfield PhD, Lucina Suarez PhD Texas Dept of State Health Services

  2. BACKGROUND

  3. METHODS • Cases from Texas Birth Defects Registry, 1999 - 2002 • Compared 14 border counties to remaining 240 counties

  4. Texas Border Counties

  5. METHODS (cont’d) • 92.1% of live births in border counties Hispanic, thus restricted all analyses to Hispanics • Examined 165 birth defects and “any reportable birth defect”

  6. METHODS (cont’d) • Chi-square tests to identify potential confounders • Poisson regression to calculate prevalence ratio for border Hispanic vs non-border Hispanic for each defect

  7. METHODS (cont’d) • 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

  8. RESULTS • 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

  9. Maternal Age Among Texas Hispanics by Border Status

  10. Maternal Education Among Texas Hispanics by Border Status

  11. Border vs Non-border Residence: Any Monitored Birth Defect Among Hispanics

  12. Examples of Defects Among Hispanics Higher in Border Areas Based on Different Analyses

  13. Number of Cardiovascular Defects Among Hispanics Higher in Border Areas Based on Different Criteria

  14. Number of All Defects Among Hispanics Higher in Border Areas Based on Different Criteria

  15. Analyses Where Defects Met Both Criteria

  16. Number of All Defects Among Hispanics Lower in Border Areas Based on Different Criteria

  17. CONCLUSIONS • 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

  18. CONCLUSIONS (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.

  19. CONCLUSIONS (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

  20. Contact information: Peter Langlois 512-458-7232 peter.langlois@dshs.state.tx.us www.dshs.state.tx.us/birthdefects

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