Association of birth defects during the perinatal period with child mortality under 5 years

ObjectiveTo calculate the impact of birth defects (BDs) diagnosed during the perinatal period on the mortality of children under 5 years of age.MethodsThis was a retrospective cohort analysis. From the monitoring system, we collected all hospital delivery, BD monitoring, and death information for ch...

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Main Authors: Donghua Xie, Jianhui Wei, Lili Xiong, Huiyuan Zhu, Xianglian Peng, Bo Li, Kehan Zou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1485176/full
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author Donghua Xie
Donghua Xie
Jianhui Wei
Lili Xiong
Huiyuan Zhu
Xianglian Peng
Bo Li
Kehan Zou
author_facet Donghua Xie
Donghua Xie
Jianhui Wei
Lili Xiong
Huiyuan Zhu
Xianglian Peng
Bo Li
Kehan Zou
author_sort Donghua Xie
collection DOAJ
description ObjectiveTo calculate the impact of birth defects (BDs) diagnosed during the perinatal period on the mortality of children under 5 years of age.MethodsThis was a retrospective cohort analysis. From the monitoring system, we collected all hospital delivery, BD monitoring, and death information for children under 5 years in Hunan Province from 2017–2022. These data were linked by ID number. Mortality rates and Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the impact of BDs on mortality in children under 5 years of age.ResultsAmong 3,807,340 live-born children, 29,879 (0.8%) had at least one type of BDs during the perinatal period, with a total of 12,215,033 person-years of follow-up. The mortality rate of the BDs group was 14.5% (95% CI: 13.7–15.3) per 1,000 person-years, which was 11.6 times (HR = 11.6, 95% CI: 10.5–12.8) greater than that of the nondefect group. The mortality rate per 1,000 person-years of girls with BDs was higher than that of boys (15.4% vs. 13.5%). For the BDs group, congenital anomalies (CAs) were the most common cause of death (57.2%). Compared with children without BDs, those with BDs had elevated mortality risks for CAs (HR, 58.1; 95% CI, 42.7–79.0), digestive (HR = 16.5, 95% CI: 6.1–45.0) and respiratory system malformations (HR, 11.9; 95% CI, 7.9–17.8), and cancer (HR = 11.1 95% CI: 4.7–26.2).ConclusionsThis study revealed that BDs were strongly associated with mortality under 5 years of age, especially in the first 28 days, for muscular, chromosomal, genetic, and nervous system abnormalities.
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spelling doaj-art-8e0dcf7d3c134c339f9f2e72a6c48c592025-08-20T03:09:34ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.14851761485176Association of birth defects during the perinatal period with child mortality under 5 yearsDonghua Xie0Donghua Xie1Jianhui Wei2Lili Xiong3Huiyuan Zhu4Xianglian Peng5Bo Li6Kehan Zou7Department of Health Management, Maternal and Child Health Hospital of Hunan Province, Changsha, ChinaNHC Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, ChinaXiangya School of Public Health, Central South University, Changsha, ChinaDepartment of Health Management, Maternal and Child Health Hospital of Hunan Province, Changsha, ChinaSchool of Public Health, University of South China, Hengyang, ChinaClinical Medical Research Center of Maternal Neonatal Diseases of Hunan Province, Maternal and Child Health Hospital of Hunan Province, Changsha, Hunan, ChinaDepartment of Health Management, Maternal and Child Health Hospital of Hunan Province, Changsha, ChinaDepartment of Health Management, Maternal and Child Health Hospital of Hunan Province, Changsha, ChinaObjectiveTo calculate the impact of birth defects (BDs) diagnosed during the perinatal period on the mortality of children under 5 years of age.MethodsThis was a retrospective cohort analysis. From the monitoring system, we collected all hospital delivery, BD monitoring, and death information for children under 5 years in Hunan Province from 2017–2022. These data were linked by ID number. Mortality rates and Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the impact of BDs on mortality in children under 5 years of age.ResultsAmong 3,807,340 live-born children, 29,879 (0.8%) had at least one type of BDs during the perinatal period, with a total of 12,215,033 person-years of follow-up. The mortality rate of the BDs group was 14.5% (95% CI: 13.7–15.3) per 1,000 person-years, which was 11.6 times (HR = 11.6, 95% CI: 10.5–12.8) greater than that of the nondefect group. The mortality rate per 1,000 person-years of girls with BDs was higher than that of boys (15.4% vs. 13.5%). For the BDs group, congenital anomalies (CAs) were the most common cause of death (57.2%). Compared with children without BDs, those with BDs had elevated mortality risks for CAs (HR, 58.1; 95% CI, 42.7–79.0), digestive (HR = 16.5, 95% CI: 6.1–45.0) and respiratory system malformations (HR, 11.9; 95% CI, 7.9–17.8), and cancer (HR = 11.1 95% CI: 4.7–26.2).ConclusionsThis study revealed that BDs were strongly associated with mortality under 5 years of age, especially in the first 28 days, for muscular, chromosomal, genetic, and nervous system abnormalities.https://www.frontiersin.org/articles/10.3389/fped.2025.1485176/fullbirth defectsmortality rate under 5 yearscause of deathhazard ratioconfidence intervalsperson-years
spellingShingle Donghua Xie
Donghua Xie
Jianhui Wei
Lili Xiong
Huiyuan Zhu
Xianglian Peng
Bo Li
Kehan Zou
Association of birth defects during the perinatal period with child mortality under 5 years
Frontiers in Pediatrics
birth defects
mortality rate under 5 years
cause of death
hazard ratio
confidence intervals
person-years
title Association of birth defects during the perinatal period with child mortality under 5 years
title_full Association of birth defects during the perinatal period with child mortality under 5 years
title_fullStr Association of birth defects during the perinatal period with child mortality under 5 years
title_full_unstemmed Association of birth defects during the perinatal period with child mortality under 5 years
title_short Association of birth defects during the perinatal period with child mortality under 5 years
title_sort association of birth defects during the perinatal period with child mortality under 5 years
topic birth defects
mortality rate under 5 years
cause of death
hazard ratio
confidence intervals
person-years
url https://www.frontiersin.org/articles/10.3389/fped.2025.1485176/full
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